Issues Arising in Psychotherapy With Lesbian, Gay, Bisexual, and Transgender Patients

In many ways, psychotherapy with lesbian, gay, bisexual, and transgender (LGBT) patients does not differ from psychotherapy for heterosexual, gender conforming, and cisgender patients. Additionally, concepts and considerations that arise in psychotherapy with LGBT patients can parallel issues that arise in psychotherapy with patients of other stigmatized minority groups. In this article, the authors discuss the concept of minority stress and its relationship with mental health conditions and review specific issues that may arise with this heterogeneous patient population, including being in the closet, coming out of the closet, the psychotherapeutic search for "causes" of sexual orientation and gender identity, and therapist self-disclosure.