Every June, Pride Month invites us to celebrate queer and trans identity, resilience, and joy. As a therapist who works with LGBTQ+ clients—and who identifies within the community—Pride is more than a rainbow-covered celebration. It’s also a moment of reckoning.
Despite progress in visibility, rights, and representation, many of the emotional and social struggles I see in therapy today mirror those I encountered as a young person navigating my own identity. In fact, some challenges have become more visible or even more acute, particularly for trans people.
My therapy room has become a mirror to these complexities: celebration and sorrow, hope and disillusionment, visibility and vulnerability, all often sitting side by side.
Legal Progress, Emotional Setbacks
One of the most distressing developments for many clients this year was the UK Supreme Court ruling that for the purposes of the Equality Act 2010, “sex” refers to biological sex assigned at birth. This means that transgender people are not legally recognised as having changed their sex, even with a Gender Recognition Certificate (GRC).
While the ruling relates only to the Equality Act, it carries a deeper cultural message: your identity is up for debate.
In sessions with trans and nonbinary clients, the emotional toll has been clear. Fear, re-traumatisation, and grief are recurring themes. Even those not directly impacted by the legal change feel the weight of growing hostility in the public sphere.
Research supports what I see in practice. A recent review in The Lancet Psychiatry found that legal and political uncertainty around transgender rights is directly linked to increased mental health challenges, including depression, anxiety, and suicidal ideation (Restar, 2023). When identity is politicised, mental health becomes collateral damage.
Therapy, in this context, becomes both a sanctuary and a form of resistance: a space to process fear, reclaim autonomy, and explore what it means to live authentically in a sometimes-hostile world.
The Myth of “Coming Out” as a Cure-All
Another persistent theme in affirming therapy is the disconnect between the cultural narrative of liberation and the reality many face after coming out. Clients often expect that once they share their identity, things will improve dramatically. And in some ways, they do. There’s relief, pride, and often a deeper sense of truth. But what follows can also be deeply isolating.
I often hear clients say, “I thought it would get easier after I came out.” Instead, they struggle to find affirming community—especially those who don’t fit the dominant portrayals of queerness in media: white, cis, able-bodied, young, and affluent.
Queer men, in particular, frequently report disillusionment with aspects of gay male culture that emphasise appearance, status, and nightlife. For those who don’t—or can’t—engage with that scene, it can feel like there’s nowhere to belong.
A study by Pachankis et al. (2020) describes this as “post-closet loneliness,” a sense of social disconnection experienced by many LGBTQ+ individuals when affirming, inclusive communities remain out of reach.
Therapy, then, becomes a space not just for healing old wounds, but for processing the loneliness that can accompany so-called liberation.
Intersectionality Isn’t Optional
One of the most essential frameworks in LGBTQ+ mental health is intersectionality—a term coined by legal scholar Kimberlé Crenshaw (1989) to describe how race, gender, sexuality, class, and ability interact to shape unique experiences of oppression and privilege.
This lens is vital. A Black trans woman’s experience is not simply “Black” plus “trans”—it’s a distinct, intersectional reality shaped by multiple systems of marginalisation. Similarly, a working-class queer person will likely face different challenges than someone more economically privileged, even if they share the same sexual orientation.
Without an intersectional understanding, therapy risks oversimplifying clients’ realities—or worse, replicating the same invisibility they face in broader society.
As affirming therapists, we must be actively aware of these dynamics. We can’t assume that sharing a queer identity with a client means sharing the same experience. Instead, we must listen with curiosity and humility, and commit to lifelong learning.
Lessons from the Therapy Room
So, what have I learned from supporting LGBTQ+ clients? A few key truths stand out:
1. Affirmation is the foundation—but not the whole house.
Being an affirming therapist is essential, but it’s not a passive label. It requires active learning, self-reflection, and engagement with current issues affecting LGBTQ+ communities.
2. Coming out is a beginning, not an ending.
It’s often the start of a more complicated journey toward self-acceptance, identity development, and community-building.
3. Queer joy is radical—but so is honouring queer grief.
Therapy must make room for both the celebration of queer lives and the mourning of what’s been lost: family acceptance, safety, belonging, or time spent in hiding.
4. Community is critical—but it’s not always accessible.
Part of the therapeutic process is helping clients grieve unmet expectations while also exploring new, more meaningful ways to connect—with others and with themselves.
5. Political and legal decisions impact mental health.
What happens “out there” matters deeply in the therapy room. We can’t separate the personal from the political in this work.
A Pride Reflection
Pride, at its best, is about authenticity and belonging. But for many LGBTQ+ people, those remain aspirational goals rather than everyday realities. My hope is that affirming therapy can be one place where people begin to reclaim those things—not just for a month, but for a lifetime.
To LGBTQ+ individuals reading this:
Your story is valid.
Your emotions are real.
And your identity deserves not just tolerance, but full celebration.
You don’t have to walk this path alone.
Interested in affirming therapy or curious about how we can work together?
Book a free discovery call today. Let’s explore how therapy can support you on your journey.
References
Crenshaw, K. (1989). Demarginalizing the intersection of race and sex: A Black feminist critique of antidiscrimination doctrine, feminist theory and antiracist politics.
Pachankis, J. E., Clark, K. A., Burton, C. L., Hughto, J. M. W., Bränström, R., & Keene, D. E. (2020). Sex, status, competition, and exclusion: Intraminority stress from within the gay community and gay and bisexual men’s mental health. Journal of Personality and Social Psychology, 119(3).
Restar, A. J. (2023). Gender-affirming care is essential for transgender health. The Lancet Psychiatry, 10(3), 175–177.
