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I’m a psychotherapist and I identify as a gay man, working predominantly with queer clients. One of the most joyful parts of my work is to witness clients move from shame into embracing their authentic selves during the therapeutic process.Ìý

Our dominant societal narratives privilege heterosexuality as the only ‘normal’ (called heteronormativity), monogamy as the ‘best’ relationships (called mononormativity), and a conventional sex life which promotes ‘vanilla’ sex (non-kinky).

Many people, including heterosexual people, don’t fit in those societal ‘norms’, but they are not aware that those norms are only societal constructs, not human nature. As a result, they think they’re broken or weird for not fitting in. The sense of brokenness tends to lead to poor mental health, and, in the extreme, to suicide.

Esther Perel says the quality of our lives depends on the quality of our relationships. I agree with her, and I see this in my practice on a regular basis. If we are surrounded by people who are judgmental about who we genuinely are, squashing down the expressions of our gender and/or sexual identities, it can make our lives miserable. When relationships improve (including friendships and social networks, as well as intimate romantic and sexual relationships), people’s quality of life improves markedly.

Because of those societal norms, many clients berate themselves for having some sexual, erotic and relational desires that aren’t reflected or affirmed in the mainstream narratives and media, thus considering themselves ’disordered’.ÌýUnfortunately, it is easy for therapists who don’t have enough knowledge about gender, sexuality and relationship diversity (GSRD) to unintentionally collude with clients’ sense of disorder. For example, it is common for a therapist to ask a polyamorous client why they chose polyamory, but they wouldn’t ask a monogamous client why they chose monogamy. If a client presents with a lack of sexual desire, the therapist could agree to work towards increasing sexual desire and even formulating theories about sexual trauma that must have caused the lack of sexual desire, when the client could actually be asexual (a legitimate sexual orientation describing low or an absence of sexual desire).

The knowledge of the sexual orientation diversities can help therapists be more aware that our favourite textbooks that formed theories were based on monogamous heterosexuality and may not always apply to clients who are outside these norms.

One of these theories is the concept of the therapist’s blank canvas. Being queer in the world, living with ongoing discrimination, LGBTQ+ people often have to continuously scan their environment to check if it is safe for us to be, trying to figure out facial expressions and body language of people in our proximity to check if they are safe. This is part of what we call minority stress: the expectation of discrimination. So, if the therapist gives nothing away, it can be frightening for a queer client, it can replicate the societal oppression and increase minority stress. Appropriate self-disclosure about being part of the LGBTQ+ community or being an ally can foster a safe space for queer clients. It can even be healing to know that there is one safe space where they can be themselves, without needing to edit themselves or hide parts of themselves.

Working with LGBTQ+ clients requires adapting some established theories, stay attuned to human diversity and helping clients find their own way in making a living outside the box an affirmative and meaningful home. When our clients get to that space of radical self-acceptance, the joy and sparks we see in their eyes are worth all the hard psychotherapeutic work.