ContentsI. Preface II. Finding an LGBTQ Friendly Therapist III. Determining if a Therapist is Competent in Working with LGBTQ People IV. Managing the Expense of Therapy V. A Statement Against Ex-Gay and Other So Called “Reparative” Therapies
Finding a supportive and understanding mental health professional (“therapist” for the sake of brevity) can be extremely helpful in navigating the process of making sense of one’s sexuality and/or gender identity, coping with the bullying transphobic and homophobic (and otherwise discriminatory) attitudes of non-affirming religious institutions and society, integrating one’s sexuality, gender identity, and spirituality, and determining if, when, and how one wants to come out to family and friends. Your campus probably has a counseling center—but often that counseling is geared towards “reparative” or other “ex-gay therapies” (see below). You might find a supportive therapist on campus—but most likely, you’ll have to look off campus for a therapist.
Unfortunately, not all therapists (either on or off campus) are trustworthy, let alone competent, in working with lesbian, gay, bisexual, and transgender people. The purpose of this guide is to assist LGBTQ students and alumni of Christian colleges in accessing competent and trustworthy mental health services. While it is beyond the scope of Safety Net to provide a national listing of therapists who have been vetted for their competence in working with LGBTQ students and alumni of religious institutions, it is our hope that this guide will empower students and alumni to make informed decisions in seeking a mental health service provider.
Approaching therapy can be daunting and even scary. For some of you, you’ve kept your story hidden for so long, it might be intimidating to share it with a stranger. We think if you ask the questions below you’ll find it less scary. The right therapist can accompany you on your journey in empowering ways, so that you do not have to face this alone.
Finding An LGBTQ Friendly Therapist
When seeking a therapist, the key question is: who is the most trustworthy person or organization who can point me towards potential therapists by offering a referall? Some caution is in order here. How does your referral source know this therapist? Why do they think this therapist would be a good resource? Have they had personal experience with this therapist, or is this one of many therapists who simply offered their name as a resource? It’s important to note that many of the lists of therapists “specializing” in working with LGBTQ clients on the internet are self-selecting, and so any person who wishes to promote oneself as LGBTQ friendly can join these lists whether or not they are trustworthy or competent.
Possible Referral Resources
- Personal referral. For example, if you have a LGBTQ student and alumni group, ask someone in the group. If you know a safe faculty or staff member, ask them.
- Through local professional alliances/organizations dedicated to working with LGBTQ persons (example: the Sexual Minority Provider Alliance in Portland — http://www.glbtcounseling.com/)
- Through your local queer resource center. If your school is in small town, there may not be a resource center, so do an Internet search of “NAME OF BIG CITY by my school” and “Queer or LBGT resource center.”
- Through a neighboring university’s queer resource center
- Through local LGBTQ affirming congregations (http://www.gaychurch.org/Find_a_Church/find_a_church.
- The Gay and Lesbian Medical Association (which, despite the name, also focuses on transgender healthcare needs) offers a healthcare provider directory (https://glmaimpak.networkats.com/members_online_new/members/dir_provider.asp) which could be useful both for people to find a good primary care physician and also a place for professional referrals to trusted “therapists.” While this is an opt-in directory, they put a badge by people who are paying members of GLMA which likely will help weed out most unsavory individuals.
- Search the internet, or ask your insurance company, about therapists who list working with LGBTQ clients as a specialty (as previously mentioned, the trouble with this is that these lists are opt in, so “reparative” therapists could just as easily list themselves as having this specialty).
Determining if a Therapist is Competent in Working with LGBTQ Individuals
The American Psychological Association has published guidelines (http://www.apa.org/pi/lgbt/resources/guidelines.aspx) for working with lesbian, gay, and bisexual clients. Knowing these guidelines can help you determine if the therapist you are seeing is acting in conformity with current professional standards for working with non-heterosexual clients.
Similar professional standards for working with transgender individuals (http://www.wpath.org/publications_standards.cfm) have been published by the World Professional Association for Transgender Health.
