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Finding a counselor can be a complicated process for anyone. Navigating credentials, different license types, availability, and affordability is daunting. If you are an LGBTQ+ individual, it can be even more difficult to find affordable, affirmative care that is effective for your specific needs.
Online counseling increases access to high-quality treatment for communities who are often marginalized in mental health care. Good mental health care is vital for members of the LGBTQ+ community, who are at a greater risk for developing a mental health condition or experiencing suicidal ideation. While both online therapy and online counseling can be helpful, online counseling is often shorter term and addresses a more specific, often situational, issue.
To make the process of finding a LGBTQ+ affirming counselor easier, we compiled a list of companies, basing our recommendations on out-of-pocket cost, accessibility, reputation, and user experience. We are confident you will be able to find the best fit for you on your search for LGBTQ+ online counseling.
Best LGBTQ+ Counseling of 2023
- Best Overall: National Queer and Trans Therapists of Color Network
- Best for Teens: Talkspace
- Best for Substance Use: Monument
- Best for Anxiety/Depression: Gay Therapy Center
- Best for Couples: Kip Therapy
- Best for OCD: TherapyDen
- Best for ADHD: Amwell
- Best for Group Counseling: Mindful Care
- Most Budget-Friendly: Open Path Collective
- Best Directory: Inclusive Therapists
Best Overall : National Queer and Trans Therapists of Color Network
- Price: Free to use directory
- Insurance Accepted?: By some therapists
- Types of Counseling: Individual, couples, and family
National Queer and Trans Therapists of Color Network prioritizes intersectionality and inclusivity by providing a directory of queer and trans clinicians of color.
Therapists are culturally sensitive and affirming
Free to use
Therapists can share your social identity
Limited search filters
Not all providers accept insurance
Number of therapists varies by location
Founded in 2016, National Queer and Trans Therapists of Color Network (NQTTCN) stands out as a directory that gives users the opportunity to find accessible BIPOC and LGBTQ-identifying clinicians.
“NQTTCN is an excellent resource for clients who want to find an affirming therapist and those who want to find a therapist who shares their LGBTQ+ identity,” says Amy Marschall, PsyD, a licensed psychologist and one of our subject matter experts. “NQTTCN is especially wonderful because they are intersectional and address racial and cultural concerns, dynamics, et cetera, in addition to gender identity and sexual orientation.”
Although NQTTCN is small, the directory’s prioritization of intersectionality provides a streamlined way to find therapists who share your identity. Users appear to recognize this unique offering as 42% of NQTTCN users surveyed said finding a therapist with a similar identity or cultural background was an important factor in their search.
That said, the search filters are more limited than other online therapist directories. Users can only adjust their results by therapists who provide virtual sessions, are accepting new clients, and offer a sliding scale.
National Queer and Trans Therapists of Color Network is free to use to find a provider. Price per session varies by therapist. Within each provider’s bio, directory users can view average cost per session and accepted payment methods, such as credit, debit, HSA/FSA, or electronic payment. Each bio also indicates whether or not the provider offers sliding scale fees or accepts insurance. Some bios list the insurance plans they accept while others do not specify.
It is worth noting that users can filter search results based on whether they need a provider that offers a sliding scale fee. Insurance plans and fee ranges are not search filter options.
The directory’s reputation in upholding its social-justice mission and prioritizing the mental health care of intersectional communities resulted in high levels of user satisfaction, with 84% of surveyed users rating NQTTCN as very good or good. Seventy-five percent of users said they were very likely or likely to recommend the company to a friend. A similar number, 74%, said the process of looking for a therapist that met their needs was very easy or easy. It is clear that NQTTCN values user experience and overall quality in its directory.
Best for Teens : Talkspace
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Talkspace
- Price: $69 to $109 per week
- Insurance Accepted?: Yes
- Types of Counseling: Individual, couples, teen
Talkspace offers virtual, LGBTQ+ affirming counseling sessions for teens with accessibility and affordability in mind.
Asynchronous messaging is available
Offers tiered pricing
Accepts insurance
Unable to choose your own therapist
Does not offer family counseling
Text counseling may not be effective
Since its founding in 2012, Talkspace has established itself as a leading provider of online, subscription-based counseling. Through its website and app, Talkspace offers secure access to counseling for individuals, teens, and families, all without leaving the house.
