Mental health issues and substance use disorders are prevalent among the LGBTQ population. Queer affirmative therapy is a therapeutic movement of significant relevance these days. Lesbian, Gay, Bisexual, Transgender, and Queer persons are viewed positively and helped to reconcile with their own identities and to build healthy relationships. It also addresses the impact of transphobia, heteronormativity, and homophobia on LGBTQ clients.
Affirmative Therapy
Queer affirmative therapy is “affirmative” because such practices affirm the experiences of people in distress. In many domains of psychiatry, queer people are marginalized socially and medically. Queer affirmative therapy is here to change the narrative and show support and affirm the struggles of marginalized people.
Therapy offers a place of safety, a place of trust, where a person can vent out their true selves without feeling judged. Queer people who are unable to be out in the open due to fear of rejection and the social stigma involved in it need a vital shift in the narrative. A counselor can offer them enough space to ensure their mental health.
The role of the therapist is to affirm the psychosocial experiences of their clients, which is of the utmost importance for people of such social disposition. Prescribing a “cure” feels inherently wrong, and so does pushing someone in a different direction.
In queer affirmative therapy, the neutrality of a therapist is questioned and issues of discrimination and marginalization are addressed heavily. Queer affirmative therapists work to identify and eliminate homophobia and transphobia within themselves. This self-work helps them recognize how critical their affirmation and understanding of the mental health issues that LGBTQ people deal with is.
Best Counselling For LGBTQ community
Despite so many efforts by egalitarians, it is still a struggle for the LGBTQ community to claim their rights and occupy safe spaces that don’t feel harsh on them. Queer affirmative therapy as a practice, is crucial for the mental health of queer people.
To say that it is not easy to live a life as a transgender individual would be an understatement. A wide variety of barriers to therapy and healthcare for such individuals to access specialist health services, especially something like gender transition services. The whole population of transgender individuals is a vulnerable one.
Transgender or gender-diverse individuals require a multidisciplinary team approach to manage their well-being. Along with the psychiatrist, the multidisciplinary team may include a general practitioner or sexual medicine practitioner, an endocrinologist, a general surgeon, a urologist or gynecologist, a plastic surgeon with expertise in sexual reassignment surgery, or a speech pathologist, depending on the individual patient’s needs.
The psychiatrist is called upon to take a lead clinician role in order to diagnose gender dysphoria. He must undertake a detailed assessment and come up with an elaborate treatment plan.
It is often necessary that a physician or endocrinologist refers a patient to a psychiatrist to establish gender dysphoria. A therapeutic alliance must be established with these individuals in order to assist them in treatment and minimize frequent changes in their behavior.
Psychiatrists should remember that transgender individuals who seek consultations may be in different stages of transition. Some of them may have clear views about the kind of interventions and treatments that they might need.
Some individuals might need help for psychotherapeutic assistance to explore their gender identity and expression, and some may need therapy to facilitate a coming-out process.
Identifying the individual’s intention for seeking professional assistance is of the utmost importance. Mental health professionals should ascertain the purpose of seeking assistance before managing the problems and undergoing further assessments.
Assessment and management of gender dysphoria along with other mental health issues transgender people may face can include the following:
- History of the patient including the development of dysphoric feelings when the person formed his gender identity.
- Detailed interview and mental examination to rule out co-morbid anxiety and mood disorders, and substance abuse and assess suicidal risk factors
- The examiner should confirm the incidence of gender dysphoria and evaluate if it is secondary to or better accounted for by some other diagnosis.
- Assessing the family dynamics, various social support mechanisms, and stigma faced by the individual in society.
- Assess the stage of transition, if the individual has completed social or medical transitioning to gender identity, or both.
- The psychiatrist shall provide essential information to individuals regarding evidence-based options which are appropriate, to encourage them to take an active role while determining the most appropriate treatment route which suits their preferences.
The main aim of psychotherapy is to offer support to transgender individuals through the process of transition from an unsatisfying life to a happier and satisfying one. It achieves it through:
- Offering optimal options to assist individuals in search of positive or desirable gender roles and expression including aid in coming out. The process of coming out is not a one-time thing and, in most cases, is a recurring process. The decision to come out should be made by the individuals and the role of the therapist is to assist and support them during the process. In the majority of cases, coming out is most comfortable when one is confident and ready. During this process, the therapist should actively screen for any mental health problems such as depression or anxiety, etc., and also assess the readiness of the individual to begin medical/hormonal transition if not undergone before.
- Improve the overall psychosocial and psychological wellbeing of transgender individuals.
- Therapists should try assessing the stigma faced by such individuals in society, and its impact on their mental health, and address such issues.
- Validate their personal experiences and emotions, to provide them hope and clarity to march forward on their journey to feel better about themselves and their identities.
The distress of gender dysphoria also has a significant impact on the family or partner of the individual. Family members might face guilt, may have a certain difficulty in role transitioning, and may also attach or be subject to stigma. Individuals with gender dysphoria might need assistance communicating their diagnosis and treatment decisions to their families.
Family therapy can address such issues. For family interventions to be effective, it is imperative to address the concerns of families so that they can provide safe environments for these individuals.
Queer affirmative therapy For better mental wellbeing
The most significant goal of psychotherapy is to help individuals achieve a sense of comfort, a sense of belonging, in their gender and sexual expression, and orientation. It is of the utmost importance to the therapist to direct their efforts towards achieving this. This is so such individuals can have healthy and happy relationships and get the most out of their lives.
Queer affirmative therapy that tends to the need of the LGBTQ community, is of critical importance in today’s world, with the difficulties such people face in opening up about themselves. However, this form of therapy is a positive hope, a light at the end of the tunnel, to those seeking it.
It is the purpose of therapy to be accepting of the truth and realities that are at times unpleasant to bear, but with consistent efforts and social change, the LGBTQ community can finally enjoy a level playing field, where their struggles and emotions feel validated, and they can enjoy their lives as much as anyone else.
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At Psychicare India, the top notch skilled and affirmative psychiatrists and Psychotherapists pledge to help every soul attain the mental health. We understand and help the person reach the optimum through therapy and behavioral change exercises.
Source: Manual on Mental Health care of Transgendered persons in India for practicing psychiatrists