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Book Review: LGBTQ Clients In Therapy

“The past offers a sad litany of ineffective, wrongheaded treatments for homosexuality, right up to the present day reparative therapy and sexual reorientations camps” writes Joe Kort.

Kort is a foremost authority on LGBTQ issues and author of several books including 10 Smart Things Gay Men Can Do To Improve Their Lives, and Gay Affirmative Therapy for the Straight Clinician. He contends that the therapist’s job when working with gay clients is to help them find their identity independent of the forces and pressures placed upon them by the world, others, and the culture itself.

In his new book, LGBTQ Clients In Therapy: Clinical Issues and Treatment Strategies, Kort brings his gay affirmative principles into the present day, incorporating the changing world of homosexuality to help clinicians understand what it truly means to be “gay aware” in today’s world.

“There’s a culture war going on around sexual orientation and identity, both within the LGBTQ communities and between those communities and the straight dominant culture. People are arguing about what it means (and should mean) to be gay, lesbian, bisexual, and queer. So you’re going to have clients coming bashed and confused and disoriented by the cultural controversies and mass shootings and prejudicial laws, and your job will be to help them find their sexual selves through their own lens, not through a political lens, and not through your lens either,” writes Kort.

Traditionally, Kort tells us, homosexuality was viewed simply as a phase – a stage that precedes heterosexuality – or rather, “straight gone bad.”

“This theory leads many psychotherapists to believe that in adolescence, young men and women get a second chance to ‘repair’ their homosexuality,” writes Kort.

Today the world has changed. Homosexuality is not a clinical disorder, a maladjustment, or a sign of an unhappy individual stuck in an internal sexual conflict. And yet, as much as reparative therapy is considered unethical at best, and abusive at worst, it is still being done.

“Too many people find themselves drawn to ‘reparative’ therapies (especially in the early stages of coming out) that supposedly will ‘return’ them to heterosexuality with all of its privileges and status,” writes Kort.

Creative in the language they use, reparative therapies often promulgate the beliefs that homosexuality: stems from stunted or immature heterosexuality; is caused by a smothering, overprotective mother; that two people in a same sex relationship are looking for parenting in each other; or that people can simply choose to change their orientation.

Gay affirmative therapy, on the other hand, embraces the gay individual as whole, complete, and worthy of a respectable place within society.

“This approach regards homophobia, as opposed to homosexuality, as a major pathological variable in the development of certain symptomatic conditions,” writes Kort.

Although clinicians commonly present themselves as “gay friendly,” gay affirmative therapy goes much further – understanding the impact of living in a heterosexually privileged world.

“Heterosexual privilege teaches LGBTQ individuals that misleading others into thinking that they are straight is the standard – indeed, the only – way to live,” writes Kort.

Along with overlooking this glaring fact, some of the errors clinicians commonly make are: not disclosing their own sexual orientation when asked; denying their homophobia or heterosexism; not offering resources; using the wrong terminology; adopting a blank screen therapeutic style; failing to recognize that gay and lesbian clients have been gay and lesbian since childhood; failing to assess the client’s stage of coming out; and believing that “a couple is a couple.”

All gay clients, Kort writes, have endured the micro-aggressions that smack of homophobia. Kort relates his own experience of a woman, claiming to not be homophobic, telling him, “I just don’t think your people should be allowed to marry.”

The role of a gay affirmative therapist is to help bring micro-aggressions – and the oppression that they represent – into consciousness so that the concept of internalized homophobia can be discussed and removed.

“Internalized homophobia is really internalized shame about being gay or lesbian – an internalization of the very thing you have been taught to despise and consider evil,” writes Kort.

It is only by acknowledging this gay shame that clinicians can truly understand the pervasive trauma that LGBTQ children grow up with, the internalized homophobia they contend with as adults, and, ultimately, help them find their way to a sense of pride.

Clinicians also need to educate themselves about the lives of LGBTQ individuals – from the terms they use and their sexuality, to the roles they play in couple relationships and the relational dynamics that are unique to them.

“As therapists we must keep as a cardinal rule that while we help clients attain clarity and reduce grief, depression, and self-destructive tendencies, we do not assign anyone a sexual orientation,” writes Kort.

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.  

LGBTQ Clients In Therapy: Clinical Issues and Treatment Strategies

Joe Kort

W.W. Norton & Company

March 2018

Softcover, 394 Pages

Book Review: LGBTQ Clients In Therapy

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Claire Nana

Claire Nana is a regular contributor and book reviewer for Psych Central.

APA Reference
Nana, C. (2018). Book Review: LGBTQ Clients In Therapy. Psych Central. Retrieved on September 28, 2020, from
Scientifically Reviewed
Last updated: 20 Jun 2018
Last reviewed: By a member of our scientific advisory board on 20 Jun 2018
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