Affirming care is not the same as tolerant care. A therapist who simply does not say anything negative about your identity is not the same as one who actively understands, affirms, and incorporates LGBTQ+ experience into their practice.

It is appropriate to interview a therapist before committing. Asking about their experience with LGBTQ+ clients, their stance on conversion therapy, and their familiarity with minority stress is entirely reasonable — and a good therapist will welcome it.

Red flags exist and matter. Misusing your name or pronouns repeatedly, treating your identity as the root problem, or showing discomfort with LGBTQ+ topics are signs to find a different provider.

Telehealth can expand your options significantly. If affirming providers are scarce locally, telehealth allows access to LGBTQ+-affirming therapists across a wider geographic area.

Cost is not always a barrier. Sliding-scale fees, community mental health centers, Open Path Collective, and Medicaid all provide pathways to affirming care at reduced cost. See our Therapy Without Insurance guide for details.

Psychology Today — psychologytoday.com/us/therapists — filter by “LGBTQ+ affirming” and your zip code

TherapyDen — therapyden.com — built specifically with LGBTQ+ inclusion in mind and allows detailed identity and specialty filtering

GLMA Provider Directory — glma.org — a directory of LGBTQ+-affirming healthcare providers maintained by GLMA: Health Professionals Advancing LGBTQ Equality

WPATH Provider Directory — wpath.org — for gender-affirming medical and mental health care, especially relevant if gender dysphoria is part of your experience. See our Gender Dysphoria Resources page

Your local LGBTQ+ community center — Many maintain vetted local provider lists and can make personal referrals based on your specific needs

Transpire Help — Reach out to us and we will do our best to help connect you with affirming mental health resources in your area

“Do you have experience working with LGBTQ+ clients?”

“Are you familiar with minority stress theory and how it affects mental health?”

“What is your stance on gender identity and sexual orientation?”

“What is your position on conversion therapy or any therapy aimed at changing identity?”

“Do you use affirming, non-pathologizing language around LGBTQ+ experiences?”

“Have you worked with clients who share my specific identity or experiences?” (e.g., transgender, bisexual, queer, intersex)

Uses your correct name and pronouns consistently, without needing repeated correction

Does not express or imply that your LGBTQ+ identity is the root of your problems

Understands that mental health challenges often stem from social stressors — discrimination, rejection, minority stress — rather than from your identity itself

Does not require you to spend session time explaining what it means to be LGBTQ+ or defending your identity

Creates space to talk openly about relationships, family, sexuality, gender, and community without awkwardness or judgment

Is genuinely curious about your specific experience rather than applying assumptions based on other clients or general knowledge

Whether mental health services are covered and at what cost-share

Whether you need a referral from a primary care provider

Whether telehealth sessions are covered at the same rate as in-person

Which specific therapists or practice groups are in-network

Using incorrect pronouns or deadnames after being corrected more than once

Treating your LGBTQ+ identity as the primary or root cause of your mental health challenges

Implying your identity is a phase, a choice, or something that could or should change

Making you feel responsible for educating them about what it means to be LGBTQ+

Visible discomfort, hesitation, or judgment when you discuss your identity, relationships, or community

Any expression of support for conversion therapy, reparative therapy, or change-based approaches to sexual orientation or gender identity