Appendix 1: Affirming vs. Non-Affirming Therapy

“Love yourself enough to set boundaries. Your time and energy are precious. You get to choose how you use them.” – Anna Taylor

The Invisible Harm of Non-Affirming Care

For LGBTQ+ individuals, especially those navigating rejection or conditional love, the type of care you receive can either heal or harm. But when you’re in the thick of it - when everyone around you, from parents to therapists, seems to treat your identity as “the problem” - it can be hard to see what’s truly happening. Gaslighting often makes you question your instincts, leaving you wondering if you’re really being hurt or if you’re just “too sensitive.”

Let’s be clear: non-affirming care isn’t just ineffective - it’s dangerous. And recognizing it, especially when it’s subtle, is the first step toward protecting yourself and reclaiming your voice.

What Non-Affirming Care Looks Like

Non-affirming care can take many forms, from outright hostility to more subtle undermining. Here are some red flags to watch for:

Conditional Acceptance

  • What It Sounds Like:
    • “I love you, but I don’t have to support your choices.”
    • “I just want what’s best for you, and I don’t think this is it.”
  • Why It’s Harmful:
    • It frames your identity as a “choice” that can and should be changed. This reinforces feelings of shame and inadequacy.

Pathologizing Your Identity

  • What It Sounds Like:
    • “Maybe this is just a phase.”
    • “Have you thought about how this might be tied to trauma?”
  • Why It’s Harmful:
    • It treats your identity as a symptom of something “wrong” with you, rather than a valid and beautiful part of who you are.

Gaslighting Your Reality

  • What It Sounds Like:
    • “I think we can agree that everyone deserves empathy.” (conflating people with attitudes, and empathy with tolerance for bigotry and other disrespectful commentary.)
    • “We’re just trying to have a reasonable discussion.”
  • Why It’s Harmful:
    • It invalidates your feelings and experiences, making you question your instincts and reality.

Prioritizing Family Dynamics Over Individual Well-Being

  • What It Sounds Like:
    • “We need to focus on how this is affecting your parents.”
    • “Families need to work together, and compromise is important.”
  • Why It’s Harmful:
    • It shifts the focus away from your needs, framing your identity as a disruption rather than something to be supported.

How to Identify Affirming Care

Affirming care is the opposite of these harmful dynamics. It centers your needs, respects your identity, and validates your experiences. Here’s what to look for:

Clear Affirmation

  • What It Sounds Like:
    • “Your identity is valid and deserves to be celebrated.”
    • “I’m here to support you, however you need.”

Empowerment, Not Control

  • What It Sounds Like:
    • “What do you think feels right for you?”
    • “Let’s focus on what makes you feel whole and supported.”

Respect for Boundaries

  • What It Sounds Like:
    • “Your boundaries are important, and I’ll honor them.”
    • “You have the right to protect your peace.”

Affirming the Journey of Questioning

  • What It Sounds Like:
    • “It’s okay if you’re still figuring things out. Your journey is your own, and I’m here to support you no matter what.”
    • “Questioning your beliefs and understanding yourself better is an important part of growth. I'm so proud of you.”
  • Why It’s Important:
    • Everyone deserves space to explore their identity without pressure to decide or conform. Questioning is not only natural but deeply aligned with the practices of self-reflection found in every major religion. Affirming care acknowledges that self-discovery is a process and that this process is valuable and valid in itself.

How to Advocate for Yourself

When you’re surrounded by people who frame your identity as a problem, self-advocacy can feel overwhelming. Here are some strategies to help you reclaim your voice:

Name the Harm: Be clear about what’s happening and how it affects you:

  • “When you say my identity is a phase, it makes me feel dismissed and unseen.”
  • “I need you to understand that questioning my identity isn’t helpful - it’s hurtful.”

Hold Firm Boundaries: Protect your mental and emotional health by setting clear limits:

  • “I won’t discuss my identity in a way that frames it as a problem.”
  • “If this conversation continues to be disrespectful, I’ll have to leave.”

Seek Outside Support: Find affirming allies, whether through support groups, friends, or community organizations. They can validate your experiences and provide perspective.

Challenge Gaslighting with Facts: When someone denies or distorts your reality, use clear, factual statements:

  • “You keep saying this is about love, but love doesn’t dismiss someone’s identity.”
  • “It’s not just my feelings - this is a well-documented harm to LGBTQ+ people.”

