Choosing a Lesbian, Gay, Bisexual-Affirming Therapist

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LGBTQ Healing: Choosing a Lesbian, Gay, Bisexual-Affirming Therapist

Adapted from Bernice Goodman, “Out of the Therapist Closet,” in Hilda Hidalgo & Travis Peterson (Eds).

NASW Resource Manual on Gay and Lesbian Issues

Updated to include trans* information

  • What extent of knowledge does the therapist have about lesbian, gay, bisexual, transgender culture?
  • How long has the therapist been working with LGBTQ clients? How many LGBTQ clients has the therapist worked with?
  • What type of training does the therapist have in working with LGBTQ clients?
  • How much understanding and knowledge does the therapist have about racism, sexism, and homophobia/biphobia/transphobia in society?
  • What is the therapist’s knowledge of and commitment to issues of diversity among LGBTQ persons and culture?
  • Can the therapist constructively challenge self-oppressive attitudes and internal biases with clients and also help to create and support new, healthy ways of being?
  • Is the therapist a visible part of the LGBTQ community?
  • What feelings do you have of this person? Is there a feeling of trust and safety? Would you feel comfortable in participating in therapy with this person?
  • Does this therapist understand the effects of institutional homophobia, biphobia, and heterosexism, trans* biases and ignorance upon LGBTQ people?
  • Can this therapist recognize the differences between appropriate behavioral responses related to societal oppression and the unique psychological difficulties that a LGBTQ person may be experiencing?
  • How well does the therapist acknowledge the impact of socially defined gender roles on an LGBTQ individual’s sense of self?

If you have additional questions about or feedback about this article, please feel free to contact me.

Partial Source


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Genderpath Newsletter Archive – October 2008

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Pathways Newsletter Oct 2008

An affirming newsletter for the gender variant community


In This Issue
Gender Identity
Community Events
In The News
Families In Transition
Join Our List

Join Our Mailing List

Gender Identity

& the DSM



DSM IV Committee on Gender Identity Disorder

The Diagnostic and Statistical Manual of Mental Disorders is undergoing its revision for publication in 2012. The Medical Model used in the DSM is the reference for Mental Health Professionals to diagnose mental illness. The DSM in its current version categorizes Gender Identity Disorder and Transvestic Fetishism (Crossdressing) as a mental illness. Much in the same way that homosexuality was classified as a mental disorder up until its revision in 1973, the DSM serves to label individuals who do not conform to the cultural requirements of a binary system with mental illness, and fails to recognize that the individual is being burdened with marginilization for failing to conform, rather than recognizing the limits of a binary gender construct.

Under current standards of care in the Medical and Psychological Fields- this diagnosis is required in order to attain the needed “treatment”, which is usually transition in some form. However, insurance companies do not reimburse for these treatments and transition further jeopardizes the individual’s access to medical care.

In my professional experience, I have found that most of my clients who are exploring their gender identity and expression seek help to deal with the effects of being a person who does not conform to the gender binary (male or female) rather than the question of gender itself. My clinical approach is in aiding each person in their pursuit of authenticity and freedom from suffering. I have learned from my clients that gender identity is about our humanity at a psychological, soulful, and emotional level. And that the right to pursue the necessary medical and therapeutic support towards authentic and self determined gender expression is a fundamental civil right.

Professionals Concerned with Gender Diagnoses in the DSM urges all trans-supportive medical and mental health practitioners and researchers to write the APA DSM-V Task Force and request that the Sexual and GID Work Group be expanded to include more affirming views of gender diversity and transition care.
For more information, contact
Kelley Winters, Ph.D.
GID Reform Advocates
A web resource providing specific recommendations for nomination with biographical information and sample letters.


Community Events

we are familyMeet & Greet for Partners of Trans Folk

Alexander Yoo, co-sponsored by GenderQueer Revolution, with the support of many other community members, is hosting a meet and greet for partners of trans folks.
When: Thursday, October 30, 7:15-9:00 PM
Location: 6310 San Vicente Blvd., Suite 410, 90048.
· Light refreshments
· Guest speakers
· Space for YOU

Come meet other Partners and Significant Others. Hear others’ stories, maybe share your own. Please RSVP by calling Alexander at (310) 773-3484, and for directions.

Light refreshments will be served. A fun opportunity to socialize with other PARTNERS and Significant Others of MTFs, FTMs, and other gender-gifted folks.

Models of Pride LGBTQ YOUTH Sponsored by PROJECT 10

When: Saturday November 1,2008
Location: Occidental College -L.A.
Event Directions

The only one of its kind, Models of Pride was created by Friends of Project 10 Inc. in 1993 as a means of providing a safe and positive environment where LGBTQ youths could be themselves, network with each other, and expose themselves to new ideas. Conference programs include a wide variety of workshops covering such topics as dating, coming out, stereotyping, student activism, cultural and religious issues, healthcare issues, and much more.


Issue: # 1 Oct/2008

footprintsWelcome to the October edition of PATHWAYS. I hope as you read, you will come away with both inspiration and information. If you have any comments, questions, or ideas for future newsletters, feel free to contact me here.



“Wherever we look upon this earth, the opportunities take shape within the problems.”

-Nelson A. Rockefeller

In The News

Stand Up and Be Counted:

National Survey Launched by National Center for Transgender Equality and National Gay & Lesbian Task Force
An important national Survey is currently underway in hopes of documenting the multiple stressor and sources of oppression and violence against gender non-conforming people. This research is an important component to establishing data to argue for reform on behalf of the gender variant community, and to raise awareness of the continued fight for civil liberties within the trans community. The data gathered will assist our community in pressing for policy reform in our health-care, academic, legal, and political institutions.

