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The clinical need for lesbian, gay, bisexual, and queer (LGBQ+) affirmative psychotherapies has been widely recognized; however, empirical research on the outcomes of such psychotherapies is limited. This chapter begins by offering definitions and delineating four key themes of LGBQ+ affirmative psychotherapies. The authors conceptualize LGBQ+ affirmative psychotherapies not as sexual orientation group specific but rather as considerations and practices that can be applied with all clients. The chapter then summarizes a search for studies to attempt a meta-analysis and discusses limitations and directions for research based on this search. The chapter ends by delineating diversity considerations and recommending therapeutic practices for advancing affirmative psychotherapy with clients of all sexual orientations.

This chapter reviews the research evidence on the effectiveness of attending to clients’ gender identity in psychotherapy. It begins with definitions and measures of gender identity and provides clinical examples. A literature search did not yield studies that fit the authors’ search criteria; thus meta-analyses were not conducted. Instead, the authors conducted a content analysis of the 10 qualitative and quantitative studies on psychotherapy with transgender individuals. The chapter concludes by highlighting the limitations of the research base, describing diversity considerations, and recommending therapeutic practices that attend to gender, gendered systems of power, oppression, and privilege.