The company launched Talkspace for Teens in 2019 to cater to ages 13 to 17. It has the same sign-up process, built into the already established Talkspace platform. Signing up as a teen involves uploading a brief video of a parent or legal guardian stating their consent for counseling. After this, the parent or legal guardian will not receive updates on what’s discussed in counseling—unless a teen indicates that they want to harm themself or others.
The confidentiality and accessibility of Talkspace can give teens an outlet for exploring their LGBTQ+ identities and processing its potential impact on their family and friends. It's imperative that LGBTQ+ adolescents receive accessible, affordable, and affirming mental health care. In one survey, a majority of LGBTQ+ youth (58%) said they experience symptoms of depression and 73% said they experience anxiety symptoms.
Talkspace’s pricing structure is a tiered subscription plan based on the type of counseling you desire as well as your location. For individual and teen counseling, Talkspace offers three plans:
- Messaging: Includes asynchronous messaging with guaranteed responses from a therapist five days a week; starts at $69 per week
- Video + messaging: Includes one live video therapy session per week plus asynchronous messaging and starts at $99 per week
- Video + messaging + workshops: Includes access to weekly Talkspace workshops, one live video session per week, and asynchronous messaging, and starts at $109 per week
Users also have the option to purchase additional live video sessions for $65 each.
Talkspace does accept insurance, including Cigna, Optum, and Blue Cross Blue Shield. The process of checking your insurance coverage is relatively straightforward and included in the sign-up process. That said, most accepted insurance plans are employer-sponsored plans.
Asynchronous text messaging through Talkspace’s platform can improve a teen’s experience with therapy. In fact, 27% of Talkspace users said multiple session types (text, audio, and video) were an important factor in their search for online counseling. Customers are consistently satisfied in Talkspace’s ease of use, straightforward sign-up process, and providers. Eighty-two percent of Talkspace users said they were very likely or likely to recommend the company to a friend, and 97% rated it as a little better, better, or much better than comparable services.
Best for Substance Use : Monument
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Monument
- Price: $0 to $249 per month
- Insurance Accepted?: Yes
- Types of Counseling: Individual, group, peer, and medication management
Monument takes a holistic approach to treating alcohol use through counseling, medication management, and LGBTQ+-specific support groups.
Therapists are experienced in treating substance use
Offers tiered subscription plans
Includes comprehensive care and peer support
Focuses on alcohol use
Some plans require additional fees
Only prescribes naltrexone or disulfiram
Founded in 2019, Monument provides evidence-based treatment and peer support to individuals struggling with alcohol use. Its founder, Mike Russell, sought to increase accessibility and affordability of substance treatment outside of inpatient rehabilitation facilities.
The intersection between alcohol use and social identity is apparent. Marginalized communities, such as individuals who identify as LGBTQ+, face a greater risk of substance use due to day-to-day microaggressions and overt discrimination. In a study from the Substance Abuse and Mental Health Services Administration (SAMHSA), researchers found 36.1% of LGBTQ+ individuals binged alcohol compared to 26.7% of heterosexual, cisgender individuals.
Monument has a free support group for LGBTQ+ individuals seeking sobriety or alcohol moderation. It also offers individual and group counseling, a 24/7 anonymous community forum, and medication management by a licensed physician. Users can choose the frequency of counseling sessions based on their paid subscription plan, but access to the forum and support groups is always free.
It is important to point out that Monument physicians only prescribe naltrexone and disulfiram, two medications that treat substance use. Psychotropic medications, such as antidepressants or anti-anxiety medications, are not available through the platform.
Users can decide which monthly subscription plan fits their needs the best based on affordability and services included. Monument has four main plans.
- Community Membership: Access to support groups and the anonymous 24/7 community forum; free
- Physician Care: Includes one appointment a month with a licensed physician for $9.99 a month plus a doctor's appointment fee of $45 per appointment (additional sessions available for $45 each).
- Total Care (Biweekly): Includes two 45-minute counseling sessions per month, unlimited physician appointments, medication management, as well as access to support groups and the forum; $149 per month
- Total Care (Weekly): Same as the biweekly plan, but with four 45-minute counseling sessions per month; $249 per month
Unlimited text messaging your physician and therapist through a secure online platform is available with each paid plan, too.
