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While the cumulative and chronic stress many LGBTQ-IA+ individuals experience may increase their need for psychiatric support, fears of being further discriminated against or invalidated by medical and mental health professionals all too often keep LGBTQ-IA+ individuals from reaching out for help.
Here are some pointers to consider when practicing with LGBTQ-IA+ patients:

CHALLENGE ASSUMPTIONS.

• There’s no easy way to tell how a person identifies. Allow yourself to ask questions like: “tell me about your relationships—what have they looked like throughout your life?” says Jeffrey Fishberger, Supervising Psychiatrist at the HIV/AIDS Center at St. Luke’s-Roosevelt Hospital who specializes in LGBTQ-IA+ care.

RECOGNIZE YOUR PATIENT IS THE EXPERT ON THEIR IDENTITY AND SEXUAL ORIENTATION.

• Allow your patient to tell you their story on their terms. Fishberger advises asking open-ended questions such as “so tell me about how you came to recognize that you were transgender”.

RESPECT YOUR PATIENT’S IDENTITY.

• Does your patient prefer to be referred to as she? Him? They? Is there a name different from the one on their birth certificate that they would prefer to be called? Ask your patient how they prefer to be addressed and treat it as you would “Mr.” “Mrs.” or “Ms.” or a nickname, advises Levana Slabodnick, LISW-S, an LGBTQ-IA+-specializing therapist and owner of Silver Linings Therapy.

UNDERSTAND THAT A PATIENT’S CONCERNS ARE ABOUT FAR MORE THAN THEIR SEXUALITY OR GENDER IDENTITY.

• While a patient may want to talk about their gender and sexual orientation, If they’re talking about an issue in their life or a set of symptoms, explore those more. Don’t assume their sexuality has something to do with it, says Slabodnick.

REMAIN CURIOUS. CONTINUE TO EDUCATE YOURSELF ABOUT LGTBQ-IA+ NEEDS.

• Education involves seeking supervision for and processing any discomfort you may have surrounding sexuality or gender, says Fishberger.
• Here are organizations to reach out to for further education:
  • American Psychiatric Association’s Office on Sexual Orientation and Gender Diversity
  • World Professional Association for Transgender Health
  • PFLAG
  • National conferences organized by the Gay and Lesbian Medical Association, the United States Conference on AIDS, and Gender Odyssey.

HERE ARE SOME KEY TERMS USED BY THE LGBTQ-IA+ COMMUNITY TO FAMILIARIZE YOURSELF WITH SHOULD THEY EVER COME UP IN A SESSION:

• Gender binary – A noun referring to the strict, traditional delineation of sex and gender along the lines of male and female.
• Gender identity – the gender that one identifies with, which may or may not correspond to the sex and gender assigned to an individual at birth
• Sexual orientation – a noun referring to whom or to what someone is attracted to. Straight, gay, bisexual, and asexual are some of the more popular terms. But there are numerous sexual orientations, including polyamorous,
  nonmonogamous, and pansexual (which involves a desire for all genders and sexes, irrespective of how a love interest identifies).
• Heteronormativity – Activities, behaviors, and sexual inclinations that are considered mainstream, traditional, or “normal”
• Cisgender – An adjective used to describe a person’s assigned sex and/or gender at birth corresponds to their gender identity
• Transgender – An adjective used to describe a person whose assigned sex and/or gender does not correspond to their gender identity
• Queer – An adjective denoting a nonidentification with heteronormativity and/or a sexual orientation that is not “straight.”

Interested in more terminology? Check out University of California, Davis’s glossary of LGTBQ terms.