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Let’s be real—therapy isn’t just about being a listening ear while someone yaps away. Instead, it’s all about creating a space where people feel safe, understood, and truly seen. And when it comes to LGBTQ+ clients, this can sometimes be a bit more complex than just saying “I hear you.”
In Singapore, while progress has been made in terms of LGBTQ+ visibility and acceptance, the reality is that many LGBTQ+ individuals still experience discrimination, stigma, and mental health challenges. From navigating family expectations to dealing with workplace biases and legal hurdles, LGBTQ+ clients bring unique experiences into therapy. This is where affirmative therapy comes in.
If you’re a therapist—or maybe just someone who cares deeply about supporting the LGBTQ+ community—here’s a crash course on affirmative therapy. What is it? Why does it matter? How do you get it right?
What Is Affirmative Therapy?
First off, affirmative therapy isn’t as simple as being LGBTQ+-friendly. It’s about affirming and creating a safe space for the LGBTQ+ community. Being friendly means being open and kind, but being affirming means actively validating and supporting LGBTQ+ identities.
Most importantly, affirmative therapy acknowledges that LGBTQ+ individuals don’t need to be “fixed”. This isn’t conversion therapy after all. Instead, it focuses on helping clients navigate their identities, societal pressures, relationships, and mental health in a way that is empowering and supportive.
The goal? To celebrate LGBTQ+ identities, help individuals embrace their authentic selves, and empower them to navigate their personal lives.
Common Challenges LGBTQ+ Clients Face
Before diving into how to practice affirmative therapy, it’s important to understand the unique struggles that LGBTQ+ individuals in Singapore face. Some common issues include:
1. Coming Out and Family Expectations
Coming out is rarely a one-time event—it’s an ongoing process. In Singapore, where traditional family values still hold significant weight, many LGBTQ+ individuals struggle with whether to come out to their parents, relatives and friends. Some risk rejection, emotional manipulation, or even being forced into marriage. Therapists need to understand the delicate balance of respecting family virtues while also affirming a client’s identity.
Additionally, the fear of losing financial support or housing can make coming out even more daunting for younger clients who are still dependent on their families. Therapists must be aware of these risks and help clients develop safe strategies for navigating these conversations.
Similarly, the topic of religion should be treated with sensitivity, as most religious beliefs are not entirely supportive of LGBTQ+ lifestyles. Understanding the nuances of these are vital for any one sharing advice to queer folks.
2. Mental Health
Studies have shown that LGBTQ+ individuals are more likely to experience depression, anxiety, and suicidal ideation. Why? Because being a minority in a society that often marginalizes you is stressful AF. This is also known as “minority stress”, which can stem from discrimination, internalized shame, or fear of rejection. A therapist practicing affirmative therapy must be able to recognize how these societal pressures impact a client’s mental health.
Furthermore, many LGBTQ+ individuals struggle with internalized homophobia or transphobia, where they subconsciously adopt negative societal beliefs about their identities. This can result in the sad situation of hating oneself, or even self-harm. Addressing these deep-seated beliefs in therapy can be crucial to helping clients develop self-acceptance.
3. Legal and Institutional Barriers
While Singapore is slowly becoming more inclusive (hello, repeal of Section 377A!), LGBTQ+ rights remain limited. Same-sex marriages are not recognized by law, adoption for LGBTQ+ individuals is tricky, and workplace discrimination still exists. These factors can contribute to stress and anxiety, and therapists must be mindful of how these structural barriers affect their LGBTQ+ clients. Understanding the common challenges clients face will help relate therapists to individuals.
Additionally, accessing healthcare can be challenging for LGBTQ+ individuals, especially transgender clients who may face difficulties in obtaining gender-affirming medical care such as reassignment surgery or even attaining hormone pills. Some may also have negative past experiences with non-affirming healthcare providers, leading to medical avoidance and untreated health issues.
4. Gender Identity and Dysphoria
For transgender clients, gender dysphoria aka the distress that arises from a mismatch between one’s gender identity and assigned sex at birth, can be a significant mental health challenge. Accessing gender-affirming care in Singapore is still complicated, making therapy a crucial source of support for trans individuals navigating their transitions. Therapists should be equipped in understanding these niche struggles, and be able to offer help with mindfulness and sensitivity.