Monument accepts major insurance plans, such as Medicare, Aetna, Blue Cross Blue Shield, UnitedHealthcare, and Cigna. Prospective users can submit their insurance information and receive confirmation of benefits within 24 hours.
While Monument’s focus is narrowly on treating alcohol use, it is successful at the services it provides, with 78% of surveyed users rating the company as excellent, very good, or good. Fifty-three percent said they used insurance benefits to pay for Monument services and 79% of users rated Monument’s value for the money as excellent, very good, or good. Overall, 97% of users said Monument was much better, better, or a little better than services they’ve used in the past.
Best for Anxiety/Depression : Gay Therapy Center
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Gay Therapy Center
- Price: Starts at $185 per session
- Insurance Accepted?: No
- Types of Counseling: Individual and couples
The Gay Therapy Center concentrates on the experiences of LGBTQ+ individuals who are at greater risk of anxiety and depression by only employing LGBTQ+ therapists.
Personally matches you to a therapist
All providers identify as LGBTQ+
Offers sex counseling
More expensive than competitors
Does not accept insurance
May not be the best fit for transgender populations
Adam Blum, a licensed marriage and family therapist, started Gay Therapy Center in 2015 after noticing a lack of LGBTQ+-affirmative spaces within private practice. Blum sought to build connections between therapists and individuals who shared the same identity. Of users surveyed, 45% stated they sought counseling on Gay Therapy Center for anxiety and 44% said they sought counseling for depression.
With over half of LGBTQ+ adults experiencing symptoms of anxiety and depression, it can be advantageous to have a therapist who knows what it is like to be discriminated against because of sexual or gender identity.
All of the therapists and psychologists at Gay Therapy Center identify as LGBTQ+. Surveyed users appear to value this feature; 27% indicated that “finding a therapist with a similar identity or cultural background as me” was the most important factor in their search for mental health care. Blum and Gay Therapy Center's intake coordinators personally match each prospective client to a therapist based on the client’s clinical needs and personal preferences. They do this with the help of a free 15-minute phone call. This consultation is a unique offering among other LGBTQ+ counseling resources.
Gay Therapy Center counseling appointments start at $185 and average $200 per session. This is on the higher end of out-of-pocket fees for private practice counseling sessions, which average between $65 to $250 each, according to GoodTherapy, an online therapist directory.
The company does not accept insurance plans but does offer straightforward advice for using out-of-network benefits to receive reimbursement for services. This additional advice might be the reason for
Of the users we surveyed, 84% rated the Gay Therapy Center as excellent, very good, or good, while 60% said they would use the company again if they needed to find another therapist. Furthermore, 89% of users said most or all of their needs were met by their provider, which might be reflective of receiving a personalized therapist match upon signing up. Fifty-seven percent of users found the Gay Therapy Center affordable or very affordable, even with the higher cost per session.
Best for Couples : Kip Therapy
- Price: $195 for couples sessions
- Insurance Accepted?: No
- Types of Counseling: Individual, couples, family, and group
Kip Therapy offers culturally informed counseling to individuals and couples, including LGBTQ+-identifying, non-monogamous, or cisgender, heterosexual couples.
Provides quality, trauma-informed care
Serves non-monogamous couples
High customer satisfaction
Available only in New York
Strict cancellation policy
Does not accept insurance
Kip Therapy was founded as an in-person group practice in 2013 that transitioned to fully virtual during the COVID-19 pandemic. The company orients itself around a social justice mission to “provide care for individuals who have been excluded from traditional counseling, particularly members of the LGBTQ+ community.”
With 54% of surveyed users very likely or likely to recommend Kip to a friend, it's clear the company is providing quality mental health care. Though its services are only available for New York residents, the company is worth mentioning on this list for its commitment to culturally informed, trauma-informed care. Kip Therapy helps LGBTQ+ couples process relational conflicts, intersectional identities, and ethical non-monogamy.
Kip Therapy offers tiered, sliding scale fees for individual and couples counseling based on the therapist’s experience.
