When was the last time you felt truly seen in a therapy session?
For many LGBTQ folks, the answer is a heavy never. Therapy is supposed to be a safe place, but for some, it’s yet another space that doesn’t quite fit. Whether it's subtle assumptions, lack of cultural understanding, or outright bias, LGBTQ individuals often find themselves navigating extra layers just to get basic mental health support. And while lots of articles talk about finding an affirming therapist, very few dive into the less obvious hurdles — the ones that aren’t talked about openly, but still leave deep marks.
Let’s explore the common (and not-so-common) challenges faced in LGBTQ therapy — and more importantly, how to work through them.
1. Therapists With Good Intentions, But Limited Understanding
A surprising number of therapists claim to be "LGBTQ-friendly," but that label doesn't always hold up in practice.
Many clients report that their therapists seemed supportive on the surface, but lacked a nuanced understanding of LGBTQ culture, gender diversity, or intersectional experiences. According to a 2022 report from The Trevor Project, 60% of LGBTQ youth said they wanted mental health care but didn’t get it, and a major barrier was fear that the provider wouldn’t understand their identity or experiences.
Sometimes, therapists unintentionally ask invasive or inappropriate questions, like, “When did you decide to be gay?” or “Are you sure you’re trans?” These microaggressions, while not always malicious, can erode trust.
How to Overcome It:
Look for providers who go beyond just labeling themselves as “affirming.” Ask questions like:
“What kind of training have you had in LGBTQ issues?”
“How do you support trans and non-binary clients?”
At Wellman Psychology, we provide LGBTQ Counseling Chicago with professionals who are not only trained, but deeply experienced in navigating the complex layers of queer and trans identities.
2. Pressure to Educate Your Therapist
Let’s be real — therapy should not feel like a teaching gig.
Too often, LGBTQ clients end up spending valuable session time explaining basic terms or advocating for their identity. This emotional labor adds a frustrating barrier to healing. And it’s not just exhausting — it can also prevent progress, especially if your therapist doesn’t grasp the deeper cultural and historical context of your experiences.
How to Overcome It:
You deserve a therapist who meets you where you are. If you find yourself constantly educating your therapist, that’s a red flag. Try using directories like Psychology Today, Therapy for Queer People of Color, or directly contacting practices like Wellman Psychology, where LGBTQ knowledge is part of the foundation — not an afterthought.
3. Intersectionality Gets Ignored
Being LGBTQ is just one part of your identity. But in therapy, it often becomes the only focus.
What happens when you're queer and Black? Or trans and disabled? Or a gay immigrant navigating trauma? Too many therapists don’t account for how these layered identities interact. This leads to generalized advice and surface-level support that misses the core of what you're dealing with.
A 2019 study from the Williams Institute found that LGBTQ people of color experience higher rates of discrimination and poorer mental health outcomes, yet are the least likely to receive culturally competent care.
How to Overcome It:
Prioritize therapists who understand the concept of intersectionality and who actively explore how your multiple identities shape your mental health. At Wellman Psychology, our LGBTQ Counseling in Chicago centers the whole person, acknowledging race, gender, class, ability, and cultural background, not just your sexuality or gender identity.
4. Misdiagnosis Due to Gender or Sexual Identity Bias
Did you know that trans and non-binary individuals are more likely to be misdiagnosed with personality disorders?
That’s because some mental health professionals mistake gender dysphoria, identity exploration, or trauma responses for pathology. For example, a non-binary person navigating fluid gender expression might be wrongly labeled as unstable. These misdiagnoses can have long-term consequences, from insurance issues to internalized stigma.
How to Overcome It:
If a diagnosis doesn’t feel right, it’s okay to question it. Seek a second opinion, especially from someone with experience in gender-affirming care. Wellman Psychology’s clinicians are trained to differentiate between identity exploration and mental illness, ensuring you receive accurate, affirming support.
5. Reluctance to Discuss Relationship Structures
Let’s talk about polyamory, kink, open relationships, and chosen families — all common and valid in LGBTQ communities.
Unfortunately, many therapists still operate within a heteronormative, monogamous framework. This creates shame or silence around alternative relationship structures, which can be vital sources of support for queer and trans folks.
How to Overcome It:
Be upfront about your relationship dynamics and watch how the therapist responds. Are they curious and respectful, or do they seem judgmental? At Wellman Psychology, we recognize the diversity of queer relationships and provide space for you to explore them without shame or awkwardness.
6. Internalized Homophobia or Transphobia Isn’t Addressed
Sometimes, the biggest battle is the one inside.
LGBTQ clients may carry years of internalized messages about being "wrong" or "broken," especially if they were raised in religious or conservative environments. Unfortunately, some therapists avoid addressing these deeper wounds — or worse, unintentionally reinforce them by glossing over their roots.
A 2023 study in the Journal of LGBTQ Issues in Counseling found that internalized stigma was significantly linked to anxiety, depression, and suicidality among queer clients, but that affirming therapy markedly reduced these symptoms over time.
How to Overcome It:
Therapy should be a space where you can unpack all parts of your identity, including the painful bits. An affirming therapist will help you challenge internalized narratives and rebuild a sense of self-worth. Wellman Psychology’s LGBTQ Counseling Chicago service is designed to gently navigate these topics, fostering real, long-term healing.
7. Lack of Focus on Joy and Resilience
Let’s flip the narrative for a moment: queer joy, trans resilience, and chosen family are powerful, life-giving forces.
Yet, therapy often becomes focused on trauma, neglecting the vibrant, affirming parts of LGBTQ life. This not only reinforces a “broken” narrative but also misses opportunities to build on strengths and joy.
How to Overcome It:
Ask your therapist if they incorporate strengths-based or resilience-based approaches. Therapy should be about more than surviving — it should be about thriving. At Wellman Psychology, we celebrate your wins, honor your joy, and believe that mental health care should uplift, not just repair.
Summary
Therapy should be a healing, validating space, but for LGBTQ individuals, the path to finding that space can be filled with roadblocks. From cultural disconnects and misdiagnoses to overlooked identities and lack of joy, there are challenges that many don’t talk about enough. But the good news? There are ways through it. You deserve care that sees all of you, honors your lived experiences, and helps you grow, not just cope.
If you’re part of the LGBTQ community and tired of feeling misunderstood in therapy, it’s time to try something different. At Wellman Psychology, we specialize in LGBTQ Counseling Chicago that’s authentic, affirming, and culturally competent. Whether you’re navigating identity, trauma, relationships, or just life, you don’t have to do it alone. Our clinicians are here to support you, not judge you.
Reach out today and let’s start building a version of therapy that actually works for you.
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