More than inclusive: How to truly show up for LGBTQIA+ clients

In light of the Supreme Court ruling, and follow-up comment and reaction, times are dark just now for the trans community, but I think lots of us in the LGBTQIA+ community are feeling the pressure of the rising political hostility, the media misinformation and the general fragility of our human rights. 

Why is this so important right now?

Therapy can be one of the only safe spaces that LGBTQIA+ individuals have, and so it is absolutely vital that it is an affirming space. 

You might be thinking - "Well, of course I'm non-judgmental!" and I absolutely get that, but there is a big difference between being non-judgemental and being actively affirming.

Whilst being non-judgemental means you offer acceptance and neutrality, it's a baseline stance and I feel not enough. Being actively affirmative means that you see your client, you respect them and support them in fully being themselves – it means you can name and validate queer identities, that you use correct names and pronouns and challenge any internalised or systemic queer phobia you may hold. It means adapting language, resources and practices to be inclusive, and it means addressing the impact of marginalisation and not pretending we live in a neutral society. Being affirming is about action, not just attitude. 

For people who've faced erasure, rejection or hostility, neutrality can feel like silence, and silence can feel like complicity. Affirmation says, you are valid, you are safe, you matter, and I will stand with you. 

So, how do we actually be affirmative?

Affirming is an ongoing process, not a one-off learning

Identity affirming practice involves a continual unlearning of cisnormativity, heteronormativity and binary thinking. It involves not assuming that people are hetero, cis, binary or monogamous – not assuming anything, really. It means continually updating yourself, be it through CPD, reading or other media on the correct terminologies to use, on current events or issues impacting your clients and on providing affirmation.  As a queer woman, if I felt that a counsellor was seeing the world purely through a heteronormative lens for example, I'd be very reluctant to work with them. 

Creating visibly safe spaces – without tokenism

Small symbols and signs can make a massive difference; rainbow stickers, pronouns on websites, or inclusive intake forms can really make LGBTQIA+ individuals feel safer. These visual clues can really lower nervous system arousal; however, steer away from performative allyship, as allyship should be constant. Again, when I've encountered forms or websites that don't take my identity into account, I feel very unseen. 

Don't wait for a client to come out – just don't assume anything

Reflect on your language usage. Cis/heteronormative language can unintentionally silence or exclude clients. Personally, I've had therapists in the past assume I have a male partner, and it's made me feel very uncomfortable (and a little annoyed). Language that isn't gendered can be used, like partner, instead of husband or ask for pronouns and offer your own. By making assumptions, you don't give the client permission to just be themself. 

Recognise the impact of minority stress and systematic harm

Minority stress is chronic stress experienced by individuals who belong to socially marginalised groups. It's ongoing and systemic. It is really important when working with LGBTQIA+ individuals that you recognise the impact of minority stress on both mental and physical health. There will be things like dealing with chronic microaggressions, political hostility and family rejection that show up in the therapy room. 

Support without centring yourself

Sometimes we can get caught up in our own reaction to an experience. If you are a cis/het person, be really conscious of your power and privilege, avoid the temptation to prove your allyship or seek validation from your clients. Even though really well-intentioned, phrases like "Don't worry - I'm really accepting" or "I treat everyone the same, no matter who they are", these kinds of responses shift the emotional labour to the client and take up space that should be focused on their needs.

If you do get something wrong, apologise without defensiveness. I know, I've found myself in the past over-apologising and making it about me, and this isn't helpful either. LGBTQIA+ individuals often have to navigate spaces where they have to justify their existence, therapy should not be one of those spaces. 

Hold space for queer joy, not just queer pain

So much queer experience is framed through trauma, but affirming therapists celebrate joy, creativity, fluidity and chosen family. Encourage exploration of pleasure, pride, connection, community and thriving. Therapy isn't just about surviving, it's about the freedom to be ourselves, too.  

Prepare for ethical activism

Reflect on the therapist's role in advocacy, in difficult times, silence can be seen as complicity. Think about how you challenge anti-LGBTQIA+ bias in professional spaces and policies. 

Seek queer supervision

If you're not a part of the LGBTQIA+ community (or even if you are), don't rely on your clients to educate you; regular supervision with a queer-affirming supervisor can really deepen your capacity to hold this work.

This work is personal, political and necessary, reflect on what you need to learn and unlearn. To be truly affirming is to walk alongside clients with humility, accountability and deep care.