Supporting LGBTQ Youth: Best Practices for Counselors

Counseling LGBTQ+ youth is a specialized and deeply sensitive field that calls for an understanding of the unique challenges and strengths of these young people. The journey of self-discovery and identity formation can be complex for any young person, but LGBTQ+ individuals often navigate additional layers of societal, familial, and internal pressures. Counselors engage in supporting LGBTQ youth as guides, listeners, and unwavering sources of affirmation and advocacy. 

Recommended course: Best Practices with Lesbian, Gay & Bisexual Youth and Their Families, Updated 1st Edition 

How to support LGBTQ youth: Understanding the development process

LGBTQ+ youth development is a multifaceted process that involves a young person’s growth and self-realization in the context of their sexual orientation and gender identity. Various factors influence this development, including individual characteristics, family dynamics, social environments, cultural norms, and systemic structures. 

Understanding sexual orientation and gender identity 

For many LGBTQ+ youth, development includes the process of understanding and naming their own feelings or their experience of gender. This can happen over time and may involve: 

Supporting LGBTQ youth through the coming out process 

Many LGBTQ+ youth go through the process of coming out, which is disclosing their sexual orientation or gender identity to others. This can be liberating but also fraught with challenges, depending on their environment and the responses of peers, family, and the community.  

When counseling LGBTQ+ youth, it’s important to remember that the responses they receive to coming out can greatly impact their development. Acceptance can bolster mental health and well-being, while rejection can lead to risks such as depression, anxiety, and even homelessness. 

Developing a positive self-concept 

A critical part of healthy development for LGBTQ+ youth is the affirmation of their identity. Counseling LGBTQ+ youth involves providing access to positive role models, resources, and supportive communities. This is key to helping them develop a positive self-concept. 

Facing and overcoming prejudice and discrimination can lead to resilience. How LGBTQ+ youth cope with adversity is important to their overall development and well-being. 

Gender transitioning and identity affirmation 

When counseling LGBTQ+ youth, it’s important to understand that transgender and non-binary youth development may include social, legal, and medical steps to affirm their gender identity. This might involve name changes, gender-affirmative healthcare, and navigating gender expression in various settings. 

Supporting LGBTQ youth in social relationships 

Social development of all youth includes navigating friendships and romantic relationships, which can be more complex for LGBTQ+ youth due to potential stigma. Connecting with other LGBTQ+ individuals and allies can be an important part of development, offering a sense of belonging and a shared experience 

In counseling LGBTQ+ youth, it’s important to consider these developmental aspects to provide environments that foster healthy growth and self-acceptance among LGBTQ+ individuals. Understanding that these developmental milestones may be determined by how much — or how little — support they receive is important for helping these individuals navigate their journey. 

Challenges faced by LGBTQ+ youth and their families 

LGBTQ+ youth and their families often face a range of challenges that can impact their mental health, well-being, and the quality of their relationships. These challenges are rooted in societal attitudes and the complexities of navigating a world that often lacks understanding and acceptance of LGBTQ+ identities. Some of the primary challenges include: 

  • Stigma and discrimination. Despite advances in LGBTQ+ rights, stigma and discrimination persist in many aspects of life, including in schools and healthcare settings. LGBTQ+ youth can experience bullying, harassment, or exclusion. These experiences can lead to increased rates of anxiety, depression, and suicidal ideation. 
  • Family acceptance. The process of coming out can be fraught with fear for LGBTQ+ youth, particularly if they anticipate negative reactions. Families may struggle with accepting their child’s identity due to cultural, religious, or personal beliefs. When counseling LGBTQ+ youth, it’s important to understand that this lack of acceptance can lead to familial conflict, estrangement, and in some cases, homelessness for these individuals. 

