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Affirmative therapy, or LGBTQ+ affirmative therapy, is a therapeutic approach that validates and advocates for the needs of sexual and gender minority individuals.

Affirmative therapy employs a positive and informed lens when working with LGBTQ+ clients, as it celebrates and validates their identities, as well as acknowledges the stigma and obstacles that these clients may face.

The opposite of affirmative therapy would be any therapeutic practice that aims to “fix” or change sexual and gender-diverse clients, or that judges or shames them.

Affirmative therapy is distinct from gender-affirming care. Gender-affirming care encompasses psychological, social, and medical care that supports an individual's gender identity. This involves a wide range of interventions, such as changing one’s name or pronouns, talk therapy, or hormone replacement therapy. Gender-affirming care has been shown to be effective and help improve well-being and life satisfaction.

When It’s Used

Affirmative therapy is primarily used to treat LGBTQ+ individuals, who benefit from therapy that takes into account a thoughtful, supportive understanding of gender and sexuality. Affirmative therapy involves an awareness of societal challenges like stigma and bias—which can result in stress, anxiety, and depression—and helps clients process and cope with those challenges, as well as mental health challenges not directly related to gender and sexuality, such as relationships, self-esteem, career, etc.

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How It Works

Sexual and gender minority individuals often face challenges of prejudice and bias, which can lead to a unique experience of stress, anxiety, avoidance, and other mental health issues. Affirmative therapy provides a supportive environment for patients to process those experiences while feeling confident that the therapist validates their identity. For example, a patient in affirmative therapy may discuss personal growth and exploration of their gender identity, or how external or internalized homophobia may have influenced them.

What to Expect

Patients should expect to discuss their experiences and address their mental health challenges with a therapist who is informed about LGBTQ+ issues and celebrates their identity. Validating their identity may take the form of using gender-neutral language, or being educated about homophobia or transphobia, among other elements.

What to Look For in an Affirmative Therapist

A good affirmative therapist is someone who is self-aware and self-reflective; they have thought deeply about their upbringing, their beliefs, and their potential biases. They are knowledgeable and educated about gender and sexuality. If something comes up in therapy that the clinician isn’t familiar with, they ask and maintain an open mind.

In addition to credentials and experience, it’s important to find a therapist with whom you feel comfortable. It can be helpful to ask a potential therapist about their approach. Questions may include:

  • How would they help with your particular concerns?
  • Have they dealt with these concerns before?
  • What is their process?
  • What is their timeline for treatment?