- Associate therapists (graduate student interns): $65 to $95 per session
- Resident therapists (post-graduate fellows): $130 to $150 per session
- Senior therapists (experienced clinicians): $170 to $225 per session
- Couples counseling: $195 per session
The first session with an associate therapist is free; it's $25 with a resident or senior therapist. You can try initial sessions with multiple therapists until you find a good fit for you.
Kip Therapy does not accept insurance. While you might be able to receive reimbursement from your plan's out-of-network benefits, the company does not state whether it will aid you in that process. If the sliding scale fees are too expensive for your budget, you can complete a financial assistance form on the website to apply for a lower fee.
Even though the company is smaller than others on this list, Kip Therapy strives to provide high-quality, LGBTQ+ affirming mental health care. User survey results indicate it succeeds in this, with 71% rating their therapist’s qualifications as excellent, very good, or good. More than two-thirds of users surveyed said most or all of their needs were met by their provider. And overall, 73% of users rated Kip Therapy as excellent, very good, or good.
Best for OCD : TherapyDen
- Price: Free to use the directory
- Insurance Accepted?: By some therapists
- Types of Counseling: Individual, couples, family, children, teen, group, and medication management
TherapyDen offers a comprehensive directory with extensive search filters to prioritize your unique needs or diagnoses when searching for a therapist.
Wide variety of search filters
Straightforward, easy to use
Values inclusivity
Smaller than other therapist directories
Users must reach out to therapists on their own
Therapist bios don’t include availability
It takes 14 to 17 years on average for individuals with OCD to receive a diagnosis and find effective, evidence-based treatment. The need to find an LGBTQ+-affirming provider could lengthen the process. TherapyDen offers a straightforward way to search for an affirming provider with experience in treating OCD.
Jeff Guenther, LPC, created TherapyDen with a mission “to be as inclusive and representative as possible.” Since its founding in 2017, TherapyDen has prioritized its social justice mission and expanded its reach substantially.
The company often features the experiences of LGBTQ+ clinicians and clients on its website and further demonstrates its affirming position in its search filters, such as Cultural and Systematic Oppression and Kink/Sexual Outsiders as well as LGBTQ+ Issues.
When searching on TherapyDen, you’re able to choose multiple specialties to narrow down your search. This allows you to filter results based on sexual or gender identity as well as mental health conditions, like obsessive compulsive disorder (OCD). Twelve percent of TherapyDen users said their OCD symptoms led them to seek online counseling, while 38% of users said they identify as neurodivergent.
TherapyDen is a free resource for counseling seekers to find local therapists based on their preferences. While fees and insurance acceptance vary by provider, you can filter your search results based on the name of your insurance plan and your ideal price range. You can also indicate whether you’d prefer a provider who offers free initial consultations.
TherapyDen’s reliability and reputability continues to increase as the directory grows. Overall, 80% of TherapyDen users surveyed rated the directory as very good or good. Its focus on inclusivity may be a leading factor in user satisfaction, as 70% of users rate the company’s mission as very good or good. Sixty-four percent said they were likely or very likely to still be seeing their therapist six months from when they were surveyed.
Best for ADHD : Amwell
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Amwell
- Price: $109 to $129 for counseling and psychiatry follow-up appointments; $279 for initial psychiatry consult
- Insurance Accepted?: Yes
- Types of Counseling: Individual, couples, family, teen, and medication management
Users can access counseling sessions and affordable, virtual medication management services through Amwell, including medication for ADHD, which may be more difficult to access through online services.
Collaborative care between psychiatrists and therapists
Accepts multiple insurance plans
Does not require a subscription
Cannot view provider bios before signing up
Website is confusing
No free consultations
Amwell, formerly American Well, is one of the oldest telemedicine providers, founded in 2006. By offering virtual counseling and psychiatry sessions, the company increases accessibility and affordability for LGBTQ+ individuals who need psychotropic medications, such as those diagnosed with ADHD.
Attention-deficit/hyperactivity disorder (ADHD) and sexual minority identities often intersect, though more research is required to better understand how the two interact. The most effective treatment for ADHD includes behavioral counseling and medication, which is why Amwell’s collaborative offering stands out among competitors. Sixteen percent of Amwell users said their ADHD diagnosis led them to seek therapy on Amwell, while 24% of users said they received psychiatric care for their ADHD symptoms.
