Therapy for LGBTQ+
Affirming therapy with a shared experience
Growing up feeling different or like something is intrinsically wrong with you is traumatic, and unfortunately the experience of many who identify as LGBTQ+. Whether you are an adolescent or an adult, I am here to support you with all the challenges that come with claiming your identity.
Growing Up LGBTQ+
While there is no one specific experience universal to all who identify as LGBTQ+, there are often common themes woven throughout.
Shame
One of the most dangerous and destructive things in the world is shame. Often it develops right alongside our growing consciousness that there is something “different” or “wrong” with us because of who we are or who we love.
We feel it when we recognize desires within ourselves that go against the social and cultural norms we were meant to abide by. We hear it’s voice on a loop in our brain. Eventually, we take on its narrative as our own.
Rejection
Equally destructive to our emotional wellbeing is our experience of rejection by important people in our lives. From this birthplace of shame, our self-concept remains fragile — we begin to internalize our understanding of who we are in relation to others’ opinions of us.
By the hometowns in which we grew up or society in general, we are made to feel that our sexuality or gender identity is perverse and wrong and will never be accepted.
Suppression
In order to survive, we often develop ways of coping with these painful experiences that deny our truth. We become experts at sucking it up, pleasing others, or “making up for” our sexuality or gender expression by being perfect in all other ways.
Long term, this can easily lead to low self-esteem or even self-loathing, and trigger even more destructive cycles of avoidance of these deeper issues, by drinking, taking substances, engaging in unsafe sexual practices or self-harm.
For many in the LGBTQ+ community, it is this shame/pride dichotomy that defines our early experiences and becomes the central feature in how we later organize our understanding of ourselves. Accepting ourselves when feeling rejected by family, friends, and society is difficult but also an incredibly courageous process.
Finding Yourself
As adolescents or even later in life, the LGBTQ+ experience involves embarking on a journey of "finding yourself”.
Sexual Exploration
While there is no specific progression or one-size-fits-all model, many LGBTQ+ young people can identify with some specific stages related to their sexual development, from the first moment of recognizing their attraction to the same sex to the point of triumphant self-acceptance.
Sexual exploration begins to help us define and put language to our truth. We may begin to share our desires and feelings with people we trust or even experience our first hookup or romantic relationship. It's ultimately a process of becoming intimately acquainted with ourselves and discovering what we like and what makes us feel good.
Coming Out
As sexual exploration tends to be about our internal journey, the “coming out” process is about how we choose to share that journey with important others in our lives.
In adolescence, not only are we tasked with the challenge of discovering who we are and where we fit in, those who identify as LGBTQ+ have the additional difficulty of navigating the social pressures and risks of homophobia, transphobia, bullying, and social rejection.
Deciding how, when, and to whom to “come out” can greatly affect these formative years of our lives.
Gender Exploration
The recognition that there is an incongruence between your body and who you know yourself to be for some comes at an early age. Others aren’t fully aware of their truth until later, often not until they finally find an open and accepting space where they feel comfortable to access and bring to awareness this hidden part of themselves.
Society frequently conflates gender identity and sexual orientation. They are separate and unique experiences and each has its own process. Developing an understanding of one’s gender and disclosure of this to others represent important strides in embracing who we are. Taking steps to change one’s outward expression or physical body to match one’s internal gender identity is a personal and complex experience.
Transitioning
For transgender individuals, there are many different areas of life where they may choose to transform their gender identity to reflect their truth, whether socially, legally, or medically.
This might look like coming out as trans to friends and family, changing aspects of their dress or grooming, asking others to use preferred pronouns, going by a different name, or legally changing their name and gender marker on critical documents.
Medically, transgender individuals may choose to pursue hormone therapy or different avenues of gender-affirming surgery that reflect their understanding of who they really are, which can culminate in a feeling of finally being at peace in their body.
Regardless of your position on the road to finding yourself...
…something that is often crucial to each person’s journey is finding a place within the larger LGBTQ+ community, however that may look for you. Often achieving a full integration of your sexual and gender identity with the rest of your life involves some elements of political or social activism, and opportunities to connect with something larger than yourself.