Additionally, therapists should be familiar with the gender-affirming process, including hormone replacement therapy (HRT), legal name and gender marker changes, and social transitioning. Being informed helps create a more supportive environment for transgender clients.
How to Be An Affirmative Therapist
Now that we’ve discussed some of the key challenges faced by the LGBTQ+ community, it’s time to move on to tangible and practical steps that one can adopt when speaking with an LGBTQ+ individual.
1. Use Inclusive Language
Words matter. A lot. Using gender-neutral language and avoiding assumptions about a client’s identity can make all the difference. Instead of asking, “Do you have a boyfriend/girlfriend?” perhaps say, “Are you in a relationship?” And while more young people are including their pronouns in their email signatures and Instagram bios, feel free to ask upfront if you’re unsure. A simple “What pronouns do you use?” shows respect and normalizes gender diversity.
2. Educate Yourself With Research
Being an LGBTQ+-affirming therapist means taking the time to educate yourself on LGBTQ+ issues without expecting clients to do the teaching. Read up on gender identities, sexual orientations, and local LGBTQ+ advocacy efforts in Singapore. Follow organizations like Oogachaga, Sayoni, and The T Project to stay informed.
Additionally, seek out professional training on LGBTQ+ mental health topics. Attending workshops or courses on affirmative therapy can help therapists develop better skills for working with LGBTQ+ clients.
3. Acknowledge and Address Internal Biases
No one is born an expert in LGBTQ+ issues. Even well-meaning therapists may carry unconscious biases influenced from upbringing or social media. Examples of these could include being taught that gender is strictly binary, or that being LGBTQ+ is just a “phase.” It’s important to regularly examine your own biases and unlearn outdated beliefs, in order to be more open minded.
4. Understand Intersectionality
LGBTQ+ individuals don’t exist in a vacuum. Neither are they confined to a box. Their experiences are shaped by multiple aspects of their identity, such as race, religion, socio-economic status, ability, etc. For example, a queer Muslim woman in Singapore might experience different challenges compared to a gay Chinese man. Affirmative therapy means recognizing these intersections and tailoring support accordingly.
5. Provide Trauma-Informed Care
LGBTQ+ individuals might have experienced trauma—whether from bullying, family rejection, or discrimination. Trauma-informed therapy means creating a safe space where clients feel heard and validated. This includes not pushing clients to come out if they’re not ready and acknowledging their lived experiences with sensitivity. If they proclaim that they are still confused about their identity, don’t force or rush them to arrive at a decision. Remember that clients need time and space to figure out their journey – you’re playing a supportive guide for them to reach there.
Additionally, for clients with past trauma related to conversion therapy or religious-based shame, therapy should focus on healing from these harmful experiences and reinforcing self-worth.
6. Offer Resources and Community Connections
Many LGBTQ+ clients benefit from connecting with support groups, advocacy organizations, or queer-friendly services. Therapists can play a role in linking clients to these resources, such as:
- Oogachaga (LGBTQ+ counseling and support services)
- The T Project (support for transgender individuals)
- Pelangi Pride Centre (LGBTQ+ library and resource center)
Making Therapy A Safe Space Is Important
Affirmative therapy is less about hearing people’s struggles, and more about creating an environment where LGBTQ+ individuals feel safe, valued, and understood. In a society where acceptance is still evolving, therapists have the power to be a source of genuine support for LGBTQ+ clients. Just think about how many lives could be changed with positive therapy methods.
By using inclusive language, educating yourself, addressing biases, understanding intersectionality, practicing trauma-informed care, and providing community connections, you can make therapy a truly enjoyable experience.
At the end of the day, therapy is about empowerment. And for LGBTQ+ clients, that means knowing they are more than just their struggles.
If you or someone you know is exploring their journey with sexual identity or coming out, A Space Between provides a safe environment for support with queer-friendly counsellors. Besides being a resource for help or navigating the challenge of coming out, A Space Between also shares advice on therapy and LGBTQ+ issues through online blog articles, as well as holding community events.