Online counseling sessions at Amwell are priced between $109 and $129 depending on the experience of the therapist. Individuals requiring psychotropic medications, such as antidepressants or medications to manage ADHD symptoms, can schedule a 45-minute initial psychiatry visit for $279. Fifteen-minute follow-up psychiatry appointments are $109 each.
Amwell accepts a wide variety of major insurance plans, such as Aetna, Blue Cross Blue Shield, Academic Health Plan, UnitedHealthcare, and more. It is important to understand your insurance benefits in order to find the correct service for you. By offering insurance coverage and fees that are lower than their competitors, it makes sense that 66% of users surveyed found Amwell services affordable or very affordable.
Amwell is a well-established online provider of physical and mental health care, and its user results reflect that with 88% of those surveyed rating the company as excellent, very good, or good. Over half of users said they were likely or very likely to see their same provider a year from now, while 91% rated their provider’s qualifications as excellent, very good, or good.
Best for Group Counseling : Mindful Care
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Mindful Care
- Price: $35 for group counseling after a $150 initial evaluation; $50 for 20-minute individual sessions and $100 for 40-minute sessions
- Insurance Accepted?: Yes
- Types of Counseling: Individual, group, and medication management
Mindful Care provides affordable group counseling on a variety of topics, including LGBTQ+ concerns.
Same-day or next-day appointments available
Accepts many insurance plans, including Medicare and Medicaid
Low cost
Only available in six states
Pricing is difficult to find
Unable to choose your therapist
Tamir Aldad, MD, founded Mindful Care in 2018 with a mission to offer same-day and next-day mental healthcare appointments. Today, the company provides individual counseling, group counseling, and medication management for the LGBTQ+ population.
Mindful Care is unique in offering online group counseling led by licensed mental health professionals. The website states its group for LGBTQ-identifying individuals “tackle[s] challenges through an inclusive, non-judgmental, and person-centered approach and promote[s] self-acceptance”. Group counseling can help individuals feel supported and seen not only by licensed professionals but also by their peers. There are multiple group times offered from 9 a.m. to 7 p.m. each day. These sessions are one hour long and typically consist of CBT techniques and peer support.
Its commitment to quick, quality care and group counseling services could be why 84% of Mindful Care users said it was much better, better, or a little better than other services they have used.
Mindful Care accepts a wide variety of health insurance plans, including Medicare and Medicaid. The company’s affordability extends to its self-pay costs, too. The company’s self-pay prices depend on the type and length of service.
- MicroTherapy: 20-minute appointment for individual counseling; $50 per session
- Individual therapy: 40-minute appointment; $100
- Group therapy: $150 for an initial intake session, then 60-minute group sessions for $35
- Medication management: 40-minute initial evaluation is $175 and 20-minute follow-up appointments cost $75
With 92% of Mindful Care users rating the company as excellent, very good, or good, it’s clear that its services are tailored to the needs of its clients. Eighty-four percent of users said Mindful Care was much better, better, or a little better than other services they have used, and 83% said they were very likely or likely to recommend the company to a friend.
Most Budget-Friendly : Open Path Collective
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Open Path Collective
- Price: $40 to $80 per session
- Insurance Accepted?: No
- Types of Counseling: Individual, couples, family, group
Open Path Collective provides culturally competent, LGBTQ+ affirming counseling for a low fee.
Inclusive search filters
Offers sliding scale fees
Can be virtual or in person
Requires a one-time membership fee
Features student counselors
Does not accept insurance plans
Founded in 2012, Open Path Collective is an therapist directory with a mission to provide affordable mental health care to middle- and low-income individuals. Counselors listed on the directory must agree to its sliding-scale fee range.
Open Path Collective also requires clinicians to have a graduate degree in counseling, psychology, or a related field. Experience and credentials will vary based on the provider.
Search filters prioritize the cultural and social experiences of counseling seekers. For instance, users can adjust their search criteria to include the therapist’s ethnicity or race, language, or specialty. Such specialties range from "body image" and “gender or sexual identity exploration” to “polyamory and alternative relationship structures” and “socioeconomic stress/issues.”
After paying a one-time membership fee of $65, users can access the sliding scale rates of therapists listed in the directory. These fees range from $40 to $70 for individual counseling and $40 to $80 for couples or family counseling. It is worth noting that you can adjust your search results based on your ideal pay range. Open Path also offers sessions with student interns for $30 each.
