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  • Writer's pictureHelen Whitehead M.C., R.C.C.

LGBTQ2+ Mental Health & Counselling

Updated: Apr 27, 2021

There are many definitions that exist under the LGBTQ2+ umbrella. Queer, trans, 2spirit, non-binary, lesbian, bi, and other expressions of diverse sexuality or gender identity. One thing that folk under that banner have in common is that LGBTQ2+ youth and adults in Canada have an increased risk of mental health challenges. Those challenges can include feelings of shame, suicidal ideation, anger, low self esteem, substance use, depression, and can negatively impact relationships. (If you are looking for LGBTQ2+ counselling click here.)

The mental health disparity between the general population and LGBTQ2+ individuals is often attributed to the theory of minority stress – a term coined by Ilan Meyer in 2003 in his groundbreaking research with sexual minority populations. In explaining this theory, Meyer established four processes that included: prejudice; stigma; concealment versus disclosure; and internalized homonegativity.

Minority Stress

  1. The first process of minority stress, prejudice, includes factors such as workplace discrimination; physical or verbal harassment and assault; and systemic or institutionalized discrimination such as religious trauma or working for a company that has transphobic or homophobic policies.

  2. The second process, stigma, relates to the stress that sexual or gender minority individuals experience in their social interactions. In understanding this, it’s important to note that perceived stigma is equally as harmful as actual stigma, as this causes the minority individual to be chronically on guard for any negative interaction.

  3. Concealment versus disclosure. The third process relates to the stressors involved in concealing identity for fear of discrimination. So this could be a teenager who is bisexual but knows their friends or family wouldn’t approve, or it could be a person in their 50s who works in an environment that is not welcoming to diversity and so they keep their sexuality secret.

  4. The fourth process is internalized homonegativity/internalized transphobia. This process is possibly the most harmful of all, as it takes all the other negative factors into account and turns them inward, creating an effect where the LGBTQ2+ individual can develop an internal sense of self-hatred, low self esteem, isolation, and lack of self value.

These processes help to explain why some LGBTQ2+ folk have more mental health challenges than non-LGBTQ2+ people. In addition, though we live in a relatively tolerant country, it’s worth remembering that hate crimes against the queer community have risen dramatically in British Columbia over the last few years so those incidents of discrimination and prejudice are still happening and they can have a deeply traumatic impact.

gay pride flag poster saying Love is Love

Counselling Safety

Along with the disparity in mental wellness, LGBTQ2+ people also tend to seek less help from mental health professionals. This is thought to be due to the fear of rejection and stigma that marginalized folk experience. Can you imagine going to your first counselling session and having your therapist wrongly assume the gender of your partner? It happens, and that type of experience is exactly what stops LGBTQ2+ folk seeking help. This is also relevant for relationship counselling, as it can be challenging for people in non-traditional relationships to reach out for help. Whether it be a gay couple wanting marriage counselling, someone in a poly-amorous relationship needing help with communication, or a trans/cis couple dealing with family conflict. Everyone should be able to get the support they need without fear of being judged or treated in any way other than with care, respect and with empathy. Everyone deserves to feel safe.

Working with Queer Clients

Counselling for LGBTQ2+ clients often includes talking about identity, the coming out process, family of origin beliefs, and personal experiences of stigma and of course, resilience and strength. It can also include work around confidence building, processing trauma, establishing a sense of self and finding ways to connect to and create community. In other words – building Pride in identity.

Gay pride flag and the trans pride flag

If you are LGBTQ2+ in B.C. and are needing some mental health support, or are starting to question your identity and would like to talk to a therapist, you are welcome to contact me. My office is based in North Vancouver but I also offer online counselling to people across British Columbia. As a member of the community myself, I am dedicated to supporting other LGBTQ2+ folks in whatever struggle you are going through. If you are unable to pay for mental health support, or don’t have extended health, Qmunity have a great free counselling program you can read about here:

If you have any questions or comments please feel free to contact me: or visit my LGBTQ Counselling page to read more.

Thanks for reading 😊

Helen Whitehead M.C., R.C.C.

Registered Clinical Counsellor

North Vancouver, B.C.

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