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I. Understanding Therapy for the LGBTQ+ Community

Online therapy has many benefits for members of the LGBTQ+ community. If you live in a rural area or just can’t find a therapist who understands the challenges facing LGBTQ+ individuals, online therapy makes it easier to access mental health care. Online therapy also allows you to engage in therapy on your terms. Maybe you don’t want to drive to an office and talk with a therapist face-to-face; with online therapy, you don’t have to. You can engage in therapy sessions via video or text, ensuring you’re as comfortable as possible.

Online therapy is also helpful if you have any physical disabilities that prevent you from climbing stairs or entering buildings without ramps. Instead of having to navigate narrow hallways or climb steps to reach a therapist’s office, you’ll be able to connect with a therapist from the comfort of your own home. As demonstrated during the COVID-19 pandemic, online therapy is especially helpful for ensuring consistency even if you have a contagious illness. If you develop symptoms of a cold or some other type of illness, you can still keep your online therapy appointment as long as you feel well enough to talk to your therapist.

The following guide provides an overview of how therapy supports members of the LGBTQ+ community and links to resources that can be helpful for navigating the coming-out process, strengthening your relationships, and learning how to be true to yourself as an LGBTQ+ individual.

II. Common LGBTQ+ Mental Health Issues

Members of the LGBTQ+ community have an increased risk of anxiety, depression, and other mental health conditions due to some of the challenges associated with coming out, exploring gender identity, and navigating relationships. LGBTQ+ individuals also have higher rates of homelessness and substance use than non-LGBTQ+ individuals.

The LGBTQ+ community experiences mental health issues at higher rates

According to the National Alliance on Mental Illness, lesbian, gay, and bisexual adults are twice as likely as non-LGB adults to develop a mental health condition. Transgender adults are four times more likely than cisgender adults to experience anxiety, depression, or another mental health disorder. The statistics are even more concerning for LGB and transgender youth.

LGB youth are more than two times as likely to report persistent feelings of hopelessness or sadness as their heterosexual peers. Transgender youth are also twice as likely as cisgender youth to seriously consider suicide, attempt suicide, and experience depressive symptoms.

Per the 2015 U.S. Transgender Survey, 40% of transgender individuals have attempted suicide at least once in their lifetimes, which is nine times the overall attempted suicide rate of 5% in the U.S. general population The high rate of attempted suicide among transgendered individuals has been attributed to pervasive mistreatment, economic hardships, and violence.

Unique mental health challenges for the LGBTQ+ community

Members of the LGBTQ+ community have some unique challenges that contribute to the increased risk of developing a mental health condition. Although society is moving in a positive direction when it comes to LGBTQ+ acceptance, coming out can still affect your relationships with family members and friends. Not everyone is as accepting as they could be, which can lead to feelings of rejection or even psychological trauma due to bullying, homophobia, transphobia, and biphobia. Substance use and homelessness are some of the most serious challenges faced by LGBTQ+ individuals. When some people are subjected to bullying and other forms of mistreatment, they turn to alcohol or drugs to help them cope, leading to increased rates of substance misuse.

III. How Online Therapy Can Help LGBTQ+ Individuals

Your sexual identity influences many aspects of your life, from parenting to navigating relationships with family members. Short-term online therapy can help you navigate the process of coming out or give you an opportunity to explore your identity, while long-term therapy is helpful for issues such as substance abuse, depression, and anxiety.

