LGBT Clients

What Is Cognitive Behavior Therapy?

Behavior Therapy and Cognitive Behavior Therapy are types of treatment that are based firmly on research findings. These approaches aid people in achieving specific changes or goals.

Changes or goals might involve:

  • A way of acting: like smoking less or being more outgoing;
  • A way of feeling: like helping a person to be less scared, less depressed, or less anxious;
  • A way of thinking: like learning to problem-solve or get rid of self-defeating thoughts;
  • A way of dealing with physical or medical problems: like lessening back pain or helping a person stick to a doctor’s suggestions.
Behavior Therapists and Cognitive Behavior Therapists usually focus more on the current situation and its solution, rather than the past. They concentrate on a person’s views and beliefs about their life, not on personality traits. Behavior Therapists and Cognitive Behavior Therapists treat individuals, parents, children, couples, and families. Replacing ways of living that do not work well with ways of living that work, and giving people more control over their lives, are common goals of behavior and cognitive behavior therapy.

HOW TO GET HELP: If you are looking for help, either for yourself or someone else, you may be tempted to call someone who advertises in a local publication or who comes up from a search of the Internet. You may, or may not, find a competent therapist in this manner. It is wise to check on the credentials of a psychotherapist. It is expected that competent therapists hold advanced academic degrees. They should be listed as members of professional organizations, such as the Association for Behavioral and Cognitive Therapies or the American Psychological Association. Of course, they should be licensed to practice in your state. You can find competent specialists who are affiliated with local universities or mental health facilities or who are listed on the websites of professional organizations. You may, of course, visit our website ( and click on "Find a CBT Therapist"

The Association for Behavioral and Cognitive Therapies (ABCT) is an interdisciplinary organization committed to the advancement of a scientific approach to the understanding and amelioration of problems of the human condition. These aims are achieved through the investigation and application of behavioral, cognitive, and other evidence-based principles to assessment, prevention, and treatment.

What you will learn in this fact sheet
  • What is sexual orientation?
  • How is biological sex different from gender?
  • What does it mean to be transgendered?
  • Do sexual minorities face prejudice?
  • Why might you want to go to therapy?
  • What should you think about when choosing a cognitive-behavioral therapist?
  • Resources

Sexual Orientation

What is sexual orientation?

  • People often think about sexual orientation as just who you enjoy having sex with. However, sexual orientation also includes:
    –who you feel romantic about
    –who you like to spend your time with
    –who you fantasize about.
  • People can be attracted to men, women, or both, regardless of their own biological sex.

What are common terms for sexual orientations?

  • “Homosexuality” refers to being attracted to people of the same sex.
  • “Gay” is usually used for men who are homosexual. “Gay” is also sometimes used for homosexual women.
  • “Lesbian” is used for homosexual women.
  • “Bisexual” is used for people who are attracted to both men and women.
  • “Heterosexual” or “straight” is used for people who are attracted to members of the opposite sex.
  • People may describe themselves many other ways, such as “queer” or “dyke”.
  • Some of the terms listed above also are used in negative ways to refer to homosexuals.

What if these labels don’t really fit me?

  • People often do not fit neatly into any one sexual orientation. For example: Some women almost always have relationships with women but may sometimes choose a man. That does not mean they call themselves bisexual. You might think of yourself as straight, but sometime you are attracted to or have sexual relationships with people of the same sex.
  • How you identify yourself (for example, “lesbian”, “queer”, “straight”) may or may not be the same as who you are attracted to or with whom you have romantic or sexual relationships. For example, someone in the clergy may identify as gay but be celibate.
Biological Sex, Gender, and Transgender
  • Biological sex is the degree to which you were born genetically male or female. “Gender” is your personal sense of feeling and behaving as female and/or male. Gender is influenced by many things, such as how you were raised and how society expects you to behave. Most people think, feel, and act in ways that are both masculine and feminine.
  • Your biological sex may or may not be the same as your gender.
  • A transgender individual is someone who was born biologicallly one sex, but feels like they have born into the wrong body
  • Transgendered men and women live their lives in different ways:
    –Some continue to live their lives according to their biological sex.
    –Some dress and live as members of the opposite sex some or all of the time.
    –Other have sex reassignment surgery and/or use hormones to change their gender appearance and make a full transition from male to female or female to male

Prejudice Against Sexual Minorities

  • Lesbian, Gay, Bisexual and Transgendered (LGBT) people are called “sexual minorities” because they have different identities, beliefs, and behaviors than heterosexual men and women. If you are a member of a sexual minority, you may experience discrimination such as:
    –Being insulted because you are a sexual minority
    –Threats of violence
    –Physical assaults
    –Discrimination in employment or housing
    –Fewer legal protections under state and federal laws
    –Lack of legal protections and benefits associated with marriage
  • Discrimination and prejudice may increase your risk for some psychological problems. For example, research shows that:
    –Lesbian and bisexual women may be at increased risk for alcohol and drug problems.
    –Gay and bisexual men may be at increased risk for depression and anxiety.
    –Compared to heterosexual youth, gay, lesbian, and bisexual youth may be at increased risk of social anxiety, depression and have increased rates of suicide.

Why Consider Therapy?

  • There are many reasons LGBT individuals might seek therapy. Some examples are:
    –Support in coping with discrimination.
    –Treatment of depression, anxiety, or substance abuse.
    –Coming out issues.
    –Grief and loss.
    –Relationship problems.
    –Parenting skills. Therapy Does Not Change Sexual or Gender Orientation
  • Homosexuality, bisexuality, and being transgender are not mental disorders. Almost all cognitive and behavioral therapists agree that this is true, regardless of the fact that DSM still lists gender identity disorder.
  • Research shows that trying to change sexual or gender orientation with conversion therapy most often has harmful effects.
  • Cognitive and behavioral therapies do not change one’s sexual orientation.

Ways Therapy Can Help

  • Cognitive and Behavior Therapy (CBT) can help you learn new skills.
  • CBT can help you improve your relationships with your partner, family, friends and coworkers. For example, this could include learning new ways of communicating with people, thinking about your relationships, managing your feelings, or handling conflict situations.
  • CBT can be a useful treatment for mental health problems, such as depression, anxiety (including social anxiety), substance abuse, and suicidal feelings.
  • CBT can help you deal with many of life’s problems that may or may not be related to your sexual or gender orientation or related to others’ response to your sexual or gender orientation.

Choosing a Therapist

  • Some people want to have a therapist who is also gay, lesbian, bisexual or transgendered. A sensitive therapist will be willing to talk about your preference and decide if she or he is a good fit with you.
  • Interviewing possible therapists can be a helpful way to decide if they are right for you. This gives you a chance to see how comfortable you are with the therapist’s style. It is all right to ask about:
    –The therapist’s training
    –What to expect in therapy
    –How much therapy will cost
    –The therapist’s opinions about sexual and gender orientation.
    –The therapist’s experience with lesbian, gay, bisexual or transgendered clients
  • Many CBT therapists specialize in specific mental health problems, such as anxiety or alcohol and drug abuse. The success of your therapy may depend on the therapist’s expertise treating the problems you face. The best way to know is to ask!
  • A good therapist is willing to talk about any worries you have about your therapy at any point. Your therapist should refer you to another therapist or agency if either of you feel that therapy is not working or there are issues that are keeping you from getting the most out of therapy. After all, it’s your time and your money!
  • CBT therapists often work through the most important problems first, so it might be that the therapist deals first with depression, leaving other areas alone for a time.
  • Remember, your sexual or gender orientation is not a disorder; you should never have to experience discrimination on the part of your therapist.


Books on lesbian, gay, bisexual and transgender issues:

The Rights of Lesbians, Gay Men, Bisexuals, and Transgender People (American Civil Liberties Union Handbook) by Nan D. Hunter, Courtney G. Joslin, & Sharon M. Mc- Gowan. This book covers the rights of lesbians, gay men, bisexuals, and transgender people under present law (freedom of speech and association, employment, housing, the military, family and parenting, and HIV)

Mom, Dad, I’m Gay: How Families Negotiate Coming Out by Ritch C. Savin-Williams. American Psychological Association

Transgender Care: Recommended Guidelines, Practical Information, and Personal Accounts by Gianna E. Israel, Donald E. Tarver, and Diane Shaffer True Selves: Understanding Transexualism for Families, Friends, Co-workers and Helping Professionals by Mildred L. Brown and Chloe Ann Rounsley

Bi Any Other Name: Bisexual People Speak Out by Loraine Hutchins and Lani Kaahumanu (classic book of essays on bisexuality) Bi Lives: Bisexual Women Tell Their Stories by Kata Orndorff (Essays with various women about their sexual identities and lives. Contains safer sex guidelines and bisexual resource list.)

Internet Resources

American Psychological Association fact sheet about sexual orientation:

Information about a toll-free hotline for your questions about gender and sexual orientation:

For information and resources for GLBT youth:

For information and resources for bisexuals:

Informative FAQ about bisexuality:


For more information or to find a therapist:

Please feel free to photocopy or reproduce this fact sheet, noting that this fact sheet was writen and produced by ABCT. You may also link directly to our site and/or to the page from which you took this fact sheet



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Association for Behavioral and Cognitive Therapies
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