LGBT Affirmative Therapy
Tips for creating a more lesbian, gay, bisexual, transgender, & queer inclusive practice
from the AAMFT Queer Affirmative Caucus
Affirmative therapy is: Definitions
an approach to therapy that embraces a positive view of Lesbian, Gay, Ally – a member of a majority group to
Bisexual, Transgender, and Queer (LGBTQ) identities and works to end oppression
relationships and addresses the negative influences that homophobia,
Asexual – an individual who has no
transphobia, and heterosexism have on the lives of LGBTQ clients
significant interest in sexual activity
Adapted from Rock, M., Carlson, T. S., & McGeorge, C. R. (2010). Does affirmative training
matter? Assessing CFT students’ beliefs about sexual orientation and their level of affirmative Bisexual – an individual who is
training. Journal of Marital and Family Therapy, 36(2), 171-184. attracted to men and women
Cisgender – a person who’s gender
identity is in line with the gender
“…I want LGBTQ clients to know that I support them and
assigned at birth
their families. Being affirmative means I treat loving
couples, families, and transgender people with the dignity, Drag – involves the performance of
gender expression; not based on sexual
respect, and affirmation they deserve; they are fine just the
orientation
way they are.”
Gay – a man who is attracted to men
Gender expression- outward expression
of gender (clothing, mannerisms,
Being an affirmative therapist involves: activities, etc…)
1. Self-reflection – reflect on your own upbringing, attitudes and Gender Identity – a person’s deeply
beliefs; acknowledge areas of privilege; recognize bias stemming held sense of their own gender,
from living in a heteronormative and gender-binaristic society. regardless of what they were assigned
at birth.
2. Get involved – live an affirmative life; become familiar with the
issues; strive for social justice and social change. Gender non-conforming – people
3. Create an affirmative setting – provide LGBT friendly reading whose experiences, behaviors,
material, literature and resources; include affirming language on interests, or identities fall outside
all paperwork; use client’s preferred name; don’t resort to stereotypical gender expectations
heteronormative assumptions , instead ask about a client’s partner Gender roles – culturally defined
4. Be open about your commitment to providing affirmative therapy behaviors, attitudes, emotions, traits,
with all clients, regardless of sexual orientation or gender identity. mannerisms, appearances and
5. With heterosexual and/or cisgender clients, act as an advocate by occupations
challenging heterosexism and the gender binary. Genderqueer – a person who feels their
gender identity is outside the binary
Tips for Affirmative Therapists
1. Talk about your LGBTQ affirmative stance to colleagues, potential
clients, family, and friends. Definitions cont.
2. Be aware of your own heteronormative and gender normative
assumptions. Challenge oppression. Heterosexism – the presumption that all
people are straight
3. Know the LGBTQ resources in your local community.
Heterosexual/straight – a man who is
4. Acknowledge that each person has a unique story related to personal attracted to women; a woman who is
discovery and disclosure of their sexual orientation and/or gender
attracted to men
identity.
5. Know the differences between sexual orientation and gender identity Homophobia – irrational fear or hatred
of LGBTQ people
6. Using correct terminology. When in doubt about how to talk about
identity, ask! Intersex – a person whose biological sex
is ambiguous; not synonymous with
7. Ensure that intake forms include a blank option for gender and
acknowledge LGBTQ relationships. transgender
8. Access LGBTQ affirmative continuing education trainings and Lesbian – a woman who is attracted to
resources for clinical practice. women
9. Include gay and lesbian literature in your waiting area. LGBTQIA – an acronym for Lesbian, Gay,
10. Get involved in LGBTQ community events and activities. Bisexual, Transgender, Queer, Intersex
Ally or Asexual
Recommended Resources: Queer – a re-appropriated term for
people whose identities challenge
Bigner, J. J., & Wetchler, J. L. (2012). Handbook of LGBT- affirmative dominant norms related to sexuality
couple and family therapy. New York, NY: Routledge.
and gender
Bieschke, K. J., Perez, R. M., & DeBord K. A. (Eds.), Handbook of
Counseling and Psychotherapy with Lesbian, Gay, Bisexual, Sexual orientation – describes an
and Transgender Clients. Washington, DC: American individual’s attraction to another
Psychological Association. person
Chernin, J. N. & Johnson, M. R. (2002). Affirmative psychotherapy Transgender – people whose gender
and counseling for lesbians and gay men. Thousand Oaks, CA: identity is different from their assigned
Sage Publishing. gender at birth
Fish, L. S., & Harvey, R. G. (2005). Nurturing Queer Youth. New Transman or Female-to-male (FTM) - a
York, NY: W. W. Norton & Company. person who is biologically female, or
Deneborough, D. (2001). Narrative Queer Counselling and Narrative assigned female at birth and identifies
Practice. Dulwich Centre Publications. as male.
Lev, A. I. (2004). Transgender emergence: Therapeutic guidelines for Transphobia – irrational fear or hatred
working with gender-variant people and their families. New of transpeople
York: The Haworth Press.
Transsexual – a person who undergoes
Ritter, K. Y. & Terndrup, A. I. &(2002). Handbook of affirmative procedures to change their body to fit
psychotherapy with lesbian and gay men. New York, NY: The their gender identity
Guilford Press.
Transwoman or Male-to-female (MTF) -
World Professional Association for Transgender Health. (2011).
Standards of care for the health of transsexual, transgender, a personal who is born biologically
and gender nonconforming people. (7th ed.). male, or assigned male at birth and
identifies as female
