How to Become an LGBTQ Competent Therapist

January 28, 2020

Being LGBTQ competent is more than just understanding the mechanics of sex or the use of pronouns. Often, potential clients contact me and tell me that they have had extreme difficulty finding a therapist who is LGBTQ competent. In the interest of developing inclusive therapists, here are some initial actions to becoming LGBTQ competent. Of course, this is a journey of constant learning and soul-searching, but it’s a place to start.

1) Know your stuff.
For starters, you must have some actual competency and knowledge. Know commonly used terms, including those for gender identities and sexual preferences and orientations. Know that gender and sexuality are two different things that can be explored together or remain entirely separate for individuals (for example, a gay man can also explore his gender expression, or not). That said, if it is relevant to the client, know how to use gender-neutral pronouns such as they/them, and please do not misgender your clients upon meeting them! One thing that I do to prevent a misgendering microaggression is to say, “I am from up north where y’all and yous do not exist, so sometimes I inadvertently say the term ‘you guys’; does that offend anyone? And if so, I’ll try my best to make sure I don’t use it at all.” In addition, be aware of the struggles that LGBTQ individuals and communities face now and have faced historically, including discrimination, violence, and systemic inequality in their families, schools, communities, and medical systems. This is just a very small sample of what you should be aware of if you want to become LGBTQ competent.

2) Expand what you know.
Know more than just the facts and the stereotypes. The LGBTQ community is very diverse, dynamic, and fluid. Sure, some clients may seem to fit ideas you have about LGBTQ people, but do not just accept that on the surface. Ask more questions to expand your idea of who they are. Never assume that just because someone looks or acts one way, they fit in a box. Also, recognize that identities are intersectional and layered. Of course, do not expect your client to educate you about themselves or their identities, as this is not their job and can be traumatizing to them. Instead, if there is something that comes up you do not know, say, “I am not really familiar with that, but I’ll look for information and expertise and come back more prepared.” This shows your client you are open, engaged, and able to take responsibility for your own learning.

3) Recognize your own biases and change them.
Bias is a very real thing, even for people who think they are “woke” or open-minded. Especially if you do not identify as LGBTQ, it may be hard to understand what it’s like for someone who does. Beyond having empathy for their human experience of pain, excitement, confusion, relief, grief, sorrow and everything in between, it’s important that your client feels understood for exactly what they are going through. To do this, you must identify your own thoughts and feelings about your clients’ identities, even the ones that you are ashamed of having. Include the stereotypical ideas or feelings that you have (for example, my sister is gay so I must know what it’s like to come out since I was there when my sister did it). Once you’ve labeled your biases and feelings, expand your perspective by reading and listening to more stories from the LGBTQ community and its members. There are resources online, podcasts, Instagram accounts, and blogs dedicated specifically to this task! Challenging your biases by getting more information and developing more empathy is very important if you want to be able to treat clients in any marginalized identity group.

4) Create a safe space for queer people, and make sure it is easily visible.
What is a safe space exactly? A safe space is usually a trigger-free, accepting and inclusive environment. Clients will be able to give feedback if you ask about what makes them feel that a space is a safe space. Generally, it should include visual clues that the place is accepting of everyone, such as the black and brown rainbow flag, the trans flag, images on flyers or promotional materials with non-heterosexual couples, or a sign that says “Everyone is Welcome Here.” This is just a start, as creating a safe space is also about you as a therapist being welcoming and open, and all the things in #1-3 contribute to this also.

5) Know what it means to be an ally, and practice this outside of the therapy room as well.
This goes without saying, but being LGBTQ competent is a part of you, not just a hat you put on and take off at work. To truly claim competence in this area, you must also actually care about what happens to members of the LGBTQ community and work to interrupt stigma and discrimination when you encounter it in your own life. This includes having tough conversations with homophobic relatives at holidays, following LGBTQ news, supporting LGBTQ-owned businesses in your community, and other things as well.

In summary, being an LGBTQ competent therapist is not a small matter, and something you must constantly work to develop. Start by developing actual competencies and knowledge, then expand that knowledge beyond the stereotypes and facts. Question yourself and understand your own biases, so you can work to eliminate them. Finally, create and show that you have a safe space for LGBTQ people, and be an ally outside of the office. This is just a start, but an important one. Happy learning.