Other factors that you might consider include:
- Has the therapist worked with other LGBTQ people? What have they learned from this experience? Feel free to ask them—as that’s part of the “getting to know” the therapist phase. If you don’t like the answers—go elsewhere.
- Are there visible indications of inclusivity or exclusivity in the therapist’s office? (a rainbow flag, a marriage equality sign, etc.)? If you don’t see these—it doesn’t mean the therapist isn’t “safe”—but visible symbols can be an obvious sign of inclusivity.
- Does the therapist recognize that not all LGBTQ clients are the same?
- Does the therapist recognize that your sexuality or gender identity might not be the issue for which you are seeking therapy?
- Does the therapist respect your preferred pronoun? Does she (or he) allow you to choose a preferred pronoun?
Most safe therapists will be comfortable addressing these questions prior to your first appointment, and it is your right to seek this information prior to making an appointment. Remember through all of this—just because you see a therapist once doesn’t mean you have to go back. The first session is usually lots of “in-take” stuff—where the therapist is trying to figure out who you are. Take this time to also figure out who the therapist is. You might need to “shop around”—to find someone you’re comfortable with. There’s nothing wrong with not going back after a first appointment. There’s nothing wrong with going to a few therapists before choosing one you are comfortable with.
Also remember that the therapist is bound by therapy/client privilege. This means that, if you are over the age of eighteen, unless you are a danger to yourself or to others, the therapist cannot divulge your story to anyone. If you are under the age of eighteen, you should discuss with your therapist whether they will keep your confidentiality from your parents, as this is not legally required (but an affirming therapist should still be willing to protect your privacy).
Managing the Expense of Therapy
Insurance companies often cover it, but that might mean telling your parents, and if you’re looking at this web-site you probably don’t want to do that. Here are a few ways to lessen the price:
Many therapists have what are called “sliding scales.” That means, the price of your therapy will be tied to your income (or most likely lack of income, if you are a student). Some places even offer free therapy to those in need. When you call the therapists ask them if they have a “sliding scale.” It could be “free” or as cheap as $10 or $20.
Sometimes therapists and LBGT centers offer group “therapy.” While you might be intimidated to share your story with strangers, you’d be surprised how much you can learn from others. Ask if there’s a “coming out” group—that’s a good place to start. There might be other groups too—so feel free to ask.
A Statement Against Ex-Gay and Other So Called “Reparative” Therapies
Just The Facts About Sexual Orientation And Youth, a publication endorsed by the American Academy of Pediatrics, the American Association of School Administrators, the American Counseling Association, the American Federation of Teachers, the American Psychological Association, the American School Counselor Association, the American School Health Association, the Interfaith Alliance Foundation, the National Association of School Psychologists, the National Association of Secondary School Principals, the National Association of Social Workers, the National Education Association, and the School Social Work Association of America stated: “Because ex-gay and transformational ministries usually characterize homosexuality as sinful or evil, promotion in schools of such ministries or of therapies associated with such ministries would likely exacerbate the risk of marginalization, harassment, harm, and fear experienced by lesbian, gay, and bisexual students” (“Just the Facts About Sexual Orientation and Youth,” p.10)
Likewise, The American Psychiatric Association stated: “As a general principle, a therapist should not determine the goal of treatment either coercively or through subtle influence. Psychotherapeutic modalities to convert or ‘repair’ homosexuality are based on developmental theories whose scientific validity is questionable. Furthermore, anecdotal reports of ‘cures’ are counterbalanced by anecdotal claims of psychological harm. In the last four decades, ‘reparative’ therapists have not produced any rigorous scientific research to substantiate their claims of cure. Until there is such research available, APA recommends that ethical practitioners refrain from attempts to change individuals’ sexual orientation, keeping in mind the medical dictum, do no harm.”
Safety Net takes a strong stance against reparative therapy, knowing from the experience of our own members the real harm that these therapies can cause. We consider reparative therapies unsafe, unethical, scientifically unsupported, and spiritually, emotionally, and mentally toxic. Students and alumni are therefore cautioned to avoid following the counsel of those who believe that God’s love for them demands that they disown the sexual orientation and/or gender identity with which God created them.