Finding a Queer Affirming Therapist

If you don’t know where to start or need help figuring out how to find a therapist who understands your unique needs as a survivor, someone who can see multiple parts of you—especially your LGBTQ+ identities—this guide is for you!

Who am I? 

I am a White, able-bodied, neurotypical, transgender woman in my 30’s. I’ve been working as a psychotherapist for around seven years. Over the last three years, I’ve specialized in working with people from the queer community. Often the people I see have a history with trauma. I am writing this from my perspective as both a queer person and a psychologist.

Throughout this guide, I use the term “queer” to stand in for the broad range of identities in the LGBTQ+ community. It certainly isn’t a term that works for every group or every person, and I recognize that. I use specific examples to highlight different identities, and I am aware that not everyone will feel seen in this article.

PLEASE NOTE

Even though a therapist can help you with your mental health, the right time to look for one is not while you’re in crisis. You’ll get better, faster help by calling a lifeline like RAINN’s National Sexual Assault Hotline, 988, Trans Lifeline, or for those 25 or younger, The Trevor Project. Many of these organizations also offer text or chat features for people who feel uncomfortable or unsafe making a phone call. 
 

Step 1:  Consider Your Needs 

Why Is Queer Affirming Therapy Important to You?

There are a variety of reasons that people pursue therapy, and your individual reasons will be  the best guides on your therapist selection quest. Consider: Do you want a therapist who is experienced in working with queer people? Why? Is it hard for you to trust straight or cisgender people? Do you have an issue you feel only another queer person could understand? Perhaps you’ve been in therapy before, but the experience was negative or lackluster. Or maybe you’re completely new to therapy, and you’re nervous to take the plunge. These reasons are all valid, and I encourage you to keep them in mind as you move through the process—you want to find someone with the right vibe. 

After determining why you want to work with a queer-affirming therapist, the next step is to think about the other factors that are important to you.

Therapy + Intersectionality

One important factor to consider when getting ready for your search is intersectionality, which refers to how your multiple identities overlap to change the way that you and your world interact. For example, a bilingual gay latino man might prefer a therapist who can speak both Spanish and English, allowing him to express everything he is thinking with less fear of being misunderstood. An autistic transfeminine person might want to see a therapist who has experience working with autistic people. A fitting therapist for this you will likely be able to accommodate your specific needs, like being COVID-conscious or being available on your day off of work. 

Types of Therapy

The most common type of therapy is talk therapy, which often looks like sitting in an office (on a couch or comfy chair) or calling in from home at your computer. I’m a talk therapist, so I’m speaking to what I know. Talk therapy is not the only way to do therapy, and there are plenty of other types of therapy that might be helpful to you. Some other modes of therapy to consider include art therapy, dance/movement therapy, music therapy, equine therapy (do you love horses?), yoga, EMDR, or trauma-informed massage therapy and acupuncture.

Groups

Group therapy or peer support groups can be incredible options for services, and often can feel more approachable. Group therapy may include some of the other modes of therapy I mentioned above—sometimes in the form of workshops. Note: Read all the information about workshop experiences carefully; some spaces are structured and led by trained professionals, while others are much more open-ended and led by people in the group. 
 

Step 2:  Understand What You’re Working With

Navigating Insurance [Ugh] and Finding Resources Are [No] Fun.

An unfortunate reality of living in America is the need to deal with the confusing messes that are the healthcare and insurance industries. Healthcare terminology often seems designed to be confusing, and figuring out insurance coverage can be super frustrating. For a relatively “quick” (and extremely silly) primer on insurance and healthcare terms, I like internet funnyman Brian David Gilbert’s “A Terrible Guide to the Terrible Terminology of U.S. Health Insurance” 

Private Insurance

Having certain kinds of insurance can make a big difference in which therapists will be accessible and/or are affordable to you, though some therapists are “private pay only”—meaning they don’t accept insurance at all. Also keep in mind that some types of therapy are rarely covered by insurance, regardless of how comprehensive your plan might be.

The absolute best way to determine (1) how to see a therapist under your insurance, (2) what your insurance covers, and (3) what you can expect to pay from seeing a therapist is to call the number on the back of your card. Asking specific questions around what you need can save a lot of trouble later on. Insurance websites also include lists of providers (and drugs, and procedures, etc.) that will work with your specific plan. 

Public/Specialized Healthcare Programs

If you have medicare, medicaid, military or VA (Veterans Affairs) benefits, you’ll need to use those systems instead of the private insurance system. While the wait for care may sometimes be longer, there are excellent people working in these systems that can and will do great work for you.

Using Other Resources

Many colleges, universities, and employers have free, limited access to therapy that can help get the ball rolling for you. I encourage you to check with your college counseling center or your job’s “employee assistance program” (EAP) for services offered for free because you are a student or employee. In addition, family, chosen family, and even some community organizations can sometimes be sources of financial support if you are comfortable asking.

Ask About a Sliding Scale.

