How I Show Up as a Therapist for LGBTQ+ Clients and for Parents Who are Struggling
I want to speak openly about something I’ve been wrestling with as both a therapist and a Christian, neutrality.
Over the years, I’ve worked with many clients who are part of the LGBTQ+ community, as well as parents who are trying to understand and respond to a child who has come out. Sometimes these worlds overlap. Sometimes they collide. And sometimes they leave therapists feeling caught in the middle, trying to be “neutral” in situations where harm is quietly happening. The idea of trying to be supportive to two differing perspectives in the therapy room has almost always called for neutrality.
Recently, I had an experience that unsettled me deeply and clarified something I’ve been holding for some time: neutrality is not always ethical. As a therapist, I am guided by professional ethics and lived experience, and there are moments when silence or “neutrality” can unintentionally reinforce harm. Practicing as a therapist and also being known as a Christian in a rural community, I’m aware that people may make assumptions about what I believe and may seek me out expecting alignment with more fundamentalist views. For the sake of transparency and safety, it feels important to be clear about the values that guide my work.
Over time, my views have changed, not because I abandoned my faith, but because as my faith deepened, I chose to listen more openly to those around me. Sitting with clients, walking alongside family members, and engaging with research and medical science has expanded my understanding of human identity, suffering and resilience. I began to notice where fundamentalist Cristian interpretations caused real harm, shame, fear and disconnection rather than healing. As a clinician, I am ethically bound to do no harm. And as a person who strives to live out the values of Christ, love, humility, mercy and care, I realized I needed to step away from beliefs that did not align with those values.
Growth for me, has meant choosing compassion and relationships over rigidity.
How I show up for LGBTQ+ clients
First and foremost, I want to be clear on what I believe and what I know professionally:
Sexual orientation and gender identity are not mental health disorders. They are not pathologies. They are not problems to be solved.
· Sexual orientation is not a choice.
· It is understood as a complex interplay of biology, neurology, and development.
· Major medical and psychological organizations agree on this.
· Attempts to change it are ineffective and harmful and can be fatal.
Conversion “therapy” is not only ineffective at changing orientation or identity, but also consistently linked with worse mental health outcomes, particularly increased suicidal ideation and suicide attempts. Research from the Family Acceptance Project found that LGBTQ+ young people whose parents actively tried to change their sexual orientation had suicide attempt rates of 48%, more than double the rate (22%) for those who did not experience such efforts. When professional conversion efforts were present, suicide attempts nearly tripled to 63%.
As a therapist I have often treated LGBTQ+ individuals who are distressed around body incongruence, social rejections, discrimination and feelings of not being safe in their schools, churches and homes. Any diagnosis of gender dysphoria is about the emotional distress a person experiences.
For LGBTQ+ clients, therapy should be a place of emotional safety, not scrutiny. A place where identity does not need to be defended, justified, or explained away. For some, therapy is the first place where they are accepted for who they are. I don’t take that lightly. Many LGBTQ+ individuals come to therapy already carrying layers of shame, fear of rejection, deep wounds of not being accepted by their family. Some have the added layer of religious harm or trauma.
My role is not to add to that burden, but to help reduce it.
In my work, this means:
Prioritizing emotional and psychological safety.
Supporting healthy identity development.
Addressing anxiety, depression, trauma, or relational stress without framing identity as the cause.
Therapy should help people feel more whole, not more divided.
In practice, this means”
I don’t ask clients to justify or explain their identity.
I don’t challenge or debate who they are. They define who they are.
I don’t frame their sexuality or gender as the source of their symptoms.
I don’t assume their family, faith background, or community is affirming or hostile.
Instead, I create space where:
The client controls how much they share and when.
Language is respectful and responsive.
Curiosity is directed toward their experience, not their identity itself.
For example, if a client presents with anxiety or depression, the work focuses on what they are experiencing internally, not on “why” they are LGBTQ +. If identity-related stress is present, it’s explored as a response to the pressure they are feeling externally, as well as rejection and fear they are experiencing, not as a personal flaw. Psychological and emotional safety means the client can exhale instead of brace.
What supporting healthy identity development looks like.
Supporting healthy identity development does not mean pushing someone toward a label, outcome or conclusion.
It means supporting integration, self-trust, and coherence however long that takes.
A healthy example:
A young adult client may be questioning aspects of their sexual orientation or gender identity and feel pressure from family, faith or culture to “figure it out” quickly or correctly."
Healthy support looks like:
Allowing internal emotional exploration without urgency.
Validating uncertainty as a normal developmental experience.
Helping the client notice what feels authentic versus what feels imposed.
