Counseling professionals serve as allies and social justice advocates for marginalized groups, including members of the sexual gender minority (SGM) community. Counselor education programs have a vital responsibility to provide counselors-in-training the resources to serve this population; however, there is limited research on how accredited counseling programs provide this preparation. There is a significant need for empirical data on implementing SGM training in counselor education. A mixed-methods approach was utilized to explore the impact of targeted SGM training for graduate counseling students in a CACREP-accredited program. Clinical implications, limitations, and program recommendations are discussed.
Drawing textual survey data from 398 LGBTQ+ people in Malaysia, our social determinants of mental health (SDMH)-centered analysis identified two overarching themes: (1) "I don't belong here nor within myself," reflecting systemic erasure, identity suppression, and relational alienation; and (2) "They hold space for me to be myself," highlighting interpersonal affirmation, emotional safety, and indirect forms of recognition-supported healing. The themes illustrate how relational dynamics shape experiences of identity affirmation, intracommunity exclusion, emotion suppression, and indirect forms of affirmation as subtle but crucial mental health resources. Our findings call for culturally attuned, relationship-centered counseling practices for LGBTQ+ individuals in Malaysia.
The purpose of this study was to examine how ally specific mentorship, supervision, education, advocacy efforts, and personal relationships with individuals identifying as sexual and gender minorities (independent variables) impacted counselors' scores on Ally Identity Development, as represented in scores on the Ally Identity Measure (AIM). The AIM assesses for the presence of attitudes and behaviors of allies to the sexual and gender minority communities. A quantitative, cross-sectional survey of 213 heterosexual and cisgender allies was conducted to assess their ally identity development activities and their AIM scores. The results of this study indicate that engagement with the independent variables had a statistically significant relationship with an increased AIM score, yet many participants indicated low participation in several of the activities. These findings may offer strategies for ally identity development such as counselor education programs ensuring access to allyship-focused opportunities as part of their clinical training program.
This conceptual article explores how rhetorical theories and digital contexts can inform LGBTQ+ counselor-in-training (CIT) professional identity development. Constructing connections between classical rhetoric, queer theory, and digital rhetoric, the article theorizes how digital environments shape LGBTQ+ identity construction (Hammack & Manago, 2025) and professional identity formation. Rhetorical listening, m & eacute;tis and love, and disidentification are proposed as strategies for resisting harmful discourses and fostering authentic identity development. These strategies support multimodal pedagogical practices that engage CITs in reflective, intersectional inquiry. Affirming pedagogical approaches grounded in rhetorical theory further helps counselor educators support LGBTQ+ CITs navigating complex sociocultural and professional landscapes.
Transgender and gender expansive (TGE) youth demonstrate additional risk for mental health issues compared to cisgender peers. Treatment options may include a referral to a residential center. TGE youth also experience unique aspects of gender identity development. Literature exists on TGE identity development and issues related to serving TGE youth in residential treatment. However, there is limited research on the intersection of these topics. This narrative case study presents one transman's gender identity development during residential treatment. Two themes emerged: family support and affirming relationships, and the role of the residential treatment facility. We offer implications for counseling TGE youth.
Lesbian, gay, bisexual, pansexual, and asexual (LGB+) individuals experience heightened psychopathology compared to heterosexual counterparts, including suicidal ideation (SI). Previous research has indicated risks of avoidant coping and protective effects of mindfulness on these disparities. We examined how these factors contribute to differences in SI among college students (n = 927, 124 LGB+). Avoidant coping did not differ by sexual orientation. Exploratory analyses revealed higher acting with awareness and non-judging (mindfulness facets) attenuated higher observed SI risk among LGB+ individuals. We outline possible mechanisms behind SI disparities among LGB+ individuals and encourage mindfulness as a counseling mechanism to target minority stressors.