Challenges LGBTQ+ individuals may face How online therapy can help
Exploring gender identity/expression and sexual orientation If you’re still exploring your gender identity or sexual orientation, a therapist can help you develop a clear picture of how you want to express yourself. A qualified therapist can also help you make informed decisions about transitioning or managing challenges related to your relationships.
Navigating coming out An experienced therapist can help you navigate the process of coming out. If you’re concerned about how people will react, your therapist can give you a safe space in which to explore your feelings. With the right level of support, you’ll be able to come out on your own terms.
Managing depression and anxiety If you have depression and/or anxiety, a therapist can help you identify your triggers and develop healthy coping mechanisms. Your therapist can also help you set goals, have a more positive outlook, and learn how to establish boundaries with loved ones, all of which can help you manage your symptoms.
Dealing with rejection and bullying Rejection affects your self-esteem and self-confidence, which can make it difficult to maintain positive relationships or work toward your goals. An experienced therapist can help you deal with feelings of rejection without engaging in self-blame. A therapist can also help you cope with the negative effects of bullying.
Treatment for substance abuse If you use alcohol or drugs as a coping mechanism, a trained therapist can help you identify your addiction triggers and understand how substance use affects your physical and mental health. Your therapist may use cognitive behavioral therapy, motivational interviewing, or contingency management to help you recognize and break harmful behavior patterns.
Discussing concerns about sexual health (STDs/HIV) You may have questions about your sexual well-being or need more information on how to protect yourself from sexually transmitted infections. A trained therapist can help you understand how to set boundaries with sexual partners and take care of your physical and mental health as you explore your sexuality.
Working through relationship issues Once you come out, you may need assistance navigating your personal relationships. Couples counseling can help you strengthen your relationship with a spouse or other romantic partner. A therapist can also help you improve relationships with parents, siblings, and other loved ones.

IV. How Online Therapy Works

If you’re interested in online therapy, you have two options for finding a therapist. The first is to ask for a referral or use the internet to find therapists in your area. You can narrow down your initial list by looking for therapists who offer telehealth appointments. The second option is to use an online therapy directory to connect with a therapist. Depending on the laws in your state, individual therapists may conduct sessions via video, live chat, text, or phone call. If you choose an online therapy service, your sessions may take place via live video or mobile app. Either way, you’ll have access to increased convenience and privacy.

Benefits of online therapy

  • Can be more affordable than in-person therapy: Online therapy gives you access to a much larger network of therapists, which may help reduce your out-of-pocket costs. Some services charge a flat rate for every appointment, ensuring no surprises occur when it’s time to pay for a session.
  • Convenient: In-person therapy has many benefits, but it’s also inconvenient. You need to find transportation to the therapist’s office, find a place to park, and schedule your appointment when the office is open. With online therapy, you never have to leave home, and you can still meet with your therapist even if you’re not feeling well or the weather is bad enough that you don’t want to go anywhere.
  • Private: Therapists understand the importance of confidentiality, but you may be concerned about going to a therapist’s office and running into someone you know. Online therapy eliminates this concern, as there’s no need to leave home to have a therapy session.
  • Flexible: Online therapy comes in many forms, including video, chat, telephone call, and text message, giving you the flexibility you need to feel comfortable. If you feel self-conscious about having a therapist see you on video, then you can do text or a telephone call instead.

How to use online therapy

If you’re interested in online therapy, you have the option of finding an individual provider or using a service that can connect you with one of hundreds of therapists. Nationwide services typically offer more communication options than individual providers, but you should be able to find a local therapist who provides at least one type of online therapy. If you want to talk to your therapist one-on-one you can connect via video. Live chat, text, and telephone therapy are a little less formal, but they can still provide all the benefits of talking through your problems with a qualified therapist.

How to connect with an online therapist How it works
Video You meet with a therapist via two-way video, which allows you and the therapist to see and hear each other. Some services offer video therapy for around $100 per session, but it may cost more if you choose a therapist on your own or need someone who specializes in a specific type of therapy.
Live chat You and the therapist communicate via a messaging tool that allows for instant communication; however, you and the therapist can’t see each other. Some services charge by the minute, while others charge an hourly or weekly fee to connect with a therapist.
Text With text-based therapy, you and your therapist communicate via text message. You won’t be able to see or hear each other, and the communication isn’t completely synchronous, which means you may not receive a response right away. Text services may charge a monthly fee or have some other type of subscription plan.
Phone call If you don’t want to use video, but you’d like something more synchronous than text-based therapy, telephone therapy is a happy medium. You’ll be able to communicate directly with the therapist without having to wait for a response to come in several hours later. Therapists typically charge an hourly fee for therapy delivered via telephone.

V. How to Find the Right Mental Health Provider

Once you decide to work with a therapist, it’s important to find the right fit. A good therapist should be able to put you at ease and listen to your concerns without judgment. It’s also important to find someone who understands how to help you explore your gender identity or sexual orientation in a healthy way.

Consider your therapy needs

The first thing you need to do is consider your therapy needs. Do you need short-term therapy to help you navigate the coming-out process, or are you seeking a long-term relationship?

