About LGBTQ+
LGBTQ+ affirmative professionals offer a safe, respectful space to explore identity, relationships, coming out, minority stress or discrimination, without pathologising sexual orientation or gender identity.
Couples therapists help partners with communication problems, frequent arguments, infidelity, crises or decisions about the future of the relationship. Sessions are usually joint, sometimes combined with individual ones.
Getting mental health care in the United States
Public health system · No single public system (Medicaid, Medicare, community mental health centers)
There is no universal public mental health service. People with low incomes may be covered by Medicaid, older adults by Medicare, and publicly funded community mental health centers and treatment facilities can be located through the federal SAMHSA locator. More information
How to check that a professional is licensed
- State licensing boards. Clinical social workers, counselors and marriage and family therapists are licensed state by state; check the relevant board in your state.
Insurance and coverage
Federal parity law (MHPAEA) requires most group health plans that cover mental health to do so on terms no more restrictive than for physical health; deductibles, copays and in-network rules still apply.
Online therapy in the United States
The clinician must normally be licensed in the state where the patient is located. Psychologists in PSYPACT member states may practice telepsychology across those states.
Urgent help in the United States
If your life or someone else's is in danger, call the emergency number now. These services can help at any time:
- 911 · Emergency (911)
- 988 · 988 Suicide & Crisis Lifeline
Information reviewed in November 2026 · Sources: findtreatment.gov, docinfo.org
Signs to look out for
Being LGBTQ+ is not a mental health problem. However, discrimination, rejection, hiding who you are or living in an unsupportive environment can create stress that affects well-being. It may help to seek support if you feel anxious or low, isolated, unsafe, conflicted about your identity, struggling with coming out, facing family rejection, or affected by harassment or violence.
What helps: treatments and professionals
Look for affirmative therapy: psychologists, psychotherapists and other professionals who respect your identity and have training in sexual and gender diversity. Evidence-based approaches such as cognitive-behavioural therapy, acceptance and commitment therapy and family therapy can be adapted to address minority stress. So-called conversion therapies are harmful and rejected by professional bodies. Peer and community groups can complement professional support.
When to seek urgent help
If you are in immediate danger, have been assaulted, or are being threatened because of your identity, contact your local emergency services. Seek urgent help too if you have thoughts of suicide or self-harm, or if you have been thrown out of your home and have nowhere safe to go. Specialised LGBTQ+ organisations in many places can offer support and guidance.
What you can do in the meantime
Connect with people and spaces where you can be yourself, whether friends, community groups or trusted online communities. You decide when, how and to whom you come out; your safety comes first. Look for reliable, affirming information sources. Look after sleep, movement and routines, and limit exposure to hostile content online. Ask potential therapists directly about their experience with LGBTQ+ clients.
What does a couples therapist do?
A couples therapist helps two people understand and improve their relationship. Day to day they work with couples on communication, recurring arguments, trust after infidelity, intimacy, life transitions such as parenthood or retirement, and decisions about continuing or separating. They stay neutral, make room for both perspectives, and teach practical skills to talk, listen and repair after conflict.
When to see a couples therapist
Couples therapy makes sense when arguments repeat without resolution, you feel distant or misunderstood, trust has been damaged, sexual or emotional intimacy has changed, or you face a big decision together. It also helps couples who want to separate respectfully. If there is violence, control or fear in the relationship, couples therapy is not appropriate; individual support and safety come first.
How to choose
When choosing, check the licence and training, the approach they use and whether they have experience with what you need. Consider practical aspects too: language, price, location or online sessions and availability. The relationship with the professional matters a great deal; if after a few sessions it does not feel right, it is fine to change.
Frequently asked questions
Does the public health system in the United States cover psychological care?
There is no universal public mental health service. People with low incomes may be covered by Medicaid, older adults by Medicare, and publicly funded community mental health centers and treatment facilities can be located through the federal SAMHSA locator.
How do I check that a couples therapist is licensed in the United States?
State licensing boards: Clinical social workers, counselors and marriage and family therapists are licensed state by state; check the relevant board in your state.
Can I have online therapy in the United States?
The clinician must normally be licensed in the state where the patient is located. Psychologists in PSYPACT member states may practice telepsychology across those states.