Challenges We Face
From homelessness to bullying at school disrupting education to family rejection and difficulty finding safe spaces to form supportive relationships, some challenges are common to the LGBTQ+ experience.
Body Image
For those of us in the LGBTQ+ community, many of us look in the mirror and see our bodies as the enemy: ugly and unlovable, too big, too wrong. We feel fat and struggle with our size. Even if we’re not fat, we fear we will become that way and organize our life around excessively dieting or exercising in pursuit of the ideal body type. We give in to eating disorders and body shaming and the belief that certain body sizes and shapes are bad or undesirable.
Although these concerns are not unique to us in the queer community, they are especially prevalent. It is a result of overcompensating for spending formative years feeling intense shame about our sexual orientation or gender identity.
Discrimination
Even in our current state of progress, discrimination —whether overt or subtle— continues to be a routine experience for those in the LGBTQ+ community. In and beyond the workplace, honest expressions of one’s sexuality or gender identity comes with a great price. For some, this can cost them their homes, access to medical care or mental health care, education, and even the ability to engage in public life.
Given the lack of protections, it is no wonder that many feel incredibly limited in their options for where to live and work and are compelled to hide their authentic selves.
Abuse & Trauma
The world continues to be an unsafe place for those in the LGBTQ+ community, not just the posing threat of discrimination, but also overt acts of violence fueled by homophobia or transphobia. This begins at school age with bullying and can carry on throughout life with even more extreme forms of physical violence.
These experiences, whether they occurred in middle school or in adult life are incredibly traumatic, and pave the way for a multitude of mental health concerns, like anxiety and depression, and get in the way of ultimate wellbeing.
Navigating Sex, Dating & Relationships
The world of LGBTQ+ relationships can be incredibly complex to navigate, whether it’s discovering the social etiquette of dating apps, finding a partner who is looking for the same balance of casual vs. seriousness, and all the common challenges that come with attempting to build a life with someone.
In LGBTQ+ relationships, you may face the added stress of feeling as though your degree of masculinity or femininity is regularly questioned or scrutinized, dealing with varied comfort levels in public displays of affection, or anxiety about introducing your partner to each other’s family.
Suicidal Thoughts
Given all of the challenges that those in the LGBTQ+ community face, it is not difficult to see how depressive and suicidal thoughts develop and take hold of many individuals. Whether it is dealing with the trauma of a physical or sexual assault, facing discrimination and bullying, difficulties reconciling contradictory religious and sexual/gender identites, receiving a HIV diagnosis, or even young people facing homelessness because of the rejection they experience by their families, it can be easy to wish that the challenges of this life were over.
While claiming your identity as a member of the LGBTQ+ community is not an easy path to walk, we do a disservice when we fail to balance the scale with the beauty and color that life in the queer community can bring. This includes our openness to new experiences, as well as a more developed sense of self that can only be found once you have embarked on the task of discovering who you are at the core, and made the decision to bring that person to life.
Living with HIV
For many years, a diagnosis of HIV felt like a death sentence, and sadly it was for many. Due to the relentless and courageous advocacy work of organizations like ACT UP, we have come a long way. There is effective treatment for HIV. Antiretroviral therapy or ART, when taken as prescribed, can reduce the viral load in a person living with HIV to undetectable. HIV is now considered a chronic but manageable illness, and people with the virus can lead a long and healthy life.
Unfortunately, an HIV diagnosis still carries a stigma and marks one as a member of particular groups of society that already experience discrimination: men who have sex with men (MSM) and drug users, even though we now know that HIV is nondiscriminate and affects everyone. For LGBTQ+ people, contracting HIV can be devastating because it means having another stigmatized and disdained identity to deal with. It can involve another “coming out” process when dealing with disclosure to family, friends, and intimate partners.
Despite consistent messaging that HIV affects us all and the advancements made in treatment, misinformation continues to be one of the biggest enemies of forward progress, and HIV stigma continues to be pervasive even among members of the LGBTQ+ community. As a result, an HIV diagnosis can still inspire an existential crisis in how you feel and think about yourself and your capacity for having rewarding future sexual or romantic relationships.