Additional challenges: Healthcare, education, and legal barriers

  • Access to LGBTQ-affirmative healthcare. Finding healthcare providers who are knowledgeable and affirming of LGBTQ+ identities can be a challenge. Transgender and non-binary youth may face additional barriers in accessing gender-affirming care, such as hormone therapy or surgery. 
  • Education and school environment. Additional challenges faced by LGBTQ+ youth occur in school environments. Schools may lack inclusive policies or fail to enforce anti-bullying measures, creating an unsafe environment for these individuals. Also, sex education programs often do not include information relevant to LGBTQ+ students, leaving them without crucial knowledge for their health and relationships. 
  • Legal and policy barriers. LGBTQ+ youth may live in regions where laws do not protect them from discrimination based on sexual orientation or gender identity. Policies that prohibit the discussion of LGBTQ+ topics in schools, further contribute to a culture of silence and exclusion. 

Supporting LGBTQ+ youth as a counselor requires a variety of approaches that include building supportive family interventions and advocating for inclusive school policies, comprehensive healthcare access, and societal shifts towards greater acceptance and understanding of LGBTQ+ identities. 

Therapeutic approaches used for counseling LGBTQ+ youth 

Family therapy with LGBTQ+ youth and their families must be sensitive. It should also be adaptable to address the specific dynamics and challenges that may arise related to sexual orientation and gender identity. There are several therapy models that can be used when counseling LGBTQ+ youth. Each of these therapies has its own unique approach. 

Structural Family Therapy (SFT) 

SFT focuses on the interactions between family members and seeks to understand and realign the family structure. In the context of LGBTQ+ youth, this might involve addressing the hierarchical power dynamics within the family that could marginalize the young person’s voice or exploring subsystems within the family that may be contributing to conflict around their identity. 

Strategic Family Therapy 

This model is aimed at resolving specific problems within the family system by altering the way family members interact. This approach seeks to identify and change the patterns of interaction within the family structure.  

It often involves directive interventions and homework assignments. Counselors and therapists may work with families of LGBTQ+ youth to disrupt negative patterns of communication and create new, more affirmative ways of interacting that support the youth’s identity. 

Solution-Focused Brief Therapy (SFBT) 

SFBT is a short-term and goal-directed collaborative approach that focuses on identifying and enhancing existing resources and strengths to help families create a desired change. When counseling LGBTQ+ youth, the therapist helps the family to envision a future where the youth’s identity is accepted. They then work to build the steps towards this reality. 

Acceptance and Commitment Therapy (ACT) 

ACT encourages individuals to accept their thoughts and feelings rather than fighting or feeling guilty for them. Applied in a family context with LGBTQ+ youth, it can help family members move toward accepting the youth’s identity. This approach can help a family commit to actions that build a supportive and affirming family environment. 

Each of these models can offer valuable frameworks for therapists counseling LGBTQ+ youth and their families. Also, maintaining a stance of curiosity, openness, and non-judgment is fundamental to supporting these families through their challenges and toward a path of greater acceptance. 

Additional interventions for LGBTQ+ youth and their families 

Interventions for LGBTQ+ youth and their families extend beyond traditional family therapy models. Interventions can include a variety of support systems designed to foster understanding, acceptance, and healthy relationships. Several additional interventions that can be used when counseling LGBTQ+ youth include educating families about LGBTQ+ issues. This psychoeducation can help dispel myths, reduce stigma, and foster a supportive family environment. 

Both LGBTQ+ youth and their families may benefit from support groups that connect them with others who have similar experiences. For youth, groups like Gay-Straight Alliances (GSA) in schools or community youth groups can provide peer support. For families, groups like PFLAG (Parents, Families, and Friends of Lesbians and Gays) offer a space for learning and shared experiences. 

Gender and sexuality alliances (GSAs) and crisis intervention services 

GSAs in schools are student-led organizations that provide a supportive space for LGBTQ+ youth to discuss their experiences. These groups also often advocate for changes within the school setting to promote acceptance and combat discrimination. 

When counseling LGBTQ+ youth, it’s crucial to have knowledge of appropriate crisis intervention services. Access to services, like hotlines or text lines, can provide immediate support for LGBTQ+ youth who are experiencing acute distress, suicidal ideation, or other emergencies. 

Being able to understand the importance of supporting LGBTQ youth through counseling provides these individuals a safe space to navigate the complexities of their identities, fosters resilience in the face of discrimination and stigma, and promotes overall mental health and well-being in a crucial stage of development.