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LGBTQIA+ Affirmative Therapy

What it is and why we need it

What is LGBTQIA+ Affirmative Therapy?

LGBTQIA+ Affirmative Therapy is when the therapist holds a positive and validating attitude towards all genders and sexualities.

A therapist who promotes LGBTQIA+ Affirmative Therapy tries to challenge the stigma and biases against members of the queer community

This is the direct opposite of conversion therapy, which is highly unethical, according to all major awarding bodies in the UK and in Europe.

LGBTQIA+ Affirmative Therapy is not a specific type of therapy, but an attitude that needs to be shared across modalities, from CBT to psychoanalysis.

Essential timeline of LGBTQIA+ Affirmative Therapy

Historically, members of the LGBTQIA+ community have been often labelled as mentally ill by mental health professionals. As a result, they’ve often been discriminated against and even persecuted.

  • Therapy came a long ways from 1905 when Freud published his 'Three Essays on the Theory of Sexuality'. I supposed that was a first attempt to understand and was probably very progressive at the time, but Freud still refers to gay men as 'inverts' because they hadn't resolve the Oedipal complex.  
  • The term ‘gay affirmative’ was invented in 1982 by Alan K. Malyon to challenge the pathologized views of homosexuality. His argument sounds very simple now, but was groundbreaking at the time: if queer people are more OK with their sexuality and gender, their mental health improves. (It is interesting to notice that often research is conducted on cis-gender gay man, leaving out a lot of the human experience) 
  • In 1987 homosexuality was finally removed from the DSM (the American Diagnostic and Statistical Manual) and no longer considered a mental health illness.
  • In 1996, Dominic Davis publishes in the UK 'Pink Therapy'. This was the first of a series of manuals helping practitioners to work with queer clients. Pink Therapy is now a training organisation for therapists. Click here to see their website.  

Why do we need LGBTQIA Affirmative Therapy today?

We still live in a society and culture strongly dominated by heteronormative constructs, where most structures are targeted to heterosexuals and cis-gender individuals. Therefore we are very likely to unconsciously absorb those biases. For these reasons it is still essential for psychotherapy to take a strong stance alongside the LGBTQIA+ community. It is important to actively promote diversity and creativity, helping individual to feel liberated and empowered in their sexuality and gender.


Davis, D. (1996). Pink Therapy. London, Open University Press.

Malyon, Alan K. (1982). 'Psychotherapeutic implications of internalized homophobia in gay men'. Journal of Homosexuality. 7 (2–3): 59–69.