Separating internal values from external expectations.
Rather than asking, “What are you, really?” Which really does happen to young people and that just breaks my heart. The work sounds more like:
“When and where do you feel safe being yourself?”
“What feels true for you right now?”
“Where do you feel tension, and where do you feel relief?”
“What parts of you feel most like yourself?”
“What do you feel makes you, you?”
Healthy identity development isn’t about defining someone.
It’s about helping them belong to themselves.
Supporting parents when values and beliefs are challenged.
I also work with parents, including Christian parents, who are struggling when a child comes out. I want to say this clearly: parents are allowed to have their feelings. I hold deep empathy for parents, and just as I have sat in hard and tender places with young people, I have also sat in dark and painful places with parents. Most parents are not motivated by rejection; they are scared. They worry about what life will be like for their child, how others might treat them, and how much their world may change. Parents want safety for their children. They want their children to be happy, and the reality is that the world can be harsh for LGBTQ+ individuals, and many parents are simply trying to protect their child from suffering.
There is also grief. Parents carry hopes, expectations, and dreams for their children, and sometimes what they are facing does not fit those imagined futures. Letting go of certain dreams can be deeply painful. Yet grief does not mean failure, and it does not mean love is absent. With support, parents can learn to release what no longer fits and begin to dream new, healthier, and more life-giving dreams for their child and for themselves. That process, while difficult, is possible. I’m happy to report that I’ve seen some beautiful outcomes.
Holding Parents with Compassion and Drawing Ethical Boundaries
Shock, grief, confusion, fear, and internal conflict do not make someone a bad parent. They make someone human. I care deeply about supporting parents as they navigate these emotions and move toward a closer, more authentic relationship with their child or adolescent.
At the same time, there are ethical boundaries in therapy that matter to me. I do not support placing pressure on a child or adolescent to carry messages, beliefs, or expectations that are harmful to their emotional or psychological well-being. Therapy must draw a clear line between processing a parent’s emotion and placing those emotions on a child. A child or adolescent should never be asked to carry the weight of a parent’s unresolved conflict around values, beliefs, or identity.
When I support parents in this situation, the focus is on:
Helping them regulate and process their emotions in appropriate spaces, so their child does not have to.
Processing fear, grief, internal conflict with compassion and honesty without blaming their child.
Helping parents prioritize safety, dignity, and developmental needs and move from fear-based reactions toward connection, understanding and care.
Learning how to preserve a safe, loving relationship.
Understanding the mental health risks associated with rejection or shaming their child.
Therapy can support parents without harming their children. That boundary matters.
When Emotional Weight Gets Placed on a Child.
Sometimes harm doesn’t come from intent, but from unprocessed emotions. Below are examples of ways parents often unintentionally may place emotional or psychological weight on a child or adolescent that therapy works to prevent.
Please note that these examples are not about blame. I share them for awareness.
Asking a child to manage a parent’s emotions, such as saying:
“This is breaking my heart.”
I don’t know how I’ll survive this.”
“You’re tearing our family apart.”
Requesting secrecy or emotional caretaking,
“Don’t tell anyone, you’ll ruin our reputation.”
“I can’t handle this, so you need to be patient with me.”
Using love or acceptance as conditional, even subtly:
“I love you, but I can’t support this.”
“We’ll see how this goes.”
“I’ll love you when you turn away from this.”
“I can’t support you until you turn away from this.”
“We’ll see what God does.”
Asking the child to delay or suppress identity for the parent’s comfort:
“Can you just wait?”
“Do you have to talk about this right now?”
“You’re too young to know. We will deal with this when you’re older.”
Using fear of hell or eternal punishment
“I’m afraid you’re going to hell.”
“This puts your soul in danger.”
“I can’t stand the thought of you being separated from God forever.”
Framing identity as spiritual failure or deception
“This isn’t who God made you to be.”
“You’re being deceived.”
“If your faith were stronger, this wouldn’t be happening.”
Positioning the child as responsible for a parent’s faith conflict, including statements like:
“You’re testing my beliefs.”
“This puts me in a terrible position with God.”
“I’ll love you when you turn away from this.”
“I can’t support you until you turn away from this.”
“We’ll see what God does.”
Using therapy to reinforce a message that increases shame or fear, such as expecting a therapist to:
Convince the child they are confused.
Frame identity as a problem to be corrected.
Asking a therapist to convince a child or adolescent that they are sinful.
Emphasizing judgement or eternal consequences over emotional safety
Why Therapy Draws a Boundary Here
Children and adolescents are still developing emotionally, neurologically and spiritually. Asking them to carry a parent’s unresolved grief, fear, or belief conflict places them in an adult emotional role they are not equipped to hold.
