As I approached the front door of my new counsellor I began to get increasingly nervous. She looked kind, but what if she'd never worked with anyone like me before? How will I bring it up? Will it make her uncomfortable?
It had been a while since I had seen a counsellor, the last time was when I was just a teenager. Troubled by various issues, I had not experienced my sexuality as one of them. I was pretty sure about liking girls, and also about liking boys. Yet when my counsellor assumed I was heterosexual, something told me that this was not a safe space for me, I shut down and stopped going to the sessions.
Years later, I found myself in an unconventional relationship, this time it was not just my sexuality I feared judgement around, but my relationship. I tentatively approached the new counsellor, 'do you work with clients who are diverse?' I asked. I can't recall what she said but it was enough to tell me that it was worth taking a chance on her. This therapist listened well and used her counselling skills of empathy and congruence to help me feel comfortable and safe. I experienced her as genuine and in those moments, I talked about my life, for the first time I did not feel judged. This meant everything.
Years later, I would train to be a counsellor myself, acutely aware of how precious a space is where we can talk about our life and feelings without feeling judged. Even with the best intentions, friends, family and colleagues don't always provide that space. To be able to speak freely without interruption, without self consciousness and to know that what is said will not be shared or come back to haunt us at a later date, is priceless. To have a space to explore what we really feel rather than how we 'should' feel is deeply valuable. It seems, only in those moments where we can explore our thoughts and feelings safely, can we find the answers we need.
Now qualified and working in private practice, I specialise in the area of gender and sexuality. This means I am pretty explicit in welcoming people expressing gender and/or sexuality diversity. As such, I have worked with clients of many different gender identities and sexual orientations. Some came to therapy to explore their gender or sexuality and others just want a counsellor who 'gets it' so they can get on with exploring the various issues that brought them to therapy. I've been surprised by how far people often travel to sessions, with many journeying across the country. It's become clear to me that perhaps there is a need that is not being met.
Approaching a new counsellor is always a risk and takes time, energy and often money. Understandably clients want to get the right counsellor straight away. If it's not clear a counsellor is open to working with clients who are gender/sexually diverse then many LGBT people won't take the risk. It's important to bear in mind the factors that often impact on LGBT people accessing therapy. (Trans) Gender and (homo/bi) sexuality has historically been pathologised with a history that includes reparative/corrective therapy being used against LGBT people.
Many of us who grow up LGBT unfortunately learnt through bullying and institutionalised heterosexuality that our gender and sexuality were not something to express but rather something to hide. Many of us hid in our lives to protect ourselves from harm, and many continue to do so - still traumatised by our formative experiences, or simply unable to come out . You will notice the high rates of social anxiety and depression in LGBT populations. We internalised homophobia, bi-phobia and transphobia and this then turns to shame. We learnt to see ourselves as 'different' and even 'weird'. This self-perception and for some, repeated rejection, kept us from connecting with others. Factors such as racism, sexism and ableism further impact on connecting. Many of us have been deeply wounded through relationships and we bring this to therapy.
These are not of course everyone's experiences but this picture is far too common. We need to be open to this possibility as we create the space for our clients to tell us their stories.
LGBT people bring a variety of topics to therapy including common experiences of navigating relationships, experiencing prejudice, and anxiety around 'coming out'. Clients who are trans and medically transitioning may share frustration and even distress around the very long waits of the gender identity clinics. Others share with pleasure a positive experience of 'coming out' or 'passing' for the first time. Alternatively, clients may not experience their gender or sexuality as an issue and have come to talk about other issues that they wish to address.
What is important is that LGBT clients know that they are safe and welcome just as they are, that their gender or sexuality is valid yet only a part of them. They are safe to be themselves, to talk about their relationships. A therapist does not have to be LGBT to provide a safe space for clients exploring or expressing gender and sexual diversity. Nor do they need to know all about LGBT lives to do great work. Compassion, empathy and kindness go a long way.
In my own work, I feel very privileged to work with clients expressing gender and/or sexual diversity, it's a great honour to feel trusted by those clients for whom trust may not come easy. To share the experience of people feeling comfortable enough with you to express their true selves. To watch people heal, explore, grow and be a part of that journey is joyous. Indeed, to see people determined to live authentically despite sometimes overwhelming obstacles this is deeply inspiring.
Debbie Clements delivers Counselling, Psychotherapy, Training and Consultancy in the area of Gender and Sexuality. This work is informed by a Masters degree in gender and sexuality, personal experience and supporting LGBT+ people of all ages through Youth and Community Development (JNC).
If you would like to speak with Debbie, you can contact through via her website: