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It's one of our specialties. We'd love to explain.

To start, here's a definition and some context: 

Lesbian, Gay, Bisexual, and Transgender (LGBT) Affirmative Therapy (Definition):

“the integration of knowledge and awareness by the therapist of the unique developmental cultural aspects of LGBT individuals, the therapist’s own self-knowledge, and the translation of this knowledge and awareness into effective and helpful therapy skills at all stages of the therapeutic process” (Perez, 2007, p. 408).

Today, all of the major mental healthcare organizations have voiced a firm commitment to ensuring the equal treatment and dignity of all LGBTQ individuals. To be honest, though, regulations are still unfolding. In 2021, the American Psychological Association updated their 2009 guidelines, which banned sexual orientation "conversion therapy," and and added a formal condemnation of therapies that sought to change gender identity. Even though those are the official rules, many LGBTQ folks would prefer not to work with just any therapist. This is how our LGBTQ clients tend to find us: LGBTQ Affirmative Therapists. 

LGBTQ Affirmative Therapists: Identity and Ideals


An LGBTQ affirmative therapist might or might not be a member of the very community that they serve. These therapists not only identify as interested in and sensitive to LGBTQ lives, they possess specific training, pertinent lived experiences, and ongoing consultation or accountability measures. From the beginning, affirmative therapists work hard to ensure their clients’ comfort.


When it comes to the focus of treatment, these therapists remain open and do not assume that the client’s reasons for seeking therapy are necessarily related to sexual orientation or gender identity. In short, they follow their client’s lead, keeping in mind that LGBTQ individuals might find themselves in varied stages of identity development. For instance, individuals suffering with anxiety might feel insecure in one area of their lives but stable and secure in their gender identity. Others might remain anxious and sensitive to others’ reactions, feeling preoccupied with signs suggesting that they have been misunderstood, disrespected, or marginalized. With this in mind, an LGBTQ affirmative therapist creates a secure space for individuals to explore their concerns, work within the relationship, and get to know the aspects of their own unique identity.


LGBTQ Clients: Finding the Right Fit


As is the case with any client, it is very important to find a therapist that understands and can provide a strong working alliance. In short, the client and therapist need to be a good fit. For LGBTQ clients, it is also important that their therapist is competent in terms of the research, cultural norms, language, use of preferred pronouns, and variations is identity, dating, sexual practices, and other arrangements that clients might be experiencing or interested in.


More broadly, LGBTQ affirmative therapists are aware of the power that they hold within the therapy setting. Thus, they examine their own biases before working with clients and are diligent in their commitment to treating LGBTQ individuals with the respect and dignity that they deserve. In many cases, LGBTQ affirmative therapists directly inform their clients of their affirmative status. If this does not happen, clients are encouraged to ask!


At Skyline Psychotherapy & Assessment Services, PLLC, our therapists strongly identify as LGBTQ Affirmative. We offer our clients our lived experiences, training, commitment, consultation, self-reflection, and drive to improve. In addition to affirmative therapy, our psychologists are also able to conduct assessments and write letters in support of gender affirming surgery. 

Check out our Services and Fees. 


Existing clients: please do not hesitate to ask your Skyline therapist how they can help you to understand and navigate your unique challenges. And for those who are considering a new course of therapy at this time, ask how we can help! Our therapists are happy to work with individuals, couples, and families that span the full spectrum of LGBTQIA+ identities. 



American Psychological Association, APA Task Force on Psychological Practice with Sexual

Minority Persons. (2021). Guidelines for Psychological Practice with Sexual Minority Persons. Retrieved from


American Psychological Association (2021). APA Resolution on Gender Identity Change

Efforts. Retrieved from


APA Task Force on Appropriate Therapeutic Responses to Sexual Orientation (2009). Report of the American Psychological Association Task Force on Appropriate Therapeutic

Responses to Sexual Orientation. Washington, DC: American Psychological Association.


Perez, R.M. (2007). The “boring” state of research and psychotherapy with lesbian, gay,

bisexual, and transgender clients: Revisiting Baron (1991). In K.J. Bieschke, R.M. Perez, & K.A., DeBord (Eds.), Handbook of counseling and psychotherapy with lesbian, gay, bisexual, and transgender clients (2nd ed., pp. 399-418). Washington, DC: American Psychological Association.

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