I’d like to give you a code phrase to unlock more affordable rates from many different therapists: “Sliding scale.” Sliding scale (sometimes called “reduced fee”) is therapist lingo for a way of seeing clients who don’t have the insurance or the financial resources to afford them otherwise by reducing the cost for those clients significantly. Our ethics codes encourage us to keep a few reduced fee slots open (if we can afford to) as a way of increasing access to our services! For example, there is a movement among therapists right now to provide more services (such as gender-affirming surgery letters) for free in order to eliminate barriers to a better life. 

Not all providers who offer sliding scale pricing advertise it, but it’s my experience that having the right fit with a client can be worth more than a few more dollars per session in the long run. If you really like a therapist you do a consultation with but don’t think you can afford them, ask if they have a way to reduce their fee! The worst that can happen is that they will say no. Be prepared that you will likely be asked to fill out a form about your income in order to access free or lower price options.
 

Step 3:  Shop Around

Now that you know what you’re looking for and what you have access to, it’s time to start shopping. I would also strongly recommend preparing answers to basic questions about you and your (non-trauma) history in advance. When you begin contacting therapists and setting up intake appointments, you’ll need to be able to list things like:

• Your age
• Chronic medical conditions
• Past therapy experiences/hospitalizations
• Medications or prescriptions that you take
• A brief sentence or two explaining why you are considering therapy 
• A few things you are looking for in a therapist based on your needs 
  (for example, a queer affirming, trauma-informed, talk therapist)
• Your insurance info and how you hope to pay

Writing down a little script for yourself can make phone calls or internet forms easier to fill out. Plus, it has the added benefit of helping you see all your needs and basic information at a glance. 
 

Vibes Matter.

Reading individual therapist profiles or website bios is really important for helping you determine goodness-of-fit. A therapist’s online profile is often both your first impression of them and the place where their personal style comes through the strongest. They have around 300 words to sell themselves to you—pay attention to what they choose to center. 

• Look for therapists who center their own queer identities or allyship 
• How do they describe their therapeutic approach? Do they talk specifically about how they hold space for trauma?
• What is the tone of their bio like? Do they seem funny, serious, generic, poorly-organized? 
• Go to their practice website and see how it looks and functions. Are they part of a giant organization or are they a one-person operation? 
• See if they have any photos or videos of their space (not stock images!). 

You can learn a lot from “vibe-checking” therapists this way. Someone who might seem good on paper may have a few details that really put you off. That’s ok, this is your decision, and you don’t have to pick anyone that you can’t see yourself sharing intimate details of your life with.  Vibes really do matter! Even a therapist who doesn’t meet all of your criteria or has less experience can be amazing for you as long as they can do the basic tasks of therapy well and you feel comfortable working with them.
 

Create Your Shortlist.

Start with Recommendations. Some of the best resources for your search can be your friends, family, and other survivors. Chances are, someone you know is seeing a therapist they really like and can recommend a practice for you to check out. It may feel uncomfortable to ask for help in this way, but it’s my experience that people receiving good care are often enthusiastic about helping others find good care as well. If you’re comfortable with it, you can ask a therapist in your life or ask one of your friends to ask their therapist to give you some recommendations. If you’re in a group text, Facebook group, or Discord server that is affirming to you, consider asking in that space too.

Check Therapist Databases

There are a variety of online databases to search. They might appear overwhelming, but use filters when searching them based on the factors you identified earlier. For example, there are thousands of therapists in Chicago, but those numbers become much smaller and easier to search when you filter for “female,” “trauma and ptsd,” “LGBTQ,” or “Spanish-speaking” therapists. The most-used database for finding a therapist is psychologytoday.com, which is solid, but very general-purpose. Goodtherapy.com is another similar site. You can also use Google Maps to find practices or agencies near you that specialize in what you’re looking for. 

Look at Community + Healthcare Programs 

If you’re uninsured and not part of another health program like Medicaid, there are many options for you. Try openpathcollective.org or therapyaccessproject.org for databases of therapists who are dedicated to reduced or no-fee services. Look for “community mental health centers” or “LGBTQ health centers” in your area and then go to their websites or physical offices to see what kind of programs are offered. Community sites are usually dedicated to seeing everyone who applies, but might have long waitlists. Some LGBTQ centers have drop-in services or free therapy groups for you to utilize.

What do Letters, Licenses and Certifications Mean?

You’ll see a variety of degrees and certifications after a therapist’s name, such as LPC, MAATC, or PhD. These acronyms are practically gibberish to people not working in the mental health industry. The best way to figure out what they mean is to Google them.  Below is some helpful information to identify specific skill sets and decode the credentials of individual providers.

PhDs + PsyDs 

The most common doctoral degrees are PhDs (doctor of philosophy) and PsyDs (doctor of psychology), which are degrees for clinical and counseling psychologists. These generally take a long time to earn, and doctoral programs have some of the most in-depth training of single degrees. 

MSWs + Other Master’s-Level Therapists

Most therapists have earned a Master's degree (a postgraduate academic degree awarded by a college or university). Some examples of their professional titles are MSW (master of social work), LMFT (licensed marriage and family therapist) or MAATC (master of arts in art therapy counseling). These degrees are generally faster to earn than doctoral degrees. Master’s-level therapists often have more work and/or life experience than doctoral-level therapists of the same age. 

