A look at “Therapy and counselling experiences of queer adults in Germany” by Sonja Bröning and Agostino Mazziotta (2024)
After the rather gloomy picture in “‘They Must Be Sick’: How Therapists See Non-Monogamous Clients”, here’s something a little more cheering. This German study asked nearly 500 queer adults about their actual experiences of therapy. The verdict? Cautious optimism, with a few sticky hooves.
What they found
The researchers surveyed 492 people online. Most were lesbian, gay, bisexual or another non-heterosexual identity, over half were in consensually non-monogamous relationships, and nearly a quarter were gender-diverse. All had recently had therapy or counselling, and most had been with their current therapist for more than ten sessions.
The headlines:
- Most people rated their therapy as successful and useful, and would recommend their therapist.
- Good practice was more common than bad. Many therapists engaged with LGBTQ+ topics when relevant and actively helped clients feel good about their identities.
- Overt discrimination was rare but not absent. 15% said their therapist had viewed their sexuality or relationship style as bad, sick or inferior. 11% felt pressured to come out, and 6% had been refused therapy after disclosing they were queer.
- Subtle missteps were more common. Over one in five (22%) said their therapist attributed their problems to being queer. Others described automatic assumptions of heterosexuality or monogamy, or a lack of basic knowledge about queer life.
- What made the biggest difference to how successful therapy felt was the therapist being affirming, understanding and actively reassuring.
A grain of glitter ✨
This is a sizeable, inclusive study that usefully separates subtle from overt bias. Its finding that affirmation is linked to better outcomes echoes plenty of other research. But a few things temper the optimism.
The sample was recruited online and through community networks, and it was mostly young, highly educated and cisgender women. Gay men were underrepresented, and trans people weren’t actively recruited, because therapy is mandatory for gender transition in Germany, which would raise different questions. People were asked about their current or most recent therapy, so those who’d had a bad experience and left may be missing. That’s a classic survivor effect. And it’s a snapshot of what clients perceived, not an objective measure of what therapists did.
Also worth noting: even “rare” overt discrimination still affected one in seven people, which isn’t nothing.
Why this matters
If you’re LGBTQIA+ and nervous about starting therapy, this study offers some reassurance. Most queer clients have positive experiences, and affirming therapists make a real difference. But it’s also completely reasonable to check a therapist’s knowledge and attitudes before you begin. Ask about their experience with queer clients, non-monogamy or gender diversity. The right therapist won’t mind; they’ll welcome it.
Most stables are friendly these days. Still, it’s wise to check for rainbow bunting before you trot in.