LGB youth often consider school to be unsafe and experience school professionals as ill equipped to support them. The study purpose was to examine cultural competencies and affirmative practice of school professionals. N = 313 school counselors/social workers completed Sexual Orientation Cultural Competency, Queer Youth Cultural Competency, and Gay Affirmative Practice scales. Multiple regression analysis found that higher levels of overall cultural competence and cultural competency skills, but not greater knowledge or positive attitudes, predicted higher levels of LGB-affirming practice. These findings point to a need for training focused on increasing affirmative practice through cultural competence skill building and in-vivo experience.
Self-identified asexual individuals are often under-represented and misunderstood including their counseling experiences. The purpose of this grounded theory study was to explore ace individuals' perceptions of shame experienced in and outside of counseling. Specifically, this study explored the influence of the TWA and shame on participants' willingness to seek counseling services in the future. Based on the findings, an emerging three-part conceptual diagram helps frame an understanding of what contributes to ace individuals' sense of comfort within their counseling experiences. Implications of this study highlight the need to improve counseling practices, training, and research.
This exploratory qualitative study focused on transgender and gender diverse (TGD) emerging adults and their experiences with mental health services while enrolled in higher education. Participants described their experiences which ranged from feeling affirmed to experiencing discrimination at the hands of providers. Results were analyzed to find two themes: the air in the room and navigating the disclosure of identity and experiences across treatment. Findings contribute to the literature by offering ways to provide mental health services to the TGD community that center their needs.
Transgender and gender expansive (TGGE) people experience increased risk for mental health issues and suicidality, as well as significant barriers to mental healthcare, due to stigma and discrimination, including from mental healthcare providers. A sample of 945 TGGE participants completed self-report surveys, measuring experiences of stigma and barriers to care, and counselor competence. Data were divided into two groups by age and analyzed through linear regressions and one-way ANOVAs. Across groups, participants (approximately 58% of younger participants and 49% of older participants) reported experiencing stigma from a healthcare provider, and all reported some barriers to care, with more than half of older participants reporting barriers related to the availability of competent care. Those who had participated in individual therapy reported the highest levels of perceived counselor competency. The results of this study suggest significant discrimination and barriers to care, including a particular gap in the ways in which family systems are addressed and supported for TGGE people. Limitations and areas of future research are discussed.
Gender minority stress contributes to health disparities between cisgender and transgender and gender non-conforming (TGNC) populations. Previous research demonstrates the effectiveness of allyship as a potential buffer to the impacts of minority stress. We centered TGNC voices to answer the question: which specific behaviors are cisgender allies engaging in that are most supportive to the TGNC community? 53 TGNC participants responded to this prompt. Researchers used a grounded theory approach to analyze the responses. Developed categories included education, respect, support and gender affirmation. Coders found that respect for personhood is the crucial component to effective allyship behavior.
Lesbian, gay, bisexual, and queer (LGBQ) youth report higher rates of suicidal thoughts and behaviors (STBs) than their peers. Using minority stress and socioecological theories, this study examined how state-level factors impact these disparities. Using Generalized Estimating Equations with secondary data, state equality index (SEI) scores were used to predict STBs among LGBQ youth. LGBQ youth in states with high SEI scores reported fewer STBs. Sadness, hopelessness, and bullying were positively associated with suicidal thoughts among LGBQ youth. Findings highlight the need for public health approaches to prevention that also create safe and affirming environments for LGBQ youth.
Using interpretative phenomenological analysis and grounded in queer, critical feminist, and crip theory, this study explores how transgender and gender-expansive adults with ADHD symptoms, who describe their traits as neurospicy, navigate mental health care. Ten participants revealed masking as a survival strategy that fosters exhaustion, barriers posed by executive functioning challenges and provider ignorance, and the importance of affirming therapeutic spaces, self-advocacy, and peer support networks. Findings align with transgender identity development models. Results call for intersectional, neurodivergence-informed counseling practices that are flexible, knowledgeable, and collaborative to address structural and epistemological challenges faced by neurodivergent TGE individuals.
This study aims to describe institutional and social supports for sexual and gender minoritized populations. Participants are from a mixed-method study on experiences of sexual violence among sexual and gender minoritized young people. Reflexive thematic analysis was used to analyze data from semi-structured interviews (n = 25). One major barrier participants described included structural discrimination and violence (i.e., biphobia, misogyny, racism), which in turn contributed to challenges accessing support systems including mental health providers, sexual health services, and positive social support from family, friends, and peers. Participants reporting experiencing positive supports highlighted the importance of validation and acceptance as part of healing.