Licenses  

All “traditional” therapists must be licensed after they graduate, which means passing an exam or two and often completing some kind of internship. You can feel confident that any therapist with a degree and a license has been vetted extensively by their school and licensing board. 

Certifications  

On top of having degrees and licenses, many therapists also have certifications, which are additional training of various lengths, usually related to a specialized type of work they want to do. Someone who is EMDR-certified, for example, is trained to deliver the eye movement desensitization reprocessing technique in their sessions. Once you start talking to therapists, you can ask them about what their degree and certifications mean to them and how they affect the way they would work with you.

Pre-licensed Professionals 

During your search, you will encounter “pre-licensed professionals”. These are students currently pursuing their degrees and can offer some of the most accessible therapy options. They are often cheaper or even free to see. Often, these therapists have less experience than actively licensed professionals. Because of this they are required to be supervised by another therapist with a license who provides important guidance and oversight–they are never doing work completely on their own. Pre-licensed professionals often leave their job within the span of a year to graduate or head to their next training job. I was a pre-licensed professional for about seven years, and I was actively working as a therapist for about five of them. 
 

Step 4:  Reach Out.

With your shortlist created, it’s time to start reaching out directly. For some, this might be the most stressful part of the process, but at least it’s the shortest. You can do a lot of things to simplify and streamline this process for yourself. You can use a script when you leave a voicemail or write an email, and when it comes time to fill out a form, just refer to the information you wrote out earlier for easy reference. 

Here is a sample script:
“Hi, my name is Jo, I use they/them pronouns, and I’m looking for a therapist to help me process my trauma. On your profile, you mentioned that you do movement work, and I think you might be a good fit for me. I would be paying for therapy out of pocket. Do you offer sliding-scale options? I am available for a consultation most evenings except Thursdays and Saturdays. My phone number is [number], my email address is [address]. Looking forward to hearing back soon!”

Consultations

Most professionals in private or group practices should offer a free consultation or put you in contact with an “intake coordinator” who will tell you more on their behalf. Consultations are usually over phone or video and last 15-30 minutes. These conversations might feel too short, too intimate, or too much like a job interview, but they’re really just opportunities to see if you feel comfortable working with that therapist. After all, if they are job interviews, you are the interviewer! 

Write out your questions beforehand and ask as many as you can. For example:  

• What is their experience and approach to working with survivors? 
• How do they work with the queer community? Consider using some terms or info from your queer community. 
• How do their own identities impact their work? 
• Are they more focused on listening or do they prefer to do activities?
• Follow up on anything good or bad you saw on their profile. 

It won’t be possible to learn everything you want to know in such a short time, but 10 minutes of asking a few questions can make a massive difference in how you see someone. Pay attention to what they say, but also how they answer questions. Do they seem knowledgeable? Thoughtful? Humble? Authoritative? Vague? Silly? Do they recognize the terms you're using or ask you to explain? Pay attention to how the therapist responds to you sharing any intimate details you choose to provide. If you don’t feel seen by them or they seem to be missing the point somehow, that’s your sign that they’re failing their interview!

The therapist will ask you questions too, and although most of them should be simple to answer, some might be more difficult. Ideally, a free consultation should not be triggering. You should be prepared to share a very basic overview of your story, and it’s up to you if you want to share any more than that. Saying “someone harmed me when I was in college” or “I am a survivor of sexual trauma” should be enough information. 

Yes. No. Maybe? 

No matter how the consult goes, you’re gaining useful information and moving through the process. If the consult goes really poorly, you have successfully eliminated someone from your search. If it goes ok, you can take some time to think about it and compare it to your other options. If it goes really well, great! You can usually make an appointment right then. Sometimes, a therapist might seem like a good fit, but not be taking clients at the time. Ask if they have a waitlist or if they can refer you to other providers that you might work well with. All therapists know other therapists, and providing referrals is an ethical responsibility of ours.
 

Step 5:  Try it Out. You’re Not Locked in, You Have agency!

The First Session(s).

Congratulations on (almost) choosing a therapist! For your first session, consider meeting in person, even if you plan to ultimately be virtual; this can help you gather more information in a shorter time. It’s perfectly acceptable to do a first session with multiple therapists to test them out before making your choice. Just because you chose to book a session with a therapist doesn’t mean they are the perfect pick for you. Even if you have found someone you like, the early sessions may not feel like therapy at first. They are gathering information about your life, and it’s part of the process. After around three sessions, you should be able to see their style come out.

It’s ok to change your mind. 

Don’t be afraid to pull the plug and fire your therapist if they do something that makes you feel scared, disrespected, or unsafe. Trust your intuition! It’s normal for your therapist to make mistakes, but there’s a big difference between a therapist who misgenders you once and quickly corrects themselves and a therapist who never seems to understand what your pronouns are at all.

Thank You

My genuine hope is that after reading this guide, you feel empowered to look for your next therapist. Making a decision can feel hard and overwhelming. By using your resources, asking for a little help, and being patient, you’ll find there are plenty of wonderful, talented, accessible, and affirming therapists out there. Let your values and intuition be your guiding stars, and you’ll be able to find the care you need and deserve.

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