Providers do not accept insurance plans in order to align with Open Path Collective’s mission to provide affordable counseling for the uninsured or underinsured.
Of the users we surveyed, 90% rated Open Path Collective as very good or good, while 84% said they were very likely or likely to recommend the company to a friend. Seventy-one percent of users said the process of looking for a therapist was very easy or easy with Open Path Collective, and 74% of users surveyed said they were able to find a counselor who met all of their needs.
Best Directory : Inclusive Therapists
- Price: Free to use directory
- Insurance Accepted?: By some therapists
- Types of Counseling: Individual, couples, teen, family, group, and medication management
Inclusive Therapists provides a way for counseling seekers to find therapists based on their social identity, such as race, sexual orientation, and gender identity.
Unique search filters for a directory
Easy to find BIPOC, LGBTQ+, and/or neurodivergent therapists
Requires therapists to be culturally competent
Search process can be tricky
Smaller directory than competitors
Does not show who offers free consultations
Inclusive Therapists, founded in 2019, focuses on the experience of marginalized communities with a mission statement to extend “culturally affirming, humble and responsive care, including tending to harms perpetuated by white cishet-patriarchy.” Its social justice goal is evident in its prioritization of BIPOC and LGBTQ+ identifying clinicians.
That goal appears to be succeeding; counseling seekers are consistently matched with culturally competent clinicians who are a part of marginalized communities themselves, and user experience seems to reflect that. Seventy-five percent of users surveyed rated the company’s mission statement as very good or good.
After reviewing its available search filters, it’s easy to see how the directory prioritizes the needs of users. Counseling seekers can adjust search criteria to specific specialties, such as asexuality, foster care, gender identity or intercultural or Interfaith relationships. Additional filters include whether or not the office has a gender-neutral bathroom, evening appointments, or public transportation accessibility. Users can also choose their ideal preferences in their counselor’s identity, including race, ethnicity, ability, neurodivergence, sexual orientation, and more.
Before listing themselves on Inclusive Therapists, each mental health professional is required to complete an interview to verify their care is culturally competent and affirming to all. Users seek out this directory because of its quality in providers; 30% of users surveyed stated therapist qualifications and expertise was the most important factor in their search on Inclusive Therapists.
The directory itself is free for users to access. Price per session varies based on the therapist’s experience and credentials.
Inclusive Therapists allows you to filter results based on accepted insurance plans and pay range, creating a more streamlined search. That said, there is no option to filter based on which providers offer free consultations.
Ninety-seven percent of users surveyed said all or most of their needs were met by the provider they found on Inclusive Therapists. Additionally, 76% of users said they were very likely or likely to be seeing their same counselor in six months, while 65% said they were very likely or likely to be seeing their same counselor in a year. Finally, 89% of users rated their overall experience with Inclusive Therapists as very good or good.
Final verdict
LGBTQ+ individuals have a wider variety of mental healthcare resources available to them today, and the number of online counseling companies that prioritize inclusivity and intersectionality seems to be increasing.
Some companies, like Kip Therapy and Mindful Care, provide good quality, affirming care, but are limited in locations served. Other companies, such as Amwell, help you access culturally competent therapists, but do not focus exclusively on LGBTQ+ experiences. However, the National Queer and Trans Therapists of Color Network effectively serves the LGBTQ+ community as a whole with a focus on intersectionality, affordability, and high-quality providers.
Other companies we considered
Because we reviewed 55 online counseling companies and 25 online therapist directories, there are many that didn’t make the list. This was due to a variety of reasons, including user survey results, patterns in customer experience, and each company’s reputation in prioritizing affirming care. For instance, BetterHelp has received negative reviews in the past regarding its inclusivity, while our experience in reviewing Pride Counseling left us wondering if the company required cultural competence training for its providers.