In therapy, the focus is on helping parents process their emotions in appropriate spaces, so children do not have to absorb them. This protects the parent-child relationship and supports long-term trust, safety, and connection. Again, I want to reiterate parents are not wrong for having strong feelings. Fear, grief, confusion, and internal conflict are human responses. Therapy exists to support parents through those emotions without placing them on their child. With support, it is possible to move from fear to understanding and from conflict to connection.
Why These Messages Cause Harm
Being told, explicitly or implicitly that their identity places them at risk of eternal punishment can lead to chronic fear, shame, anxiety, depression and spiritual harm or even trauma. Over time, these messages damage trust and can push a young person away, not only from their parents, but from faith itself.
Holding Faith While Protecting Relationship
Parents do not have to abandon their faith or deeply held beliefs in order to love their child well. Many parents fear that honoring or respecting their child will mean compromising their beliefs. In practice, how a parent responds often matters more than what they believe.
Faith-honoring responses that protect relationships may include:
“I love you. Nothing about this changes that.”
“I’m still working through my beliefs, and that’s mine to carry, not yours.”
“You don’t have to protect me from the truth.”
“I don’t have all the answers, but I’m willing to keep listening.”
Maintaining relationship does not require agreement.
It requires love, humility, safety, and presence.
For many families, choosing connection over control becomes the bridge that keeps both relationship and faith, possible over time. Yes, some parents over time may change their views and some do not. What is most important is the relationship; the love and safety provided to all involved.
The limits of “ethical neutrality”
For a long time, I worked in community mental health. I saw all kinds of individuals and when I saw parents with fundamentalist views struggling with this situation, I believed that ethical neutrality was the right thing. It was the way so many counselors and therapists are trained and how not to rock the boat. It was thought that we should avoid taking sides or holding strong positions. I still believe that what I think and feel in the therapy room is irrelevant most of the time, because it’s not about me. Over time though, I’ve learned that neutrality has limits. Working with the LGBTQ+ community is one of those times.
We are not neutral about abuse.
We are not neutral about racism.
We are not neutral about domestic violence.
And I don’t believe we should be neutral when a young person’s identity is being framed as sinful, broken, or disordered in ways that put their mental health at risk. Not being neutral doesn’t mean we impose our own beliefs. It means we do not participate in harm.
I don’t mediate theology in the therapy room. I don’t act as an authority on theology. My role is not to determine who is right or wrong in matters of theology or another person’s religious beliefs.
My role is to protect emotional and psychological well-being, especially when minors are involved.
Shaming children will have long term effects
that hurting and scared parents can’t always see in the moment.
I don’t claim to be an expert in LGBTQ+ identity, but I am deeply experienced in working with trauma. In my private practice, I’ve worked with many individuals whose trauma is tied not to their identity itself, but to how it was received, particularly within families and faith communities. The coming-out-process, and the responses that follow, can leave lasting emotional wounds. When a person’s core identity is met with rejection or conditional love, it can deeply disrupt their sense of belonging and safety, often showing up years later in therapy.
Holding faith and ethics together
I’ve been a Christian for 37 years, but I didn’t grow up Christian. My views on sexuality and faith weren’t formed in isolation. I knew gay and lesbian people long before these conversations were politicized, and long before I was a therapist. I’ve watched many live healthy, loving, grounded lives. Over the years, I’ve also been part of fundamentalist Christian spaces where fear and assumptions shaped how people talked about sexuality, often in ways that didn’t match what I was seeing in real relationships. My faith has been shaped by Scripture, study, lived experience, and listening.
I no longer understand love as something that requires separating people from who they are.
I hold my faith with humility and continue to wrestle with it, trusting that faith does not require certainty to be sincere. In fact, uncertainty has become part of my faith. What remains clear is this; I will never use faith as a tool of shame, control, or harm, especially toward children and adolescents who are seeking safety, understanding, and belonging.
What this means for my practice
I am available to:
LGBTQ+ clients seeking supportive, affirming care
Parents who want help processing their own reactions in ways that protect their child
Families who are working toward safety, communication, and relational repair
I am not able to:
Provide therapy that treats sexual orientation or gender identity as a disorder
Use scripture or doctrine to correct or shame a client
Participate in treatment that prioritizes belief enforcement over emotional safety
This stance is not about exclusion. It is about ethics, care, and responsibility.
If you’re navigating these questions, whether as an LGBTQ+ individual, a parent, or someone caught between faith and compassion — you are not alone. You deserve support that does not require you to disappear parts of yourself in order to heal.
