LGBTQ+ Affirmative CBT

16 Sessions

Identity development is a natural part of being human. But for people who identify as LGBTQ+, that journey often unfolds in a world that can feel invalidating, unsafe, or even hostile. What starts as typical self-discovery can become complicated by minority stress—the chronic impact of stigma, discrimination, and invisibility. Over time, this pressure can lead to anxiety, depression, hypervigilance, and internalized negative beliefs.

The LGBTQ+ Affirmative CBT plan combines evidence-based cognitive behavioral therapy (CBT) with culturally competent care tailored to sexual and gender minority experiences. Delivered over 16 structured sessions, the plan focuses on building emotional resilience, challenging internalized stigma, and developing practical tools to help you live more fully and authentically.

Treatment follows a few foundational phases:

Assessment of unique stressors related to identity, environment, and relationships
Cognitive restructuring to challenge negative self-beliefs rooted in minority stress
Behavioral strategies to reduce avoidance and increase confidence
Skills development for navigating real-world interactions and systems

For teens, the focus includes identity exploration, peer and family dynamics, and social-emotional development. For adults, therapy often centers on long-term patterns of internalized stigma, relationship challenges, and navigating workplaces and institutions.

Sessions are delivered virtually, with limited in-person availability.

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The privilege of a lifetime is being who you are. - Joseph Campbell

This plan is designed for teens and adults who identify as lesbian, gay, bisexual, transgender, queer, or any sexual or gender minority. While many LGBTQ+ individuals thrive without therapy, some may experience distress related to identity, self-acceptance, or social belonging. When this distress becomes persistent or overwhelming, targeted support can help.

Minority stress can leave you feeling anxious or depressed when navigating coming out, unsure how to integrate your identity with other aspects of your life, or drained by the emotional toll of persistent microaggressions or rejection. If you're feeling stuck, isolated, or unsupported in your identity, this plan offers an affirming space to process, grow, and heal.

Common indicators for this plan include:

Internalized stigma manifesting as negative beliefs about one's identity
Anxiety or depression related to coming out or transitioning processes
Difficulty integrating sexual or gender identity with other aspects of self
Hypervigilance in social situations due to anticipated rejection
Relationship complexities specific to LGBTQ+ contexts
Distress related to family acceptance or rejection
Gender dysphoria and associated emotional responses
Diminished resilience against persistent microaggressions
Conflict between cultural, religious, or family values and sexual/gender identity
Identity exploration questions requiring affirmative space without pathologization

Why you might choose this plan

What to expect

Adolescence is already a complex time for identity development. For LGBTQ+ teens, the process can be even more layered. Many youth become aware of their sexual orientation or gender identity in environments that lack supportive role models—or worse, in places where their identities are invalidated.

They may face rejection from peers, school-based harassment, or conflict at home. While some teens can name the source of their distress, others may show signs like school avoidance, emotional withdrawal, irritability, or slipping academic performance. While social media can facilitate connection, it can also be a source of added pressure and harassment.

That said, LGBTQ+ youth often demonstrate remarkable resilience when supported. With affirming care, they’re able to build confidence, navigate challenges, and shape healthy identities. Early intervention can make a lasting difference in both emotional wellbeing and long-term outcomes.

In-person, telehealth or both

How long does therapy take?

Affirmative mental health care goes beyond being supportive—it’s about using evidence-based tools to directly address the psychological impact of minority stress. At Therapy Lab, our clinicians combine proven cognitive behavioral strategies with a deep understanding of how systemic and social pressures affect LGBTQ+ individuals.

Your therapist will take an intersectional approach, recognizing how your gender and sexual identity intersect with other important aspects of your experience, including race, religion, family dynamics, or socioeconomic status. Care for teens may include family sessions to increase support at home, while treatment for adults often centers on healthy relationships, communication, and success in personal and professional life.

Therapy Lab clinicians hold advanced degrees in clinical psychology, clinical child/adolescent psychology, and related science-based clinical practices, with specialized training in LGBTQ+ affirmative care. Research demonstrates that affirmative cognitive-behavioral approaches specifically targeting minority stress mechanisms show superior outcomes compared to general therapy models not adapted for LGBTQ+ contexts. To learn more, please see the resources below.

About Therapy Lab therapists

Austin, A., & Craig, S. L. (2015). Transgender affirmative cognitive behavioral therapy: Clinical considerations and applications. Professional Psychology: Research and Practice, 46(1), 21-29.
Cohen, J. M., Blasey, C., Barr Taylor, C., Weiss, B. J., & Newman, M. G. (2016). Anxiety and related disorders and concealment in sexual minority young adults. Behavior Therapy, 47(1), 91-101.
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Pachankis, J. E., Hatzenbuehler, M. L., Rendina, H. J., Safren, S. A., & Parsons, J. T. (2015). LGB-affirmative cognitive-behavioral therapy for young adult gay and bisexual men: A randomized controlled trial of a transdiagnostic minority stress approach. Journal of Consulting and Clinical Psychology, 83(5), 875-889.