Mental Health

Questions and Answers about Bisexual, Transgender, and Questioning (LBGTQ) Youth and Their Families

Being gay is not a mental or physical disorder. And being gay, lesbian, bisexual, or transgendered, or questioning your sexual orientation or gender identity, does not mean you need counseling or therapy. Nevertheless, given the hostility and oppression that gay people often encounter, and the homophobia that is present in our society, it should come as no surprise that gay people and their families may seek counseling to overcome depression or mental distress. Here are some questions and answers on this subject.

Do all LGBTQ youth need therapy or counseling?

No. However, therapists can often help to clarify issues that LGBTQ people may have about their sexual orientation or gender identity. In 1973 the American Psychiatric Association, the largest organization of American psychiatrists, removed the term “homosexuality” from its official manual that lists all recognized mental and emotional disorders. People are not mentally unhealthy by virtue of being gay.

Should parents and family members go to therapy or counseling?

Family members of gay people are also just as psychologically healthy as the rest of the world. But, when a person comes out, his or her family may become upset or experience a period of grief or sense of loss. These feelings may interfere with family relationships or cause other problems. Support groups like those provided by PFLAG, may help. Support groups help family members feel less alone with the unfamiliar, and provide a place to talk about feelings and anxieties with other families in similar situations. If feelings of frustration, anger, loss or grief continue, or if other issues interfere with daily life, it may be useful for family members to seek counseling or therapy, individually or as a group.

Can therapy or counseling, or medical treatment change sexual orientation?

No. The American Psychiatric Association, the American Psychoanalytic Association, and the American Psychological Association, the American Academy of Pediatrics, the American Medical Association, as well as many other professional organizations all agree that reparative therapy or so-called “conversion therapy” has not been able to change a person’s sexual orientation. The American Psychological Association finds many problems with most “ex-gay” organizations and “reparative therapy” practices because most of these programs come from an ideological perspective that condemns homosexuality. The majority of professional health organizations warn against “reparative therapy” because many groups claiming to be able to change sexual orientation don’t provide a professionally neutral environment and their methods of treatment interfere with the clients/patients’ right to un-biased treatment and self-determination. In fact, the American Psychiatric Association cautions against “reparative therapy” because it is not only ineffective, but also potentially dangerous to the mental health of the client.

But some people appear to change. Why?

There are at least two reasons, maybe more. For some people sexual orientation is not an either/or thing. Their sexual orientation may vary over time and in response to circumstances. Society makes so many judgments and imposes so many negative consequences for being GLBT that understanding and accepting one’s sexual orientation or gender identity can be difficult and take time. Some people need to experience one or more partners before understanding their true feelings. One’s sexual orientation does not change because one wishes it, or because someone else wants you to change, or an authority figure says you should change.

Then, people can always change their behavior. And doing so may appear to others as a change of orientation. But sexual orientation refers to who you are attracted to, which is not always the same as who you are being sexual with. However, it is clear that when people chose to act in ways that do not reflect their true feelings, they often suffer psychologically.

The American Psychological Association’s Answers to Your Questions About Sexual Orientation and Homosexuality

How can counseling/therapy help gay people and their families?

It is important to recognize that because of our society’s attitudes about sexual orientation, many gay people face conflicts and hassles, stigmatization, violence and discrimination on a daily basis. These things are factors that contribute to depression, anxiety, and the development of mental health disorders. And many gay people, and their friends and families, seek the help of mental health professionals to better deal with problems associated with this intolerance. Support groups and counseling can also help gay people and their family members alleviate feelings of isolation, anger, sadness, and poor self-esteem. Group therapy can help families better understand their loved ones’ coming out process and work to resolve conflicts associated with coming out.

How do I, as a parent, search for a counselor or therapist specializing in the needs of LGBTQ youth?

First of all, you should consider whether or not your child needs or wants therapy, remembering that some LGBTQ youth may not need to see a therapist or psychiatrist. Consult your child’s doctor and ask him/her about therapy and, if advised, what type might be appropriate and whether your child needs to see a psychologist, a psychiatrist, counselor, or another professional. You can also contact any of the organizations listed below, and they will help answer questions you may have and may also help with referrals. If you are comfortable talking with other parents who understand what you are going through, attending a PFLAG parent support group is a good way to meet other parents and get some advice about where to start your search. If your child is unwilling to see a therapist and you still feel that it is necessary, you may want to see a therapist yourself with an agreement to match your child visit for visit. This gesture of understanding will reassure your child that you love and care about his or her mental health. And seeing a therapist yourself will most likely provide you with greater insight into how your child is feeling and how you can better deal with emotions related to your child’s sexual orientation.

How do I, as the parent or friend of an LGBTQ person, look for a therapist or counselor for myself?

You, too, should consult your physician for guidance on what type of care is needed. You should consider the same financial and practical questions you would consider when looking for a therapist for your child. If you feel comfortable doing so, ask a trusted friend. The American Psychiatric Association recommends that you conduct telephone and in-person interviews with potential therapists/psychiatrists to best select someone who is right for you and your family.

What questions might I want to ask before my child or I receive counseling?

  1. What qualities am I looking for in a mental heath professional? Do I prefer to talk to a man or a woman or does it matter? Do I want to see someone who is gay or straight? Ask your child if he/she has any preferences about the person they would like to see.
  2. What am I prepared to pay for counseling? What insurance benefits are available to me?
  3. What locations do I consider accessible for a health care provider?

What questions should I ask a prospective counselor?

  1. Does the health provider specialize in one particular form of therapy or treatment? The American Psychiatric Association advises that potential clients beware of a therapist who espouses only one kind of treatment as the only one that works. Psychiatrists have a multitude of ways to help you and will work with you to create a treatment program appropriate for you.
  2. Does the potential therapist/psychiatrist/care professional believe in “reparative therapy” or that one can change sexual orientation. If so, this person will likely not provide helpful care for you or your child.
  3. Has the prospective provider worked with GLBTQ people on issues like the one you have? Often or only occasionally?
  4. How much will it cost? If you do not have insurance, or your insurance is not adequate, will the mental health care provider adjust the charge?
  5. Does the provider have appointment availability that will fit into your schedule?

Remember that finding the right health care professional can be difficult. The following is a list of mental health organizations; these national organizations may help answer questions you have and may help with referrals in your area.

Mental Health Professionals in the DC Metropolitan Area

Below you will find links to support groups, mental health professionals, counselors, and organizations that specialize in providing care to gay lesbian bisexual and transgendered people and/or their friends and families.

For Metro DC PFLAG’s therapist listing or contact for referral, call 202-638-3852.