How to Support Your Client Who is Coming Out as LGBTQIA+

By Kristie Overstreet on January 14, 2019

You feel confident and competent in your clinical skills, but there is always something you can improve on. Even the most skilled clinician has room to grow. One area to ensure you are providing the best care is for your LGBTQIA+ clients. They face many barriers throughout their lives, and you can be great support for the community.

Let’s start with defining the acronym LGBTQIA+. This stands for lesbian, gay, bisexual, transgender, queer, intersex, asexual, and the (+) plus includes all of the other identities along the spectrum. This symbol is used to be inclusive of identities that aren’t included in the acronym. Using LGBTQIA+ versus LGBT is more inclusive of all identities.

Many LGBTQIA+ clients face discrimination in their jobs, healthcare, and housing. Other issues that these clients face are bullying in school/work, depression, anxiety, the risk of suicide due to rejection, substance abuse, and gender discrimination. Family, religious, and social rejections are also common among LGBTQIA+ individuals.

The clinical space needs to be nonjudgmental, welcoming, and safe. However, there are some clinicians whose prejudice about gender and sexual identity cause harm to their clients. As a clinician, you want to support your client and help them work through their problems. Here are the do’s and don’t when it comes to supporting these clients.


  • Affirm your client and who they are as a person
  • Listen to your client’s narrative and experience versus assuming
  • Attend training to learn how to better work with LGBTQIA+ clients
  • Be mindful of transference and countertransference
  • Seek supervision as needed from an experienced clinician who specializes in working with LGBTQIA+ clients
  • Be aware of your nonverbal communication including facial expressions and body mechanics during the session
  • Assess for present or past suicide ideations in all clients
  • Be an advocate and ally outside the clinical setting
  • Practice self-care so you can continue to be an amazing clinician


  • Be judgmental about your client’s identity
  • Think that your client has a mental illness or diagnosis because of their identity
  • Assume that the client is seeking counseling because they are LGBTQIA+
  • Narrow your client’s identity by avoiding or not addressing how the session relates to their identity if this is what they want to discuss
  • Inflate your client’s identity by making the session all about this part of them unless they want to focus on this
  • Think that you know how to best work with LGBTQIA+ clients because you know someone in the community
  • Use terms such as transsexual, transgenderism, or gender bender which are offensive to many individuals
  • Give a diagnosis of gender dysphoria to every transgender, gender nonbinary, or gender queer client because every person does not experience this
  • Think that your client needs to change their sexual or gender identity to have better mental health

LGBTQIA+ individuals deserve a clinical setting that provides dignity and respect. Your ability to support and assist your clients may be the only safe space they have. Whether you are giving care through therapy, support groups, or volunteering in the community, your assistance is making a difference in the lives of your clients. Thank you for supporting your clients and the LGBTQIA+ community.


Dr. Kristie Overstreet is a clinical sexologist, certified sex therapist, licensed professional clinical counselor, author, speaker, and consultant. She holds a Ph.D. in Clinical Sexology, Master of Arts in Professional Counseling, and a Bachelor of Science in Biology. She is a licensed counselor in California, Florida, Georgia, and Louisiana. She is also a Certified Sex Therapist and Certified Addiction Professional. She has over 12 years of clinical experience specializing in sex therapy, transgender healthcare, relationships, and helping counselors build their private practice. She is president of Therapy Department, a private practice that provides counseling, training, speaking, and consulting services across the United States.  For more information about Dr. Kristie's work visit


Commenter Name
February 5, 2019

I truly appreciate and enjoy your questions and website.

Commenter Name
March 4, 2019

Thanks for that information. It was very helpful as well as reaffirmation as to how to be respectful to all people.

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