  • What do you need in a therapist? For best results, you need to feel comfortable sharing personal things with your therapist. That’s why it’s important to determine what you need in a therapy professional. You might feel more comfortable working with a male or female therapist, or someone who specializes in working with LGBTQ+ individuals. The age of the therapist is also an important consideration. Some people prefer working with older therapists, while others prefer to work with therapists around their own age.
  • What specifically do you need help with? Before choosing a therapist, determine what you need help with. If you want to work on your substance use, a therapist with no experience in substance use disorders may not be the best match. You’ll also need to consider whether you want to involve a romantic partner in your therapy sessions. If you do, it might be beneficial to choose a therapist who has extensive experience working with couples.

Ask for referrals

You may feel more comfortable working with a therapist who’s been vetted by someone you trust. That’s why asking for referrals can be helpful.

  • Consult friends and family: If you know a trusted family member or friend who’s been seeing a therapist, ask for a referral. Even if their therapist can’t meet your needs, you may be able to secure a referral to someone who can. If your family and friends aren’t as supportive as you’d like them to be, then you may want to skip this step and seek a referral from a local LGBTQ+ community group or from your physician or another health professional.
  • Consult local LGBTQ+ community groups or health centers: If your area has a community group or health center dedicated to LGBTQ+ issues, ask for a referral or visit the organization’s website to look for a list of recommended resources. An employee or volunteer may be able to offer a personal recommendation or direct you to someone who can.
  • Consult LGBTQ+ organizations: Some organizations have listings for queer or queer affirming therapists and other mental health professionals. Health Professionals Advancing LGBTQ Equality and The Association of LGBTQ+ Psychiatrists are two such organizations.

Research and ask questions

Once you have a few names in mind, spend a little time researching each one to narrow down your list and get closer to making an appointment. The vetting process should include checking credentials, reading reviews, and having an initial session with each therapist.

  • Check their credentials: You may come across therapists who list themselves as licensed professional counselors, licensed clinical social workers, licensed marriage and family therapists, or psychiatrists. To verify a therapist’s professional license, use your favorite search engine to locate the appropriate licensing body. For psychiatrists, this is usually the medical board in your state. LCSWs, LMFTs, and professional counselors may be licensed by a bureau of occupational licensing or a similar agency. Once you identify the correct organization, visit its website and look for a license lookup or license verification tool.
  • Read reviews: Check online reviews to see what other people are saying about their experiences with each therapist.
  • Interview or do an initial session: If you’re not comfortable choosing a therapist based on reviews alone, conduct an interview or schedule an initial consultation with each therapist. Make sure the therapist doesn’t use any practices that have been discredited or deemed harmful. Ask the therapist, do you have experience working with people who identify as _______?

Build a relationship with your therapist

Once you choose a therapist, it can take some time to develop a trusting relationship. If you have a bad experience during your first session, it’s okay not to go back, but don’t worry if you don’t click with your therapist right away.

  • Be patient: You’ll need to talk with your therapist regularly to develop a relationship based on mutual respect and understanding. During the first few sessions, your therapist may ask questions about your family background, education, romantic relationships, and career to determine the best therapeutic approach to use during future sessions.
  • Trust the process: The process of building a relationship with your therapist isn’t a linear one. It’s natural to have some ups and downs along the way. For example, you may experience some discomfort the first time you discuss bullying or some other type of trauma, even if you previously felt comfortable with the therapist.
  • Keep an open mind: Therapists use a wide range of techniques to help people improve their mental health. It’s good to have boundaries, but it’s also important to keep an open mind. If your therapist suggests a technique you’re not sure about, ask questions and try to understand how the technique may help you instead of immediately refusing to try it.

VI. LGBTQ+ Resources

Whether you’re questioning your sexual orientation or interested in exploring your gender identity, it’s important to have support from people you can trust. If you need more information about therapy, medical care, and other services for LGBTQ+ individuals, visit the following resources. With the right information, you can make better decisions about your life.

