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Sexuality and Mental Health: How to Support Your Clients

Apr 18, 2022

Being gay, lesbian, queer, pansexual, asexual, demisexual, bisexual, or any other sexual identity doesn’t mean you have a mental health problem – but the experiences related to a person’s sexuality can contribute to mental health struggles.

It’s not uncommon for people to experience bullying because of their sexuality – or to be treated differently because of it. These sorts of experiences can be incredibly harmful; being made to feel different from your peers, unsupported or misunderstood by the people around you, or even that your sexuality is not accepted can all cause a great deal of damage.

Second-hand experiences (just like a therapist’s experience of second-hand trauma) can also play their part: even if a person hasn’t directly experienced any of the above, knowing someone who has been treated this way because of their sexual identity can make them worried about being open with their own sexuality – causing them to feel isolated and unsafe.

The clients coming to you, then, are looking for a safe space in which to share.

Supporting Your Clients with My Little Therapy Box

A person’s sexual identity isn’t simply about who they have sex with; sexuality pertains to a broad spectrum of feelings, emotions and attractions – or a lack of sexual attraction or romantic attachment.

In my little therapy box, my own resource containing 40 individually designed mood cards for personal and professional use (ideal for growth and healing, aiding conversations, or journal writing), the ‘sexuality’ card asks the reader to think about what’s causing them to feel unhappy or distressed in terms of their sexuality. They’re also invited to consider whether this feeling is new or long-standing.

Posing these questions to your client helps them to identify the problem, acknowledge how long they’ve felt this way, and really uncover how this challenge is impacting their wellbeing, relationships, and mental health.

Using the prompts on the sexuality card of my little therapy box, you can encourage your clients to explore this issue further – either in conversation with you, or by writing things down. Ask them to identify what thoughts they’ve been experiencing, and how these particular thoughts about their sexuality have made them feel.

It’s important to remember here that everyone is an individual, and everyone’s sexuality – and sexual journey – is entirely unique. Remind your clients that sexuality can be fluid; it doesn’t have to be rigidly defined. You should also encourage your clients to embrace and fully connect with their sexuality; it cannot be ignored, and trying to do so isn’t healthy for body or mind.

Understanding Sexual Terms

If you’re going to be supporting clients through their struggles with sexuality, it’s important that you understand some of the most common terms.

  • asexual: asexual refers to a person who experiences little or no sexual attraction to other people; they might also lack interest in sexual relationships or sexual behaviour. Someone who identifies as asexual may however still experience a romantic attraction to others.
  • aromantic: aromantic refers to a person who experiences little or no romantic attraction to other people; they may also lack interest in romantic behaviour. Someone who identifies as aromantic may however still experience sexual attraction to others.
  • bisexual: someone identifying as bisexual is typically attracted to more than one gender.
  • gay: someone identifying as gay is predominantly attracted to people of the same gender.
  • heterosexual: someone identifying as heterosexual is predominantly attracted to people of a different gender
  • lesbian: lesbian refers to someone who identifies as female, and who is predominantly attracted to people who also identify as female.
  • pansexual: pansexual refers to a person who has feelings or an attraction to people of all gender identities.
  • queer: the term queer is used to describe a range of gender identities and sexual identities, outside of heterosexual and cisgender. Queer can mean different things to different people.
  • demisexual: demisexual refers to a person who experiences little or no sexual attraction to people, until they develop romantic feelings.

This list is entirely non-exhaustive. For a more comprehensive list of terms, visit stonewall.

What Will Your Clients Need Help With?

Clients struggling with their sexuality may need your support with: feeling different, or like they don’t fit in; being stereotyped; experiencing prejudice; being bullied; feeling unsafe; having their sexuality mislabelled or misunderstood; worrying about coming out; feeling confused about their sexuality, or under pressure to label themselves; being made to feel ashamed or unsupported, or even being cast out by family or friends.

It’s important to learn all you can about the challenges facing your clients, and to offer them a safe, non-judgmental space in which to air their feelings. You might also want to consider directing them to resources and support groups – either local or national – that could help them to feel less alone.

Useful Links

  • MindOut: A mental health service run by and for lesbians, gay, bisexual, trans and queer people with experience of mental health issues.
  • Galop: A dedicated LGBT+ anti-violence charity.
  • Albert Kennedy Trust: For LGBTQ+ people aged 16-25 in the UK, facing or experiencing homelessness, or living in a hostile environment.
  • Switchboard: Confidential support and advice for members of the LGBT+ community.
  • Stonewall: Information and support for lesbian, gay, bisexual and transgender (LGBT) people.

Access your FREE 'Creative Therapy Training'

My Little Therapy box all started with my passion for helping clients in therapy who struggle to open up and articulate their feelings into words.

In this 30-minute training session, I share the barriers some clients face in therapy and how we as therapists can help them overcome this by using creative ways to help them engage and get the most out of the therapeutic relationship.

This is the same presentation I was invited to deliver at this year’s BACP Annual Online conference.


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