DESCRIPTION: AN ARTICLE THAT EXPLAINS WHAT QUEER-AFFIRMATIVE THERAPY IS AND WHY IT IS REQUIRED

A basic tenet of most psychotherapeutic work is the understanding that mental health and one’s sociocultural environment are intimately tied. Your social identity forms an important context that affects many outcomes such as your financial standing, access to important resources, experiences of inclusion or discrimination, and more. 

Gender and sexual orientations are important social identities that have the potential to shape people’s lives. For individuals belonging to the queer community, their identities often impact their lives in ways that can’t be captured through the cis-heterosexual lens that most psychological theories still seem to operate from. For instance, psychological research on disorders and their treatment had often relied on samples of heterosexual men for a very long time, failing to address how this manifested in different populations.

Certain experiences such as discrimination, alienation, and sexual violence in the queer community are issues that can’t be extricated from the sociocultural atmosphere in which the community is embedded. Nor can the ways in which they impact people, such as trauma, stress, or depression, be separated. People’s responses, symptoms, and mental healthcare in these cases need to come from an informed perspective that takes these realities into account. What we need, then, is a transformative and inclusive approach.

What is Queer-Affirmative Therapy?

The queer community has historically been marginalised and their identities pathologised by mainstream psychological interventions. Until as recently as 1973, the Diagnostic and Statistical Manual of Mental Disorders labelled homosexuality as a mental disorder. This legitimised traumatising and harmful practices such as conversion therapy and ‘corrective’ sexual violence.  A counter-movement to this, set against the backdrop of widespread protests in the United States in the 1970s, was queer-affirmative therapy. It is an approach rooted in a set of core principles that “affirm” or promote understanding, acceptance, and validation of diverse gender and sexual identities. The earliest form of this therapy emphasised moving away from the conversion of homosexuality to heterosexuality and focusing on affirming the client’s identity.

A therapist or counsellor from any psychological specialisation can be queer-affirmative. Rather than a particular technique or a treatment modality, the approach refers more to a set of core principles that translate into inclusive practices. While a typical therapy session varies depending on the therapist and the client, queer-affirmative therapy has some common features: 

• It demands self-reflection from the therapist’s end. The therapist actively engages in recognising their own privilege, biases, and where their understanding comes from. 
• Queer-affirmative therapists are also involved in advocating for social change and justice.
• Therapists aid their client’s self-exploration by providing LGBTQIA+ friendly reading material and resources; including inclusive language in all paperwork; and using client’s preferred name and pronouns. 
• Even when working with heterosexual and/or cisgender clients, the therapist challenges heteronormativity and sexism.

The impact of these practices is that they allow the client to learn more about themselves in a space free of judgement or heteronormative expectations. For individuals whose identities have been constantly erased or trivialised, this can be a powerful experience as they learn to claim their space, better understand their experiences, and receive the empathy and support they might not have received from other spaces.

Queer-Affirmative Therapy for Survivor-Victims of Sexual Violence

Worldwide, LGBTQIA+ individuals experience high levels of violence, particularly intimate partner and childhood sexual abuse. For instance, a UNESCO study on sexual harassment at educational institutions in Tamil Nadu found that a little less than 50% of the LGBTQIA+ students surveyed had experienced sexual violence in primary schools. A South Asian study set in Nepal also found that 1 in 4 sexual and gender minority individuals have experienced verbal and physical harassment by law enforcement.  Moreover, survivor-victims from the community are also more prone to double victimisation, facing discrimination from law enforcement bodies and healthcare providers.

Queer-affirmative therapists are then also equipped to help clients navigate these stressors in a way that doesn’t stigmatise their sexualities. Queer individuals also face some unique stressors such as microaggressions, familial violence, institutionalised discrimination, gender dysphoria and more. Queer-affirmative therapy can also aid them in understanding their experiences and identities more holistically.

Queer-Affirmative vs. Queer-Friendly Therapy

Queer-friendly therapists are simply accepting of their clients’ identities. Queer-friendliness becomes especially important in countries and contexts where the identities of LGBTQIA+ individuals are not even recognised or are penalised. 

However,  for a community that often has to fear further discrimination or worse, involuntary disclosure of their identities from their therapists, it is simply not enough to just be queer-friendly. While queer-friendly therapists are accepting, they may not be equipped with the skills, training, and sensitivity required to assist with concerns faced by LGBTQIA+ individuals.

How to Ensure a Therapist is Queer-Affirmative

Listed below are some markers you may look out for before starting therapy with a new mental health practitioner in India:

• Practitioners who have received relevant and credible certifications (such as the Queer Affirmative Counselling Practice course by Mariwala Health Initiative). 
• Practitioners belonging to the queer community.
• If the practitioner or organisation has been mentioned in a crowdsourced list (such as the Pink List) curated by people from the community. 
• If the practitioner is and continues to be open and willing to answer specifics about queer-affirmation in their practice.

Having shared that, finding quality mental health care should not be exhausting. Our team at TCR has created a repository of trauma-informed and queer-affirmative therapists after carefully considering answers to questions about their practice. Each professional listed has worked with student survivor-victims of sexual misconduct. Here is how we assess our therapists are queer-affirmative:

• We only list therapists that are sex-positive allies or members of the LGBTQIA+ community.
• We make a distinction between queer-affirmative individuals and practitioners. This means mental health professionals need to have already worked with intersectional language and methods for queer individuals before being listed on our website.
• We use multiple layers of verification including, but not limited to, participating in verified training programs, personal interviews with therapists, scrutinising intake responses, and trusted referrals.

Queer-affirmative therapy is a powerful and compassionate therapeutic framework that recognises and affirms the diversity of experiences of the queer community. It holds the potential to positively affect a community that still has limited access to healthcare, let alone affirmative healthcare services. In embracing queer-affirmative therapy, we pave the way for a world where each member of the queer community is accorded the respect, care, and support that is rightfully theirs.

References

Ahlenback, V. (2022). Ending Violence Against LGBTQI+ People: Global evidence and emerging insights into what works, Policy Brief, Ending Violence Helpdesk, London UK. 

Chakrabarty, P. (2020, July 24). Understanding Queer Affirmative Therapy: Here’s Everything You Need to Know. Shethepeople. https://www.shethepeople.tv/home-top-video/unpacking-queer-affirmative-therapy-india/ 

Chakravarty, S., Mariwala, R., Nair, P. (2021, June 11). Why mental health professionals must shift from being queer friendly to queer affirmative. Scroll. https://scroll.in/article/997207/why-mental-health-professionals-must-shift-from-being-queer-friendly-to-queer-affirmative 

North Dakota State University. LGBT Affirmative Therapy. https://www.ndsu.edu/fileadmin/hdfs/documents/misc/Affirmative_therapy_handout.pdf 

Ravi, N. (2021, June 29). Queer Affirmative Therapy: Origin, Need and Practice. Sociology Group. https://www.sociologygroup.com/queer-affirmative-therapy/#:~:text=Origins%20of%20queer%20affirmative%20therapy,fully%20written%20off%20the%20DSM. 

Weiss, R. (2014, April 9). Understanding LGBTQ-Affirmative Psychotherapy. PscyhCentral. https://psychcentral.com/blog/sex/2014/04/understanding-lgbtq-affirmative-psychotherapy#1