I am often asked, “Do you work with same-sex couples and the LGBT community?”  My answer and response to this question is always an emphatic, “Yes I do!  I am very comfortable and proud to work with the LGBTIQ community.”  Perhaps as many as a quarter of the clients I work with identify as LGBTIQ.

So what does that mean I hear you ask… The acronym LGBTIQ is an expansion of the previously used term LGBT.  It represents those who are lesbian, gay, bisexual, transgender, queer and questioning, and intersex.

Despite changing cultural awareness and acceptance of diverse sexual orientation and gender identification, LGBTIQ peeps (of all ages) will often experience things like oppression, discrimination, bullying, rejection, and marginalisation differently.

Indeed, the narrative that the LGBTIQ community develops about who they are, and how they fit within society is sometimes echoed by other feeling states that include self-doubt, isolation, guilt, shame and dysphoria.  Prejudice and discrimination tells LGBTIQ folk that they are less important than their peers and this can lead to a sense of aloneness, a lack of confidence, “minority stress” (Meyer, 2003) and trauma.

This does not mean that all LGBTIQ clients will present in therapy with under-developed confidence or shame about their sex, sexuality or gender.  But many will present with some residual expressions of trauma simply because they have lived with a sense of chronic stress due to their position in society as a member of a minority group (National LGBTI Health Alliance, 2014).

When used in an inclusive and empowering way, words like lesbian, gay, genderqueer, bi, trans, queer, intersex, F2M, and gender-fluid are important cultural markers.  A little bit like seeing the rainbow flag flying proud at a new destination or stuck discretely in the window of a safe place.  Or perhaps it’s more like coming home, finding safety in the metaphor of words, their implicit meaning and a shared cultural narrative.  All of this because the words appear to dance on the page and say, “It’s going to be OK, I can really relate to what you’re feeling, thinking and trying to tell me”.

In addition to the above, a big part of the work I do with LGBTIQ clients centres around identifying survival and resilience strategies and working collaboratively to co-create new narratives and future goals that are less deficit-based.

Practitioners familiar with LGBT individuals find that their clients are usually quite tough, that they respond to hardships and personal tragedy with notable resilience, and are remarkably creative in devising ways of transforming hardships into opportunities (Smith & Gray, 2009).

In conclusion, while some LGBTIQ clients do indeed have identifiably unique experiences such as “coming out” to friends and community and “transitioning” from one gender presentation to something other, they can equally be reframed as “dropping into” and “coming home” experiences.  Implicit in both is a sense of process.  Both experiences are about finding ways to be more congruent, balanced and comfortable with the internal, external and in-between worlds that we inhabit.

Please don’t hesitate to share this post or leave a comment if the above resonates for you. Also, please get in touch if you would like to set up a session or chat about your situation.


Meyer, I. (2003). Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: Conceptual issues and research evidence. Psychological Bulletin, 129(5), 674-697.

National LGBTI Health Alliance (2014). Working therapeutically with LGBTI clients: a practice wisdom resource.

Smith, M., & Gray, S. (2009) The Courage to Challenge: A New Measure of Hardiness in LGBT Adults, Journal of Gay & Lesbian Social Services, 21:1, 73-89

Disclaimer: This article contains the views of the author and is not a replacement for therapeutic support. Please reach out to a registered therapist if you are experiencing distress and require assistance.