All transgender and gender non-conforming people are urged to participate in this research by completing a brief, confidential and electronic survey compiled experts in social research, transgender advocacy and policy reform.

Click here to participate in the survey.



Our families are a place of refuge and comfort. But they are also a place of well known roles and ways of relating. Partners create roles and expectations for each other in a delicate dance of intimacy and love. And children grow into roles that are well worn by the time they reach adulthood. These ways of being and relating as a family create a kind of homeostasis-a settling into the familiar and the known which we seek to continue. Even when our family homeostasis isn’t working or healthy-we will unconsciously resist changing it.
But the only constant is change. And healthy families are also capable of adapting to new circumstances, stressors and challenges.

redwoodsThere are few events in a family that can match the impact of a Transgender person coming out. So how is a family to adapt to the radical change that comes with gender transition? What are the hallmarks of a family that is capable of making the journey of gender transition -to find a richer sense of family and belonging?

Communication and Deep Listening
The family system, like any system, strives to maintain a kind of balance within itself. Healthy family systems are cohesive. Meaning, there is a sense of working together, closeness, and connection. Communication is an essential part of this level of health. Conflict is not suppressed. The family has healthy ways of resolving disagreements and restoring a sense of safety. Family members listen with empathy to each other. This means that as we practice deep listening-we are seeking to understand the experience of the other, rather than focusing on what we imagine that experience is or should be.

Most families have some combination of strengths and weaknesses. Under stress-the weakest link can often be communication and deep listening. We stop listening to each other when we feel threatened, afraid, angry and hurt. These emotions can hijack us and derail effective communication. I coach families and couples in conflict to use methods of slowing down their communication, focusing on one issue at a time, taking time outs and using writing as a means to improve understanding. By using these methods-emotions can be cooled off-so that we can make a more mindful response.

It helps tremendously if the transgender family member has done a lot of work to prepare for their disclosure so that they are less easily hijacked and can devote their energy to staying open, providing information. By the time the disclosure is made, they know how to take care of themselves and they have sufficiently dealt with their fears so that they are not center stage.

Grieving Our Losses
Of course all healthy family systems can experience changes and traumas that rock it to its core-a move, a marriage, a birth, a death. Change has elements of death and birth. There is a before and after.

When I work with family members who have a loved one who is coming out to them as transgendered-there is this kind of unsteadiness and disorientation that comes with grief. Mothers and Fathers say to me “How will we___?” And the question is really – “How will we be the family we were?” It’s as if this person, who has revealed their carefully held secret, and uttered their truth but still lives-is dead. Nothing will ever be the same. And its true, it won’t. What endures beyond the grief? Love.

For families in transition, healing doesn’t mean returning to the old way of being. Healing means integrating and moving ahead with what is now the new normal-having grieved the losses and learned the lessons that these changes tend to bring to us.

Facing Pain
It’s in our nature to avoid pain and seek pleasure. In the face of change that we do not welcome, we cling to the past. This can create a kind of toxic resistance to the growth and adaptation that could bring healing. Why? We fear pain. At some level-when we are in pain-it is because we are resisting what needs to come forth in our lives, our children, ourselves. We believe that by resisting-we can stop it, turn the clock back, change it. This belief seems to promise protection from the pain we fear we cannot survive or tolerate. Paradoxically however, this “protection” tends to bring us more pain than it prevents.

Many family members of people in transition often ask me, wouldn’t it be less painful for my loved one to accept who they are? Aren’t you as their therapist be doing them a dis-service to encourage them and support them in such a radical act? How is it healthy to support a process that includes possible rejection, physical and emotional pain, family conflict, and tremendous emotional strain, if you could avoid it.

For families of loved ones in transition, this question is the first hurdle for understanding. Yielding the assumption that a) their loved one would be in less pain by remaining as they are (in their biologically conforming gender role), b) that the pain of change is greater than the silent misery of entropy. At this point, I explain to the family that maybe for the first time in their lives, their loved one is accepting themselves for who they are. They have been carrying a hidden burden, a pretense, a lie, that is literally, at times, threatening their life. And our perception of who they are, is not in reality, who they are.

And thus begins the long strange journey of deconstructing the social construct of gender as we have been accustomed to understanding it. The mental demolition of a bias we didn’t know we had.

Love and Fear
In my work with the gender gifted-one of their greatest fears and primary reasons for having hidden their true feelings for so long-is their fear of losing their families. Similarly, family members agonize over the loss of their loved known as the son or daughter they have known and loved in the past and the imagined future. The ties of family are an integral part of our identity. Transition becomes a family life cycle event. The family is on a journey as well as the family member who is undergoing transition. The family will be in chaos, grief and then restabilize itself as the assumptions, the dreams, the expectations-all must reorganized. The roles and relationships will be reworked while incorporating this new gender expression. Perhaps the daughter will now be the son. She, will be he. Perhaps the husband will be a female partner, a wife and mother. These are radical shifts. And yet, not so much. These are the labels, layered in bi-nary gender pronouns, that we attach to child, person, partner and parent.

I have been continually amazed to witness the ability of families to embrace their transgendered sons and daughters, partners and parents, sisters and brothers. This of course takes time and careful and thoughtful work on the part of all concerned. My role as a therapist in the family experiencing the birth pains of transition-is to facilitate growth through a process of education, communication and relationship work that enables the family to move through this complicated terrain. I am part teacher, part mentor, part confessional. For many of my clients-there are long periods of time when I am the only witness to their story.

The one ingredient in these families that is more crucial than all the rest? Love is greater than fear.

For more resources for families in Transition-please visit my website:


lisa - headshotBe well and happy,

Lisa Maurel, MFT


Next Month:

Gender 101: The Binary and Beyond;

The Harvey Milk Story

- movie review


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