I'd like to share the definitions I operate from when working with LGBT clients and issues.
Why seek a therapist with awareness of/expertise in LBGT culture and issues?
LGBT culturally competent therapists get that you are more than your sexual orientation/gender identity. Certainly not everyone LGBT is seeking therapy for issues related to their sexual orientation and/or gender identity! At the same time, it is crucial for the therapist to "get" the many ways societal prejudice and discrimination create problems that LGBT clients may seek to address in therapy. As a trauma therapist I understand the individual within the context of multiple levels of oppression (and privilege). Many institutions and individuals within our culture continue to hold anti-LGBT biases such that growing up LGBT often is a stigmatized and traumatic experience. If you have felt stigmatized because of your sexual orientation or gender identity, the last thing you want is to have to spend valuable time educating a therapist about your orientation or identity, or talking about your sexuality/gender because your therapist considers it to be a "problem." You have a right to a therapist that is affirming and educated about the LGBT communities.
What are some issues LGBT clients might want to address in therapy?
1. Coming out issues: Coming out refers to the process of recognizing your own sexual orientation or gender identity and deciding whom to share it with and how to do that. Coming out is a life long process for most LGBT people. Do you need a safe place to explore your sexual orientation? Are you struggling with internalized shame or fear about what it means to be LGBT? You may be comfortable with your identity but fear rejection by important people or discrimination on the job. Parents of LGBT children might seek therapy to understand how to support their child in this process. You may also be wondering what it means about your identity if your choice of partner changes, or your partner transitions form one sex/gender to another.
2. Relationship issues: Stigma impacts our ability to have healthy relationships and sexuality. Are you struggling with your ability to form and maintain healthy relationships? Are you wondering if your sexual behavior is compulsive? Too much? Too little? Are you questioning whether monogamy works for you and thinking about exploring other options? Do you identify as polyamorous and fear this being pathologized? Are you kink identified? Are you wanting to discuss the differences between bdsm and abuse? If you are bisexual, are you tired of explaining that this does not always equal nonmonogamous?
3. LGBT-related trauma: LGBT clients experience all the same traumatic events as heterosexual individuals. In addition, they may also experience traumas related to their sexual orientation or gender identity. You may have experienced bullying as a child or teen related to your presumed sexual orientation or gender expression. You may have experienced physical or sexual assault (gay bashing). You may experience same-sex domestic violence, which carries with it additional stigma and barriers to treatment. You may have expereinced prior therapy that focused on trying to "cure" your sex orientation or gender variance or defined it as pathology. You may have been traumatized by cultural institutions that still stigmatize LGBT individuals and identities. Where you rejected by your faith community? Discharged from the military? Shunned by friends or family? Fired from a job? If you are bisexual, are you dealing with misconceptions from straight and queer culture alike? All of these are traumatic events that may be addressed in therapy. 4. Accessing community support: We often here talk about the LGBT community, as if there is only one! In reality there are many sub-communities and finding your niche can be difficult. Therapists with awareness of the communities locally and at large can help guide you in seeking support and a place where you fit. LGBT affirming churches, support groups, recreational activities are all out there if you know where to look.