Compare the best LGBTQ+ counseling
Company | Price | Insurance Accepted? | Types of Counseling Offered |
---|---|---|---|
National Queer and Trans Therapists of Color Network Best Overall | Free to use directory | By some therapists | Individual, couples, and family |
Gay Therapy Center Best for Anxiety/Depression | Starts at $185 per session | No | Individual and couples |
Kip Therapy Best for Couples | $200 to $250 for couples sessions | No | Individual, couples, family, and group |
TherapyDen Best for OCD | Free to use directory | By some therapists | Individual, couples, family, children, teen, group, and medication management |
Amwell Best for ADHD | $109 to $129 for counseling and psychiatry follow-up appointments, $279 for the initial psychiatry consult | Yes | Individual, couples, family, teen, and medication management |
Talkspace Best for Teens | $69 to $109 per week | Yes | Individual, couples, and teen |
Mindful Care Best for Group Counseling | $35 for group counseling with a $150 initial evaluation, $50 for 20-minute individual sessions and $100 for 40-minutes | Yes | Individual, group, and medication management |
Monument Best for Alcohol Use | $0 to $249 per month | Yes | Individual, group, peer, and medication management |
Open Path Collective Most Budget-Friendly | $30 to $80 per session | No | Individual, couples, family, and group |
Inclusive Therapists Best Directory | Free to use directory | By some therapists | Individual, couples, teen, family, group, and medication management |
Guide to choosing the best LGBTQ+ counseling
What is LGBTQ+ counseling?
LGBTQ+ affirming counseling involves providing culturally competent care for a variety of mental health issues, including those related to your social identity. “But not everything has to center around trauma,” says Hannah Owens, a licensed social worker and one of our subject matter experts. “Even simply understanding the day-to-day experience of someone in the LGBTQIA+ community, and completely normalizing those experiences, is another step towards affirming care.”
If a mental health provider says something to you that is offensive or makes you feel uncomfortable, you are not required to continue to see the provider. Counseling should be a safe place to explore your gender and sexual identities or expression, while also navigating other mental health conditions, such as depression, anxiety, or substance use.
Why is LGBTQ+ affirming counseling important?
According to the United States Census Bureau, LGBTQ+ individuals were nearly two times more likely to experience symptoms of anxiety and depression compared to cisgender, heterosexual populations. The Trevor Project, a non-profit organization focused on suicide prevention for LGBTQ+ youth, says that 45% of LGBTQ+ youth seriously considered attempting suicide in 2022.
“LGBTQ+ individuals are at higher risk for mental health concerns than cishet individuals due to discrimination and systemic oppression, as well as rejection from their own families,” says psychologist Amy Marschall. “If counseling reinforces and re-creates these oppressive and harmful systems, these clients will be further traumatized and harmed rather than helped. We know that best practice for LGBTQ+ clients is to affirm their identity.”
Counseling that affirms the identity and experiences of LGBTQ+ individuals is essential for this population to receive comprehensive, high-quality mental health care. Affirming providers are culturally competent and able to recommend tools that will benefit specific sexual and gender identities as well as understand how current events, new legislation, and day-to-day experiences can impact mental health.
Outcome studies continue to show the importance of affirming care for LGBTQ+ individuals. For example, a 2022 study found that gender-affirming care decreased depression symptoms by 60% for transgender and nonbinary individuals.
What types of therapy could be considered LGBTQ+ counseling?
Several types of therapy modalities are appropriate for LGBTQ+ counseling. Sometimes, however, a person’s presenting problem might require a specific type of counseling. For example, complex trauma might require eye motion desensitization and reprocessing therapy (EMDR) or somatic counseling, while grief might be better treated with cognitive behavioral therapy.
“The LGBTQIA+ community is not a monolith,” says Owens. “Different people will respond differently to each therapeutic modality depending on their personal issues and experiences, as well as what they are looking to get from therapy.”
It is important to confirm potential providers’ affirming stances towards the LGBTQ+ population before you work with them. Whether your reason for seeking counseling involves issues specifically related to your sexual orientation or gender identity, it is important for mental health professionals to be familiar with how your experience within the LGBTQ+ population differs systemically.
How do I know if a counseling service is truly LGBTQ+ affirming?
There is a greater number of LGBTQ+ affirming online counseling services than ever before. Still, it can be difficult to navigate which providers or companies are truly affirming.
When looking for an affirming counseling service, you might search for the following on its website.