  • Parents, Families and Friends of Lesbians and Gays (PFLAG): PFLAG is an organization dedicated to ensuring that all people are valued and respected. Membership is open to LGBTQ+ individuals, their family members, and allies advocating for equal rights. PFLAG has active chapters throughout the United States, making it a good source of support in your community.
  • American Civil Liberties Union: The American Civil Liberties Union works to ensure that LGBTQ+ of all ages, races, and ethnic backgrounds can live their lives free of discrimination and harassment. ACLU attorneys file lawsuits against employers, government organizations, and health care facilities to ensure that LGBTQ+ individuals have equal access to employment, health care, and public services.
  • National LGBTQ Task Force: The National LGBTQ Task Force is an advocacy group that works to make sure LGBTQ+ individuals have equal access to freedom and justice. Activists work to end discrimination and eliminate barriers for the LGBTQ+ community when it comes to health care, employment, housing, retirement, and other aspects of life.
  • GLAAD: Founded in 1985, GLAAD advocates for the acceptance of all LGBTQ+ individuals by working with media organizations to ensure that television shows, news coverage, and advertising promote acceptance and discourage discrimination. GLAAD has also organized national marches and other events to increase awareness of important issues in the LGBTQ+ community.
  • Bisexual Resource Center: BRC is a nonprofit organization dedicated to raising awareness of bisexuality and advocating for bisexual visibility. Because bisexual individuals are discriminated against by both heterosexuals and other members of the LGBTQ+ community, BRC aims to provide support and work toward a world where everyone is celebrated.
  • The Trevor Project: The Trevor Project offers a variety of life-affirming programs to prevent suicide among LGBTQ+ individuals under the age of 25. Trained counselors are available via telephone, text message, and instant message to provide crisis intervention when needed. The Trevor Project also offers training for teachers and other allies.
  • Gay, Lesbian and Straight Education Network: GLSEN aims to eliminate discrimination in schools and other educational environments. The organization conducts an annual survey to determine what it’s like for LGBTQ+ youth to attend public and private schools in the United States. GLSEN also has local chapters working to cultivate safe school environments for LGBTQ+ children and teens.
  • The Association of LGBTQ+ Psychiatrists: AGLP members are psychiatrists committed to conducting research to determine best practices in delivering mental health care to members of the LGBTQ+ community. Members also work with the American Psychological Association to influence policy and ensure that LGBTQ+ individuals can live their lives as free from discrimination as possible.
  • Forge: Forge dedicates its resources to building resilience in the transgender community. The organization offers training and resources to help family, friends, and professionals support transgender individuals in a respectful way. Forge also has resources available on building healthy relationships as a transgender individual, having positive interactions with community members, and transgender health care.
  • National Center for Transgender Equality: NCTE works to increase acceptance of transgender individuals and influence policy so that members of the transgender community can work, attend school, and participate in community activities without fear of discrimination. The organization emphasizes equal opportunity and access to health care, safety, and justice as part of its mission.
  • GSA Network: The GSA Network consists of student-led chapters at middle schools and high schools throughout the United States. Chapter members work to promote social change and increase acceptance of youth of all orientations and identities. The GSA Network also has virtual chapters to ensure LGBTQ+ students can stay connected even when they’re not in school.
  • It Gets Better Project: The mission of the It Gets Better Project is to empower LGBTQ+ youth and remind them that they’re not alone. What started out as a social media campaign is now a global platform that brings LGBTQ+ youth together and promotes acceptance of every sexual orientation and gender identity.
  • American Veterans for Equal Rights: Founded in 1990, AVER is made up of active services members, retirees, and reserve members advocating for the equal treatment of all members of the military, including the LGBTQ+ individuals who are often oppressed by military policies. AVER has chapters throughout the United States to ensure strong support in each region.
  • Transgender Law Center: The Transgender Law Center employs community-focused strategies to ensure transgender individuals can thrive no matter where they live. Members advocate for equal treatment of transgender individuals in prisons, schools, health care facilities, and workplaces, helping to prevent discrimination and give members of the transgender community more freedom.
  • National Center for Lesbian Rights: With a commitment to racial and economic justice, the NCLR promotes equal rights for LGBTQ+ individuals. Members work to influence public policy and educate members of the public on some of the key issues faced by members of the LGBTQ+ community. When necessary, the NCLR files lawsuits to remedy situations involving discrimination.

VII. Sources

Learn more from the sources used in this guide: