Choosing a therapist is rarely simple. When you are LGBTQI+, there is often an extra question sitting underneath the practical ones: will this person understand me without me having to explain myself first?
If you are in Bangkok, or living elsewhere in Southeast Asia and looking for English- speaking support online, this guide covers what LGBTQI+ counselling is, what makes therapy genuinely affirming, and what to look for before you book. If you would like a shorter checklist, our earlier post on how to find an LGBTQI+ affirming therapist in Bangkok or online is a good companion to this one.
What is LGBTQI+ Counselling?
LGBTQI+ counselling is counselling that is informed by, and respectful of, the lives of lesbian, gay, bisexual, transgender, queer, intersex, asexual and other sexually and gender diverse people. It is not a separate type of therapy with its own special techniques. It is counselling offered by someone who understands LGBTQI+ identities and experiences, and who sees them as a natural part of who you are. You may come across other names for the same thing, such as LGBTQ therapy, queer counselling or inclusive therapy. These terms overlap a great deal, so the label matters less than how the counsellor actually works with you.
What Makes Counselling ‘LGBTQI+ Affirming’?
Affirmative therapy means the counsellor actively supports your sexual orientation, gender identity and relationship choices as valid and healthy. That is a step beyond simply being tolerant. A tolerant therapist may be polite but still treat your identity as the thing that needs explaining or solving. An affirming therapist does not.
In practice, affirming counselling usually looks like this:
● Your therapist does not assume you are heterosexual or cisgender
● They use the name, pronouns and words you use for yourself and the people in your life
● They already understand experiences such as coming out, family rejection and discrimination, so you are not left teaching them
● They treat your relationships with respect, whatever shape they take
● They follow your lead on what you want to talk about
This is not an approach invented for one community. It is a stance a skilled counsellor brings to established ways of working. Professional bodies take it seriously too: the American Psychological Association, for example, publishes separate practice guidelines for working with sexual minority people and for working with transgender and gender non-conforming people.
Who Is LGBTQI+ Counselling For?
It is for anyone who would like to work with a non-judgemental and affirming counsellor. That includes people who are certain of their identity, people who are still working it out, and people who simply want a therapist who will not make them feel like an exception.
It is also for the people around you. At Unicorn Care, we also support parents, siblings and partners of LGBTQI+ people who want help understanding and supporting someone they love. Our counselling is for adults (18+) of any gender and sexuality.
If you are wondering whether you actually need a queer-affirming therapist, there is no rule. Plenty of people feel comfortable with any respectful counsellor. Others find that not having to explain their background, again, leaves more room for the things they came to talk about. It is a personal choice, and you are allowed to prefer the option that feels safer.
What Issues Can LGBTQI+ Counselling Help With?
Some people come to counselling to explore their identity. Others come about something that has nothing to do with it. Both are welcome.
Common reasons people seek LGBTQI+ counselling include:
● Making sense of your gender or sexual identity
● Coming out, or preparing to, and managing how others respond
● Letting go of internalised beliefs about gender and sexuality that stop you living authentically
● Rejection or discrimination from family members, colleagues or others
● Gender dysphoria and support through the process of transitioning
● Anxiety and depression, low self-esteem or a negative self-image
● Relationship and family issues outside a heteronormative or cisgender viewpoint
● Couples counselling, including different stages of coming out within a partnership
If you are looking for support around gender identity, our LGBTQI+ counselling page explains more about how we work with transgender and gender diverse clients. Counselling is a space to talk and be heard. It is separate from any medical care you may be considering, and a counsellor can help you think through how you feel about the choices in front of you.
What is Minority Stress - and Why Does It Matter?
Minority stress is the term for the extra pressure that comes from belonging to a stigmatised group. It was set out in detail by psychologist Ilan H. Meyer in a 2003 paper in Psychological Bulletin. Meyer reviewed research on lesbian, gay and bisexual people and found a higher prevalence of mental disorders than among heterosexual people. He explained this through minority stress, in which stigma, prejudice and discriminationcreate a hostile and stressful social environment. The stress processes he describedinclude experiencing prejudice, expecting rejection, hiding or concealing your identity, and internalised homophobia (Meyer, 2003).
Why does this matter if you are choosing a therapist? Because it changes the question. If anxiety or low mood is partly a response to living with prejudice, then the problem is not that something is wrong with you. A therapist who understands this will not treat your identity as the cause. They will look at the pressures around you, and at how you have learned to cope with them. Meyer’s paper focused on lesbian, gay and bisexual people. Transgender and gender diverse people have their own experiences, and good affirming practice recognises that rather than treating everyone as the same.
How is LGBTQI+ Counselling Different from Regular Therapy?
The core of counselling stays the same: a confidential space, a trusting relationship and a counsellor who listens carefully. The differences are in the details.
● Less explaining. You do not have to start from scratch with each new therapist
● Context is understood. Discrimination, family dynamics and community experiences are taken seriously
● Identity is not treated as the problem. The focus is on what you want help with
● Language is respected. Your words for yourself and your relationships are the ones used in the room
● You lead. Your goals shape the sessions, not a checklist of assumptions
Our approach at Unicorn Care is person-centred, which means you are treated as the expert in your own life.
What Can I Expect From My First LGBTQI+ Counselling Session?
Starting is often the hardest part, so here is what usually happens. If you would like to check whether we are the right fit, you can book a free 20-minute consultation first. It is a chance to share a little about what you are looking for, ask questions and see how it feels to talk to us. There is no pressure to book anything afterwards.
A standard appointment lasts around 50 minutes. In the first session you might talk about what has brought you to counselling, what you hope will change and anything that would help you feel comfortable. You do not need to have your thoughts in order, and you do not need to share more than you want to. The number of sessions varies from person to person, depending on what you are working on and what your goals are. It also helps to know that you can ask questions of your therapist. Questions worth asking include:
● Have you worked with LGBTQI+ clients before?
● How do you approach topics such as gender identity or relationship structure?
● What training or professional membership do you have?
● How do you handle confidentiality, particularly for online sessions?
● What are your fees and how do you handle cancellations?
A good therapist will welcome these questions.
Can I Access LGBTQI+ Counselling Online?
Yes. Online counselling is a practical option if you live outside central Bangkok, travel regularly, have a busy schedule or would simply feel more comfortable at home. Unicorn Care offers both in-person and online appointments in English, to people of any nationality, with evening and weekend availability. Dr Stephanie Garner can also be flexible across time zones.
This can be especially useful for LGBTQI+ people in Thailand who are part of the expat and international community, or for those in other parts of Southeast Asia where English-speaking affirming support is harder to find. For online sessions, it helps to choose a private space, use headphones if others are nearby and check your connection before you start.
LGBTQI+ Counselling in Bangkok: What Makes Unicorn Care Different?
Unicorn Care is a counselling practice in central Bangkok that works with adults who identify as LGBTQI+, polyamorous or practising consensual non-monogamy, and with BDSM and kink practitioners. This is what we do day to day, not an extra we have added on.
Here are a few details that may help you decide:
● Experience: Dr Stephanie Garner is a member of the Australian Counselling Association and has lived and worked in Bangkok since 2012. She specialises in working with gender, sexuality and relationship diverse clients.
● Approach: Person-centred counselling that is sex positive, body positive and passion positive
● Flexibility: In-person and online sessions, with a wide range of opening hours, including evenings and weekends
● Cost: A 50-minute appointment is THB 3,000, with a THB 500 discount for transgender clients. In certain circumstances a further discount may be possible. We can issue invoices and receipts, though you would need to check with your insurer about cover
● Access: Our office is on Soi Sukhumvit 13 and is wheelchair accessible
Many people also find it reassuring to know that Thailand has become the first country in Southeast Asia to legalise same-sex marriage, which came into force on 23 January 2025 (BBC News; Love Foundation Thailand). Legal change is welcome, though it does not automatically change how safe every family, workplace or healthcare setting feels. That is why having a space that is affirming from the first conversation still matters. If you and your partner are looking for support together, our LGBTQI+ counselling offers couples counselling too. If you are curious about how your early relationships shape your patterns as an adult, our post on attachment styles may also be of interest. And if you are exploring other relationship structures, you can read about our polyamorous and CNM counselling.
A Note on Confidentiality
For many LGBTQI+ people, privacy is not a small detail. Worries about who might find out about your identity, or how your information is stored, are completely reasonable, and they can stop people from reaching out at all.
Therapy confidentiality should be explained to you clearly before you begin. Whichever private counselling service in Bangkok you choose, it is fair to ask how your information is kept, what the limits of confidentiality are and how online sessions are kept private. At Unicorn Care, you can read our Privacy Notice, and you are very welcome to ask us anything directly before booking, including during your free consultation.
Taking the First Step
Finding a therapist who is truly affirming can take a little time, and it is fine to talk to more than one person before deciding. What matters is that you come away from the conversation feeling respected, listened to and free to be yourself. If you would like to talk to us, you can arrange a free 20-minute consultation via our contact page. You can also read more about Unicorn Care, browse our FAQs or explore the rest of the Unicorn Blog.
If you are in distress right now, please contact local emergency services or call the Thai Department of Mental Health hotline on 1323, which offers free, confidential support 24 hours a day.
Unicorn Care is a counselling practice in central Bangkok, supporting LGBTQI+, polyamorous/CNM and kink communities, in person and online.
Sources
● Meyer, I. H. (2003). Prejudice, Social Stress, and Mental Health in Lesbian, Gay, and Bisexual Populations: Conceptual Issues and Research Evidence. Psychological Bulletin, 129(5), 674-697. https://pmc.ncbi.nlm.nih.gov/articles/PMC2072932/
● American Psychological Association. Guidelines for Psychological Practice with Sexual Minority Persons (2021), listed under APA Special Populations Policies. https://www.apa.org/about/policy/special-populations
● American Psychological Association (2015). Guidelines for Psychological Practice with Transgender and Gender Nonconforming People. American Psychologist. https://pubmed.ncbi.nlm.nih.gov/26653312/
● BBC News. Thai king signs same-sex marriage bill into law. https://www.bbc.com/news/articles/cn03we6zpk1o
● Love Foundation Thailand. Thailand’s Marriage-Equality Law: Effective Date Moved to January 23, 2025. https://lovefoundation.or.th/en/equal-marriage-law-change-date/
● Thailand Department of Mental Health, 1323 Mental Health Hotline. https://dmh.go.th/
● Unicorn Care website details (fees, formats, services and practitioner information): https://www.unicorncare.one/faqs and https://www.unicorncare.one/about