LGBTQ+ counselling

Written by Katherine Nicholls
Katherine Nicholls
Counselling Directory Content Team

Reviewed by Lindsay Roadnight
Last updated 8th November 2022 | Next update due 7th November 2025

Our sexuality and gender can form a big part of our identity and those who don’t fit society’s heteronormative ideal can come up against more challenges. Those who identify as LGBTQ+ can be seen as ‘different’ by some, facing discrimination, bullying and a lack of understanding which can lead to mental health concerns.

While things in society are slowly moving forward in terms of acceptance, we still have a long way to go. Incredibly, the World Health Organisation only removed ‘homosexuality’ as a formal psychiatric diagnosis in 1992.

The fact is, being LGBTQ+ does not lead to mental health problems - dealing with other people’s adverse reactions does. Because of this, those who don’t identify as heterosexual are more likely to experience mental health problems. Here we’ll explore sexuality and mental health in more detail, where to find support and coming out concerns.

Sex and relationship therapist Rebecca Harrison explains how an LGBTQ+ therapist can help with a range of issues, and what to look for when searching for an LGBTQ+ therapist. 

Sexuality and mental health

LGBTQ+ people can be at a greater risk of developing a mental health condition than those in the wider population. According to the Mental Health Foundation, a survey carried out by Stonewall found that half of LGBTQ+ people experience depression and three in five experience anxiety.

The reasons for this are complex and not entirely understood, however, most mental health problems experienced can be linked to discrimination, bullying, homophobia, biphobia or transphobia.

If you identify as LGBTQ+ and you’re struggling with your mental health, know that you’re not alone. You may be particularly prone to:

  • Depression - when you experience a low mood for a long period of time.
  • Anxiety - when you feel especially anxious or worried for long periods of time or at a high intensity.
  • Self-harm - when you hurt yourself on purpose to cope with difficult emotions.
  • Suicidal thoughts - when you feel very low and as if there is no way out.

You may experience rejection from those around you, including friends, family and work colleagues. Other factors may also complicate things, for example where you live, your ethnicity and religious background. Understandably, this can all have a big impact on your sense of self-worth and your confidence. You may feel the need to hide this part of yourself from others, and this can be damaging in itself.

Some people may find they turn to alcohol and drugs to help them cope with difficult emotions. If you’re worried about the way you’re using alcohol or drugs, your doctor, a counsellor or an addiction helpline can offer support.

There are hidden covert messages in the media about what it means to be 'normal' which in some way reinforces the message that being different is not acceptable. The notion of 'fitting in' not just in the wider community but within LGBT communities can and does come with its own pressures.

- Read more on LGBT mental health.

LGBTQ+ counselling

Speaking to a counsellor can help with some of the difficulties you’re facing, such as:

  • finding it hard to accept your sexuality
  • coping with other people’s reactions
  • low self-esteem and low self-confidence
  • fear of violence or abuse in public places
  • effects of bullying and discrimination
  • feeling as if your body does not reflect your true gender (gender dysphoria)
  • transitioning

If you develop a mental health condition, talking therapies can help you find new ways of coping and either overcome or manage your condition. What’s important is for you to find a counsellor who you trust and feel able to talk to openly about your experiences. For this reason, it can be helpful to check your counsellor has experience working with LGBTQ+ people and/or has had appropriate training.

If at any point you feel uncomfortable with your counsellor, remember you have every right to stop your sessions and find a more suitable counsellor for you.

I find that people come to me either because they want to discuss their sexuality or gender identity, or because they want that to be understood as something that is a part of them, but it’s not what they’re seeking therapy for. A cisgender, heterosexual therapist will often be able to offer that, but not always.

- Jennifer Tomkinson, MBACP (Accred), PGDip, shares tips for finding a therapist if you identify as LGBTQ+

Therapists who can help with LGBTQ+ related concerns

Other forms of support

Aside from talking therapy and counselling, many LGBTQ+ people find it helpful to connect with others in the community. You may want to join a support group online or connect with campaigners. There are a number of organisations and charities that support and campaign for LGBTQ+ people, Mind has an excellent list of resources.

Discrimination - what’s the law?

Attitudes in the UK towards the LGBTQ+ community do slowly seem to be improving, however, there are still some people who discriminate against others based on their gender and/or sexuality. There is a law against this at work and in wider society - The Equality Act 2010.

This protects gay, lesbian, bisexual and trans people and anyone who experiences discrimination because they associate with LGBTQ+ people. You can find out more about what the Equality Act 2010 covers and includes on the website.  

Coming out

The term ‘coming out’ is often used to describe when you tell people about your sexual orientation and/or your gender identity. For some, it can take a long time to feel comfortable to do this. It’s important to know that you don’t need to come out at a certain time, you simply need to do what feels good and right for you.

Having these conversations can be difficult. You may experience unpleasant reactions and even rejection in some cases. This can make coming out an emotionally trying time. And sadly, for many, coming out isn’t a one-time thing. Every time you meet someone new or start a new job, for example, you may need to consider when or how much of your identity as an LGBTQ+ person you want to share.

Despite what may sound like negative repercussions of coming out, this doesn’t happen to everyone. Many people are supported and understood by those they’re coming out to.

Hiding who you are, however, can be an incredibly difficult thing to do and can be damaging to your mental health and well-being.

I had a realisation that I was gay and that it wasn’t a good thing to be. I began a nine-year battle with hiding the deepest part of who I was. This was one of the heaviest masks I wore.

- Read Chris Dudley's experience of OCD and depression.

Everyone will ‘come out’ in different ways. For many, it’s a series of conversations that take place between the LGBTQ+ person and the people in their life they want to tell. It’s important for you to come out in a way that feels right for you and your circumstances.

Telling someone you trust and believe will be supportive first can be a good idea. They can then provide you with some support as you tell others in your life. Picking a time when you can talk through any concerns and worries is also recommended.

Try to keep in mind that although this is likely something you have known about yourself for a long time, for others, it may be a surprise. Initial reactions may be laced with shock, and they may change over time.

Creating a support network, whether that includes friends, family members, online communities or professional support (or all of these!) can be incredibly helpful when taking this step.

Above all, please remember you are not alone. With greater understanding, kindness and representation hopefully making its way through society - we can only push for progress.

Further help

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