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As a provider in an ever-increasing global community, chances are you’re going to have LGBTQIA+ clients who also identify with a racial or ethnic background or a disability.
Belonging to multiple communities, especially those that have historically been oppressed or marginalized, creates unique mental health challenges.
If we want to provide the best support for these clients, we must recognize this intersectionality and take additional steps to send the message that we’re a safe space for treatment.
The impact of isolation and otherness
Taking an intersectional approach with LGBTQIA+ clients is near to my heart. I’ve dedicated a large portion of my career to treating LGBTQIA+ clients, and I Identify as both queer and Latina.
I have personal experience with the challenges of not fitting wholly into one group. Or, worse, feeling not quite enough of any group to feel fully part of it.
We know that LGBTQIA+ clients have increased rates of depression, anxiety, isolation and loneliness. Social and cultural biases increase feelings of being on the outside, of not being accepted or equally valued. Add to that the fact that racism and ableism exists in the LBGTQIA+ community just as in any other, and it compounds feelings of isolation and otherness. I often hear, “I don’t fit in that easily. I’m too queer for my racial community and I’m too racialized for my queer community.”
It’s quite lonely and exacerbates any existing mental health challenges, especially anxiety and depression.
An elevated need for understanding
The pandemic further increased isolation, depression, and loneliness. Community events that brought LGBTQIA+ individuals together were halted. No longer could these individuals gather outside of their heteronormative communities in person and gain a sense of belonging.
Increasingly, therapy is the place where people are seeking acceptance, understanding, and connection.
7 ways to provide greater support and inclusivity
There are things you can do to increase inclusivity with LGBTQIA+ clients, so when they do reach out, you’re equipped with supportive messaging and practices.
Don’t assume
You may see someone of color or someone who has expressed themselves as queer, and move foward without realizing that additional identities factor into the way they experience the world.
Intentionally explore backgrounds and identities that articulate the full expression and experiences of each person.
Use inclusive language
Across the board, make sure your intake forms, notes, and verbal interaction reflect inclusive language with gender neutral terms. A few examples are to use ‘spouse’ or ‘partner’ rather than ‘wife’ or ‘husband,’ and use ‘they’ and ‘them’ before you can confirm the person’s gender identity.
Better yet, have a space for people to indicate their preferred pronouns at the outset. Everything sends a message. When you’re using inclusive language, it sends the message that it’s safe for the client to reveal all of themselves.
For more information, check out the APA’s guidelines for inclusive language.
Educate yourself
Proactively read about the challenges of minorities within minorities: People who belong to two or more oppressed communities. Attend trainings that address this directly or ones that use an intersectional lens.
Oppressed or marginalized communities often feel they bear the burden of educating, and it can feel overwhelming. This is especially true for people who have experienced trauma as a result of being part of an oppressed group.
We must continue to do our own research and remain aware of the histories and experiences of our clients.
Prioritize the therapeutic alliance
Our clients are, of course, humans first. Prioritizing the relationship helps reinforce feelings of unconditional positive regard and safety. This is paramount to individuals that have been victims of hate, prejudice, racism, biased actions, and oppression.
Ask about social support
Explore if and where the client is getting support. Ask if they are getting support from one community, more than one, or none. Understanding the level of support and belonging is a priority to planning effective care.
Continue emphasizing safety
It may take a while for clients to fully open up and explore their history of being part of the LGBTQIA+ community, or any other community. Keep inviting, and let them reveal themselves at their own pace.
Rely on your clinical intuition
While these practices have helped me serve LGBTQIA+ clients over the years, they are additions to my foundational clinical skills. Things aren’t binary or always clear. Trust that the skills you’ve honed over the years will help you make decisions along the way that put your clients’ human needs above all else. Keep in mind that if you do invite LGBTQIA+ clients into your practice, communicate that in your bio. Let clients know you are a safe space. Consider revealing any group that you identify with. This emphasizes your level of understanding and compassion. Ultimately, recognizing LGBTQIA+ clients as layered, with the possibility of multiple group identities that influence their mental health, goes a long way.
For so many LGBTQIA+ clients, it’s a big step to even reach out for professional help. We want to reduce any additional barrier or stigma and create the most welcoming space we can.
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