- A strong social justice mission
- LGBTQ+-specific support groups or online resources
- Search filters that include aspects of LGBTQ+ identities
- Providers who identify as LGBTQ+
- Photographic representation of LGBTQ+ couples and individuals
- A statement about cultural awareness trainings that are available to its providers
It is imperative to find quality mental health care that affirms your sexual or gender identity. As our subject matter expert Hannah Owens points out, “A therapist who is not informed and sensitive to the experiences of members of the LGBTQIA+ population can do more harm than good, misunderstanding their sexual and gender identities, mixing up or blatantly ignoring correct pronouns, or referring to their client's identity as a 'choice' or 'lifestyle.'”
Is medication management available with LGBTQ+ counseling?
Medication management is often available on the same online platforms that offer LGBTQ+ affirming counseling. There are multiple companies on this list that offer both, such as Talkiatry, Amwell, Teladoc, and Mindful Care.
Often, the process involves meeting virtually with a physician or psychiatrist to discuss your mental health needs and health history. Then, your licensed professional will prescribe any necessary medications. It is worth noting that psychiatry services and the medications themselves come at an extra cost, and are often part of a longer term therapy treatment rather than counseling, which is typically shorter-term.
Some online psychiatry companies require the prescription to be picked up at your local pharmacy while others send medications directly to your front door. It’s important to consider which feature you prefer when seeking an online resource for your mental health care.
Comparing online LGBTQ+ counseling services
When comparing online LGBTQ+ affirming counseling services, it’s important to consider factors that will help you find the best fit, including:
- Out-of-pocket cost, which could range from $30 to upwards of $250 per session depending on the company and your insurance coverage
- Insurance coverage, such as what services your insurance covers and what your copays and deductibles might be
- Ease of scheduling, such as whether the company has a built-in scheduling platform or whether you need to schedule each session with your provider
- Method of counseling, which could include asynchronous text messaging, phone calls, or video calls
- Ease of switching therapists, such as whether you are required to state a reason for switching or whether you can do it easily on the platform or via a patient portal without calling customer service
- Whether the company specializes in one specific identity or allows for intersectional representation, if you identify as a member of multiple communities.
What if I'm having thoughts of harming myself?
The Suicide and Crisis Lifeline, 988, is now available for individuals to call or text if they are struggling with suicidal ideation or self-harming behaviors. The Lifeline is open 24 hours a day, 7 days a week.
The Trevor Project also provides 24-hour, 7-day crisis support for LGBTQ+ youth via text, call, or online chat.
If you are having thoughts of harming yourself and online crisis resources are not helping, please call 911 or go to your nearest emergency room.
Frequently Asked Questions
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Does online LGBTQ+ counseling typically accept insurance?
Whether you can use insurance benefits to cover online counseling will depend on the platform, the provider, and your insurance plan. If the counseling company accepts insurance, providers will use diagnostic codes to bill your insurance based on your presenting problem rather than demographic information, such as your sexual orientation or gender identity, unless it is clinically relevant. If the company does not accept insurance, it might be worth familiarizing yourself with your plan’s out-of-network benefits and how to access them.
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What are some conditions an LGBTQ+ counselor can help address?
Counselors can help address a multitude of conditions from eating disorders and substance use to major life transitions and identity questions. Specific to the LGBTQ+ experience, a counselor can help you manage symptoms of depression and anxiety, explore your identity and gender or sexual expression, grieve the loss of relationships with friends or family, as well as increase self-acceptance and overall confidence.
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What is an LGBTQ+ affirming provider?
An LBGTQ+ affirming mental health provider seeks to understand and continue to learn about LGBTQ+ identities and how social identity shapes day-to-day experiences. They take into consideration the stress of discrimination, heterosexism, and trauma regarding one’s gender or sexual experience. Affirmative providers understand the significant role one’s social identity plays, yet do not make it the sole focus of treatment.
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Can a counselor help you come out?
Counseling presents an opportunity for you to safely explore what your gender and sexual identity mean to you before discussing it with others. It can offer a protected way for individuals to explore positive and negative effects of coming out to those around them. Counselors can be helpful by providing space for you to process your expectations about coming out as well as emotion regulation skills during these conversations.
Methodology
When creating this roundup, we reviewed 55 online counseling companies and 25 therapist directories by surveying users and utilizing most of the services ourselves. We considered which companies prioritized statements of LGBTQ+ affirming care and cultural competence as well as what services were specifically provided to the LGBTQ+ population.
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