Seeking out a therapist is a mighty task.
Trying to find the right fit…
Availability that works for you…
Somebody who works with your mental health concerns…
An office that’s not too far away if you want to see them in person…
A therapeutic style that meshes with your needs…
And a financial investment that aligns with your wallet…
Now, add in being a queer person and searching for a therapist who won’t misgender you, spout homophobic conceptualizations, or actively vote against your rights to exist and love freely. Especially with knowing that the therapy field’s history is fraught with conversion therapy and a nasty tendency of pathologizing being gay as a mental illness…
Ugh. Help!
It can feel like there are a lot of stars that have to align.
It’s one thing to find a provider who’s friendly, but you want a provider who actively affirms your whole self, including your sexual and gender identity. Somebody who understands the extra stressors involved with living in this world as a LGBTQIA+ person. Somebody who understands the nuances of experiencing LGBTQ-related stress on the daily (psst, see the attached LGBTQ-related stress checklist if you’re wondering what it’s like to live in a world or spaces that taught you that who you are is wrong).
What is LGBTQ-related stress?
LGBTQ-related stress is the extra stress that LGBTQ+ folks face (on top of the usual stressors all humans face) due to societal anti-LGBTQ stigma and growing up and/or living in a society that stigmatizes LGBTQ+ people and communities.
Research shows that LGBTQ people face disproportionate rates of depression, anxiety, and emotion-based disorders, but it’s the LGBTQ-related stress that fuels the mental health differences between LGBTQ people and their heterosexual and cisgender peers.
Let me be clear: it is entirely normal and EXPECTED to feel anxious, depressed, or other types of distress in response to LGBTQ-related stress. However, it doesn’t have to be dealt with alone or without support.
Where LGBTQ-related stress shows up
If several of these feel familiar, that’s not a personal failing — it’s a predictable response to an unfair set of circumstances. This is exactly the territory LGBTQ-affirmative CBT is built to address.
What is LGBTQ-affirmative CBT?
Researchers at the Yale LGBTQ Mental Health Initiative developed LGBTQ-Affirmative Cognitive Behavioral Therapy as an evidence-based psychotherapy framework designed to reduce depression, anxiety, and substance use by addressing the specific impacts of minority stress and societal stigma.
LGBTQ-Affirming CBT is a skills-based treatment approach made for and by the LGBTQ community, with the ultimate goal of changing less helpful ways of coping and replacing those with more helpful ways of managing experiences.
There are 6 core principles that inform every session of LGBTQ-Affirming CBT:
1. Depression and anxiety are normal responses to LGBTQ-related stress
2. Early and ongoing exposure to LGBTQ-related stress can teach LGBTQ people powerful and negative lessons about themselves
3. LGBTQ people can be empowered to effectively cope with the unfair consequences of LGBTQ-related stress
4. LGBTQ people possess unique strengths
5. Genuine, authentic relationships are essential for LGBTQ people’s mental health
6. Intersectional identities can be sources of stress and resilience
This treatment builds on LGBTQ people’s strengths and resilience because LGBTQ communities have a well-endowed history of collective resilience, as well as personal strengths in the face of stigma.
How LGBTQ-affirmative CBT works at ChangeWell Psych
At ChangeWell, LGBTQ-affirming therapy isn’t a separate track bolted onto generic CBT — it’s woven into how we conceptualize a client’s whole story from the first session. We offer this work in-person in Charlotte, NC and via teletherapy across 43 states, for teens (13+) and adults.
Is LGBTQ-affirmative CBT right for you?
You don’t need a crisis to start. Many clients come in simply tired of managing LGBTQ-related stress alone. A free 15-minute consultation is a low-pressure way to see if this approach — and this team — is the fit you’ve been looking for.
[Schedule your free 15-minute consultation]
FAQ
Is LGBTQ-affirmative CBT different from regular CBT? Yes — it uses the same evidence-based CBT skills but applies them specifically to minority stress, internalized stigma, and identity-related experiences that generic CBT often misses.
Do I have to be fully “out” to start LGBTQ-affirming therapy? No. Affirming therapy meets you wherever you are in your process, including if you’re still exploring your identity or not out to everyone in your life.
Does ChangeWell offer LGBTQ-affirming therapy outside of North Carolina? Yes — ChangeWell provides teletherapy across 43 states in addition to in-person sessions in Charlotte, NC.
Aliya Saulson, LCSW, is a licensed clinical social worker at ChangeWell Psych specializing in relational trauma, loss, and boundary-setting, with a strong focus on LGBTQ-affirming care. [Learn more about Aliya →]