When Authority Figures Align with Non-Affirming Parents

Therapists, clergy, or educators often hold significant power. When they align with non-affirming parents, the resulting dynamics can feel like the entire world is against you. This creates profound confusion and deepens the emotional harm, particularly for children already struggling to navigate rejection and conditional love. Authority figures are expected to serve as neutral or affirming support systems, but when they fail to do so - or worse, when they perpetuate harm - it amplifies the damage.

Affirming care has been recognized as the gold standard by the American Psychological Association (APA) since 2007. The APA’s resolution on sexual orientation and gender diversity emphasizes that therapeutic practices should affirm LGBTQ+ identities as natural and valid, while rejecting any form of conversion therapy or attempts to change an individual’s identity. Affirming care centers on promoting mental health and self-acceptance, ensuring the individual feels supported and seen. Non-affirming therapists, however, often distort the concept of “affirmation” in ways that are subtle but deeply damaging. They may use language that appears supportive on the surface while perpetuating rejection in practice.

For example, a non-affirming therapist might justify conversations about a parent’s refusal to celebrate their child’s identity or relationship by framing it as an issue of religious belief or cultural values. They may encourage the child to “respect” the parent’s discomfort, effectively placing the burden of reconciliation and emotional labor on the child. Each time this happens, the therapist allows harmful narratives to persist, validating the parent’s rejection and sidelining the child’s need for affirmation. The confusion this creates can lead to feelings of gaslighting, where the child begins to question their own experiences and emotions.

Here’s how to navigate these dynamics and advocate for your mental health:

Question Their Approach: Ask direct questions to uncover potential biases:

“Do you believe LGBTQ+ identities are valid?”

“How do you approach family conflicts involving identity?”

Look for clear, affirmative responses. Avoid therapists who deflect, use vague language, or attempt to frame LGBTQ+ identity as a source of conflict.

Redirect the Focus: Shift the conversation back to your needs:

“This isn’t about my parents’ discomfort - it’s about my safety and well-being.”

Insist that your identity and emotional health are the priority, rather than framing discussions around reconciling with non-affirming attitudes.

Document the Harm: Keep detailed notes about what authority figures say and do. For instance, if a therapist consistently validates harmful narratives or fails to support your identity, write down specific examples. This can be invaluable if you decide to report them to professional boards or seek alternative support.

Recognize Gaslighting Tactics: Be aware of language that seems supportive but subtly undermines your identity. Statements like: “Your parents are coming from a place of love” or “Maybe this is a misunderstanding” can minimize your experiences and create confusion. Trust your instincts if something feels off.

Seek Affirming Professionals: Transition to an affirming therapist or counselor whenever possible. Affirming professionals explicitly advertise their support for LGBTQ+ clients and are well-versed in the unique challenges you may face. Look for certifications or affiliations with organizations that prioritize LGBTQ+ mental health.

Understanding the History of Affirming Care

The APA’s 2007 resolution was a landmark moment in the recognition of LGBTQ+ mental health needs. It rejected outdated practices like conversion therapy and affirmed that diverse sexual orientations and gender identities are natural variations of human experience. The resolution emphasized the importance of promoting self-acceptance and protecting LGBTQ+ individuals from harm. Affirming care has since become the ethical standard across reputable mental health organizations, yet non-affirming practices persist in subtle forms, often under the guise of neutrality or cultural sensitivity.

By aligning with non-affirming parents, authority figures not only violate these ethical standards but also perpetuate the very harm the APA sought to eliminate. It’s essential to recognize when this is happening and to seek environments where your identity and mental health are genuinely respected.

Remember: you deserve care that affirms who you are, not care that asks you to compromise your truth to accommodate others’ discomfort.

Reflection and Reclaiming Your Power

The weight of being treated as a problem isn’t yours to carry. Affirming care starts with recognizing your worth and advocating for the respect you deserve.

Ask yourself:

  • Am I in a space where my identity is celebrated, not questioned?
  • What steps can I take to surround myself with affirming care?
  • How can I protect my peace when faced with non-affirming attitudes?

Remember: You are not the problem. Their refusal to see you for who you are - that’s the problem. And you have the power to step out of their narrative and into your truth.