LGBTQ Clients in Therapy:

Clinical Issues and Treatment Strategies


All the answers clinicians need to work effectively with LGBTQ clients.

A therapist who treats LGBTQ clients often must be more than “gay friendly.” Clinical experience, scientific research, and cultural understanding are advancing rapidly, and the task of being LGBTQ informed is ever-changing in today’s world.

This book covers topics such as how to avoid making the common mistake of believing that “a couple is a couple,” thus treating LGBTQ couples the same as their heterosexual counterparts; how to treat clients struggling in “mixed” orientation marriages and relationships (straight and LGBTQ spouses in the same couple); and how to work with all clients who have non-heteronormative sexual behaviors and practices. Perhaps most importantly, the book discusses covert cultural sexual abuse (the trauma suffered from having to suppress one’s own sexual and gender identity) as well as the difficult process of coming out to family and friends.

A therapist’s job is to help clients and their identities through their own lens and not anyone else’s―especially the therapist’s. The gay affirmative principles put forward in this book will help you build a stronger relationship with your LGBTQ clients and become the go-to therapist in your area.



CHAPTER 1 Psychotherapy for LGBTQ People: Setting the Record—Straight!

CHAPTER 2 What Is Gay Affirmative Therapy?

CHAPTER 3 Growing Up Lesbian, Gay, or Bisexual

CHAPTER 4 Covert Cultural Sexual Abuse

CHAPTER 5 Trauma From Growing Up LGBTQ

CHAPTER 6 Developmental Insults

CHAPTER 7 Coming Out

CHAPTER 8 Helping Families of Lesbians and Gays


CHAPTER 10 Working With Today’s Lesbian and Gay Couples

CHAPTER 11 The New Mixed Marriage or Relationship: One LGBTQ Spouse and One Straight

CHAPTER 12 Gay Affirmative Therapy Principles in Clinical Practice: Establishing a Differential Diagnosis

CHAPTER 13 Working With Today’s LGBTQ Teen

CHAPTER 14 The Transgender Client

CHAPTER 15 The Bisexual Client

CHAPTER 16 Sexual Fluidity




Shining the light on a topic that is often shied away from, Joe Kort calls upon all clinicians, gay or straight, to move past their ignorance, look deeper, and do better work. His book should be required reading for any clinician interested in expanding their consciousness. Which should be all.

Psych Central

Joe Kort’s LGBTQ Clients in Therapy reflects his extensive clinical and teaching experience in working with sexual minorities. His book is a good starting point for any clinician wishing to learn how to best serve LGBTQ populations.

Jack Drescher MD, Clinical Professor of Psychiatry, Columbia University

Joe Kort’s contribution to LGBTQ therapeutic literature is substantive and trailblazing and should be required reading for any therapist working with LGBTQ clients. In this new book, the author updates the data and cultural shifts as well as deepens and extends his original contributions. While addressed to the context of a specific client, Kort’s clinical insights can expand the consciousness of any therapist. We recommend his book to all therapists.

Harville Hendrix PhD & Helen LaKelly Hunt PhD

This beautifully written, accessible book is not just for the straight therapist, every one of whom should purchase a copy. Therapists who identify as LGBTQ also will want Dr. Kort’s book because it updates theoretical approaches to thinking about and treating the younger generation who think about sexual orientation differently than their elders. Plus, as an AASECT-certified sex therapist, Dr. Kort includes straightforward information on understanding LGBTQ sexuality that other authors shy away from.

Stephanie Buehler PsyD CST-S, The Buehler Institute

This updated and informed clinical manual crafts a compassionate narrative for the trauma, drama and shifting diorama of gender and sexual relationship diversity in America.  By naming historical and contemporary psychotherapy ignorance Kort opens the readers mind to essential psychotherapy skills and practices for today’s LGBTQ clients.

Douglas Braun-Harvey MFT CST CSTS, The Harvey Institute