In 2022, Florida became the first state to formally enforce LGBTQ+ restrictions in the K-12 school environment with the passage of the "Don't Say Gay" bill. This discriminatory state legislation provided other politicians with a guide for targeting LGBTQ+ youth and their allies within school settings, and now, there are four other states that have successfully followed this dangerous model. With these laws on the rise, there have been spikes in mental health concerns for LGBTQ+ youth and their allies as many worry about the safety and security of the students within these affected areas. As of December 2023, there have been 42 bills across 23 states that seek to pass identical restrictions, indicating that school counselors within the United States must be prepared to support their local youth populations. Thankfully, the American Counseling Association (ACA) Advocacy Competency Domains offers school counselors a blueprint for both acting on behalf of and alongside LGBTQ+ youth. This article serves as an affirmative advocacy model for school counselors working with LGBTQ+ youth around the nation to combat the discriminatory bills that continue to target these vulnerable students.
We are called to accurately represent gender diversity in empirical research, but studies require careful planning to ensure the representation and retention of transgender participants during analysis. In qualitative studies, participant information provides important context for the findings but transgender participants may be identifiable through triangulation of demographic information. In quantitative studies, transgender participants may be omitted or aggregated during data cleaning. Strategies for recruiting, representing, and retaining transgender participants in qualitative and quantitative studies are essential. This manuscript describes considerations and concerns that are relevant to counseling researchers as well as recommendations for studies of various designs.
Internalized homophobia plays a significant role in the lives of LGBTGEQIAP+ clients, often leading to mental health concerns. Despite quantitative inquiry, internalized homophobia has a dearth of qualitative research containing narratives. This study employed a narrative Bildungsroman to give words to queer counselors about their coming-of-age journey traversing internalized homophobia and solicited insights about modern-day queer youth. Ten interviews were collected, which were analyzed revealing seven themes. Data suggested two useful counseling techniques: using therapeutic self-disclosure and actively challenging homophobic and transphobic discourse in counseling with queer youth. Researchers provide a discussion of findings, implications, and directions for future research.
Despite the growing body of research documenting mental health disparities for LGBTQ+ Black, Indigenous, and People of Color, there is a dearth of research examining the links between help-seeking and psychological distress. Kinship, identity concealment, relationship satisfaction, and community networks have surfaced as prominent features of LGBTQ+ and BIPOC community experiences, yet empirical research linking these phenomena is scarce. Through a moderation analysis with 274 LGBTQ+ BIPOC participants, we examined the relationships between LGBTQ+-based oppression (heterosexism) and help-seeking with the moderating variables of relationship satisfaction and identity affirmation. Explanations for cultural nuances and help-seeking among LGBTQ+ BIPOC are further explored.
Comprehensive and standardized training in LGBTQ+ affirming counseling remains underdeveloped in our profession. Using consensual qualitative research, we interviewed 14 counselors who developed a specialty in LGBTQ+ affirming counseling to inform professional development and clinical training in affirming practice. In this second article of the series, we review three of the seven identified domains, with a focus on counselor preparation. Our results provide insight into enhancing LGBTQ+ affirming counseling through enhancing counselor education and professional advocacy. We conclude by discussing implications, limitations, and suggestions for future research.
Research shows lesbian, gay, bisexual, trans and intersex (LGBTI) people are vulnerable to more adverse childhood experiences (ACEs). The research focused on the perceptions of experiencing ACEs among 36 Portuguese LGBTI people who were exposed to domestic violence by their parents or other family members (M = 34.11; SD = 10.77). Semi-structured individual interviews were conducted and data were subjected to thematic analysis. Results reveal a great exposure to different types of domestic violence, such as psychological, physical and sexual abuse, corrective practices and home expulsion. Affirmative and trauma-informed approaches, especially in counseling, are required to address LGBTI children's needs.
