The ban on conversion therapy is a start. But now the mental health profession should look for ways to be proactively affirming of the Rainbow community, writes Sophie Jackson.

You step into a colourful room, rainbow flags on the walls and rainbow knick-knacks on windowsills. Your new therapist greets you, shares their pronouns and asks for yours. You want to talk about a homophobic conversation you heard this week, and the therapist not only listens but can understand the true impact of what you experienced. This is a session with a queer-affirming therapist.

Put the words “queer” and “therapy” into Google recently and the results will have largely been about conversion “therapy”, a form of abuse that aims to convert someone from gay and/or trans to straight and/or cisgender. The government’s recent commitment to ban conversion therapy in Aotearoa, though worth celebrating, is only the first step toward improving mental health within the Rainbow community. The next step is improving access to therapy that celebrates and affirms queer people. Finding a therapist at all can be the biggest barrier to queer people accessing mental healthcare. Part of the issue can be fear of rejection, and in openly acknowledging their queerness to a stranger.

As therapist Rachel Hendron puts it, “Many queer people have already had unpleasant, shaming or abusive experiences from family, teachers, parents, community leaders and so when they reach out for support queer people should feel confident that they won’t experience this from their therapist and unfortunately people still do.” All this has to be overcome to begin the process of seeking therapy.

Looking for a therapist who is also queer-affirming might mean digging through Google (dodging upsetting information about conversion therapy as you go) or possibly seeking a referral through friends. Dee Morgan, a private counsellor working with queer, polyamorous and kinky clients, recognises the burden of this experience. “Word of mouth is exhausting. It’s very effective but if someone has to go talk to 73 friends and go ‘I need therapy, I need a person who can do this, Google is failing me’, that’s frustrating for everybody.”

There are several practical reasons why it might be difficult to find a queer-affirming therapist. One issue is the way that therapists tend to advertise themselves. Although some are out and proud – Dee Morgan owns the website qpk.nz and has a homepage decorated with rainbows and queer-inclusive language – some simply bury “LGBTQ+ friendly” within a long description of their practice, and don’t give any real context of what that looks like in their practice.

Secondly – and even more importantly – there just aren’t enough therapists working with the Rainbow community. I spoke to five queer-affirming therapists (three of whom are also queer themselves) and every single one was either fully booked with queer clients, or aware of the pressure on their fellow therapists working with the Rainbow community. When Dee Morgan first went in search of such a therapist for herself around nine years ago, “there was nobody”. This lack of options was what drove her to start her practice, and to be completely open with clients about her queer identity and commitment to the community.

Within public services, the problem is even more acute. “Clients have said to me they might not be asked about whether they have a preference for a queer or queer-friendly therapist, and even if they are, then one might not be available,” says registered clinical psychologist Zoe Deverick. The privilege of choice is really only available to those who can afford private therapy. In conversations I had with queer friends, the same issue was raised time and time again: not everyone can afford regular therapy, let alone afford the therapist that might be their ideal fit.

Once a queer person does access queer-affirming therapy, the impact on their life can be huge. Dee Morgan describes it as “positive ripples”. Not only does the person in therapy benefit, but what they learn in therapy can ripple out to benefit their friends, family and partner(s). According to Deverick, therapy provides “a safe place” when other aspects of a queer person’s environment “aren’t affirming”. The additional pressure of homophobia or transphobia on a queer person can be eased by therapy, if only for an hour a week.

Registered psychotherapist Patricia Pataki says therapy can be especially well-suited to queer people and their way of thinking. “Queer people are often artistic, creative, they tend to have a great sense of humour and many of them are highly self-reflective, which is a huge asset in therapy.” Morgan agrees, suggesting that because queer people have already dealt with the emotional challenge and breakthrough that comes with accepting their sexuality or gender identity, they can be more open to learning and growing in a therapeutic space.

So why are there so few queer-affirming therapists? The simple answer is that there is no formal incentive or expectation that therapists in Aotearoa make their practice queer-affirming. Several of the therapists I spoke to said that learning about the Rainbow community was only a very small part of their training. OutLine’s general manager Claire Black says it’s long past time the mental health profession began taking the issue seriously. “Basic Rainbow competence in mental health professions is still stunningly lacking. There’s a long history of Rainbow identities being pathologised by mental health professionals, and there are still no requirements or expectations that mainstream mental health professionals meet even a baseline level of awareness and competence in this area.”

Those therapists who are queer-friendly have to be self-motivated to learn about and work with the Rainbow community. Pataki says it’s a step worth taking, and that the process may not be as challenging as it sounds. “I think what a therapist needs to be queer-allied is just to be interested and willing to work with this client group. Any therapist can learn how to do that, if they are committed and willing to seek out some additional training or to get some additional supervision around the topic from a more experienced colleague.”

For queer and queer-affirming therapist Shannon Granich, it can be as simple as keeping up to date with “political, social, and medical movements and practices” so her clients feel understood. Granich says the number of queer-affirming therapists is not going to grow on its own. “Until there is a standardised level of education around New Zealand when training to be in the medical, mental health, or social service industries – [one] that provides a basic understanding of Rainbow identities and issues Rainbow people face – this difficulty in accessing queer friendly support will remain.”

There is hope on the horizon. Granich currently supervises fellow therapists and is able to offer support to those wanting to learn about the Rainbow Community. Morgan is seeing promising signs too. “There are a few people I know who are in the process of going through training, who are already part of the queer community or kink community or polyamorous, and they’re like ‘yeah I wanna be doing this too!’” She is planning to offer placements when she can to help new queer-friendly therapists get into the profession and gain experience. She’s hopeful about the future of queer mental health care, and believes that people are increasingly interested in working with the Rainbow community. “Give it another five years and we’ll see!”

In the meantime, there are options out there. The biggest challenge is starting the search. For queer people who are looking for help, the charities OutLine and RainbowYOUTH can both help with accessing queer-friendly therapy. Although some of the therapists in this article are booked up, they may also be able to offer alternative recommendations to those who ask.

It doesn’t stop there. Claire Black from OutLine argues that queer mental health care goes well beyond therapy. “There are also lots of structural components to mental health – housing, employment, discrimination, isolation, health, and addressing intersecting forms of oppression.” For queer Māori or takatāpui, mental healthcare may not include therapy at all; instead, exploring collective bonds with whānau, engagement with te ao Māori, and unlearning post-colonialist views on gender and sexuality can all be crucial to their wellbeing.

We are moving forward and improving conditions for the Rainbow community, but it’s up to the government now to set the standard higher; not just to end the trauma of conversion therapy, but to make it easier to access support to deal with the everyday trauma of living with homophobia and transphobia. Individual therapists can also act to improve their profession, but it will often be therapists who are queer themselves who will take on the challenge of working with the underserved Rainbow community. Queer-friendly therapy is only one step on the journey toward healing and justice for Aotearoa’s Rainbow community. What’s clear is leaving conversion therapy in Aotearoa’s past is just the beginning of the work ahead.

Helplines

OUTLine NZ – 0800 688 5463 (OUTLINE) is a sexuality and gender identity helpline that provides confidential telephone support.

Youthline – 0800 376 633, free text 234 or email talk@youthline.co.nz or online chat.

Need to talk? Free call or text 1737 any time for support from a trained counsellor.

Lifeline – 0800 543 354 (0800 LIFELINE) or free text 4357 (HELP).