Rebuilding Trust in LGBTQ+ Mental Health Care: When Therapy Falls Short

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Rebuilding Trust in LGBTQ+ Mental Health Care: When Therapy Falls Short

Let’s be real—therapy doesn’t always go the way it should. Especially if you’re LGBTQIA+, you may have walked into a therapy office hoping for support and instead walked out feeling dismissed, misunderstood, or worse, harmed. And if that’s been your experience, you’re not alone. Many queer and trans folks have had to protect themselves by walking away from mental health care entirely.

But that doesn’t mean therapy isn’t for you. It might just mean that the person you worked with wasn’t equipped to support you. The issue might not be with therapy—it might be with the therapist.

At Be Well Berlin and Affirming Psychological Services, we understand how deeply personal and vulnerable it is to seek help. Especially after a negative experience, trying again can feel impossible. But we’re here to remind you: there are providers who do get it. There is support out there that’s informed, respectful, and truly affirming of your identity and your lived experience.

If you’ve ever said, “therapy didn’t work for me,” let’s unpack what that might really mean—and how healing is still possible.
 

When “Therapy Didn’t Work” Actually Means Something Else
 

We’ve heard it more times than we can count: “Therapy didn’t help me.” But what we often find is that the deeper truth sounds more like this:

 

  • My therapist didn’t understand what it means to be LGBTQIA+
  • The space didn’t feel emotionally or culturally safe
  • My identity felt invisible, questioned, or minimized
  • I wasn’t ready to go there yet—and nobody helped me figure that out
 
None of that is your fault.
 

The Relationship Matters More Than the Treatment Manual
 

There’s solid research to back this up. A 2022 review in Frontiers in Psychology found that one of the strongest predictors of success in therapy isn’t the treatment method—it’s the relationship between the client and the therapist. If the relationship doesn’t feel safe, supportive, and collaborative, the best treatment plan in the world won’t matter.

Trust is the foundation. If you didn’t have that in therapy before, it makes sense that you didn’t feel helped.

Cultural Incompetence Isn’t Just Annoying—It’s Harmful


For queer and trans individuals, microaggressions, misgendering, or subtle erasure by a mental health provider can compound trauma—not relieve it.

The 2015 U.S.  Transgender Survey found that 33% of transgender people who saw a healthcare provider in the previous year reported at least one negative experience related to being transgender—including being verbally harassed, refused treatment, or misgendered.

This level of harm often leads to clients avoiding care altogether—sometimes for years. That’s why affirming, trauma-informed mental health care isn’t a luxury—it’s essential.
 

Readiness and Timing Matter

Even when a therapist is affirming, some clients simply aren’t ready to engage in the work. That’s completely normal. Readiness means having enough safety and emotional bandwidth to process what hurts. For LGBTQ+ individuals, this may only be possible once basic needs are met, trauma has stabilized, or identity feels more integrated.

At Be Well Berlin, we meet people wherever they’re at—whether you’re just beginning to think about care or returning after a long break.

What Identity-Affirming, Trauma-Informed Therapy Looks Like
Affirming care doesn’t just mean “we don’t judge you.” It means:
 
  • Using correct pronouns and chosen names
  • Validating experiences of minority stress and trauma
  • Understanding that identity is fluid and context-driven
  • Competence in LGBTQ+ mental health, gender dysphoria, trauma, and somatic concerns
  • Integrating intersectionality and systemic awareness into treatment

We don’t work around your identity—we work with it.

Why Medication + Psychotherapy Can Be a Game-Changer

For many clients, therapy alone is not enough. If you’re dealing with depression, anxiety, insomnia, trauma, or ADHD, the right medication can:

  • Increase emotional stability
  • Boost energy, focus, and motivation
  • Calm anxiety enough to engage fully in therapy
 
At Be Well Berlin, we specialize in psychiatric medication management that’s integrated with psychotherapy. That means:
 
  • A full diagnostic assessment
  • Personalized medication plans tied to your therapy goals
  • Ongoing check-ins and adjustments
  • Use of evidence-based approaches like CBT, motivational interviewing, and trauma-informed care


🔹 Be Well Berlin
Primary Care + Psychiatry-Informed Mental Health in California & Alaska
Be Well Berlin is a queer-owned, affirming practice based in West Hollywood, offering inclusive telehealth for LGBTQ+ individuals across California and Alaska—including Anchorage, Fairbanks, Juneau, and the Mat-Su Valley. Led by Isaac Berlin, FNP-C, the practice provides accessible, culturally competent care for adults seeking integrated support for both physical and mental health.
We specialize in:
 
Isaac brings a primary care psychiatry lens to every visit—blending medical care, psychopharmacology, and evidence-based therapy for a comprehensive, affirming, and trauma-informed healing experience.

👉 Explore care options or schedule an appointment

🔹 Affirming Psychological Services

LGBTQ+ Psychotherapy Across California Founded by Dr. Katie Moore, Affirming Psychological Services is a team of affirming therapists and psychiatric providers serving clients across California. We specialize in:
  • LGBTQIA+ identity development
  • Trauma, anxiety, and depression
  • Relationship and family healing
  • Culturally competent therapy rooted in social justice
 
Whether you’ve had a tough experience with therapy before—or are seeking care for the first time—we’re here when you are.

👉 Meet our providers


Final Thoughts

If therapy hasn’t worked in the past, it doesn’t mean you failed—or that healing isn’t possible. It may simply mean you didn’t have the right support.
Affirming, integrated care—especially for LGBTQ+ clients—can feel radically different when it centers you, your identity, and your readiness.

🧠 Be Well Berlin and Affirming Psychological Services are here to help you re-engage on your terms—with care that affirms every part of who you are.