LGBTQIA+ affirming therapy is an approach to care designed to help you feel comfortable and affirmed by your therapist. Affirmative therapy takes the position that all sexual orientations and gender identities exist on a continuum and are healthy and natural. Affirmative therapy can be integrated with other therapy models, like CBT, DBT, or trauma informed care, and emphasizes the unique minority stressors you may face, such as higher rates of discrimination, violence, or stigma. This type of therapy aims to help you build effective coping skills to handle those stressors, highlight your strengths and resilience, and feel empowered in your body and sexual orientation. Additionally, LGBTQIA+ affirming therapy does not make the assumption that you are seeking mental health services simply because of your sexual orientation or gender identity.

LGBTQIA+ affirming therapy has shown to be effective in treating depression, anxiety, and substance use, among other mental health concerns. LGBTQIA+ affirming therapy includes both sexual orientation and gender affirming care.

The Sexual and Gender Affirming Models of Care: The sexual orientation and gender affirming models of care affirm the continuum of sexual orientation and gender identity and help you explore, define, and live out your identity(s), without therapist judgment or preconceived beliefs about what your identity(s) "should be". Sexual orientation and gender affirming care is highly individualized and focuses on your specific needs. This type of care may include interventions like psychoeducation about sexual orientation and gender identity (appropriate to age and developmental level), building parental, family, and community support (if appropriate and desired), social changes, or medical interventions. Additionally, sexual orientation and gender affirming care may lead you to conclude you don’t want to make any changes, and that’s ok too!

If you’re exploring gender affirming care, interventions may include social changes, gender affirming hormone therapy, or surgical interventions.

Social changes, which are reversible and can be adapted if your gender identity shifts in the future, are typically done in a stepwise manner. For example, you may first begin to use a new name or pronouns in your home or with the people closest to you, and if this change feels positive, you may start incorporating these changes in other environments, such as at school or work. Social transitions may also include changing your clothing style or participating in new activities and hobbies that are more aligned with your gender.

Additionally, you may choose to explore gender affirming hormone therapy or surgical interventions to allow your body to develop physical changes that align with your gender identity.

Gender Affirming Surgery Evaluation and Letter: If you choose to explore gender affirming surgery, your medical insurance and/or your medical provider will likely require you to receive an assessment and referral letter before you receive care. The guidelines for surgical assessment have been provided by World Professional Association for Transgender Health (WPATH), Standards of Care Version 8, which you can access here. In addition to the criteria established by WPATH, your assessment will ensure you have: (1) realistic expectations of what surgery can and can not do and that you are emotionally prepared for the possibility of potential complications or outcomes that are different than what you expected, and (2) adequate support during both the pre- and post-surgery period. This includes having someone to take you to and from surgery and help you with any of your recovery needs.