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by Susan Joyner

Nov 21, 2023

Beyond Labels: Navigating LGBTQ+ Identity and Relationships in a Diverse World

QueerPsych spoke with Susan Joyner to discuss affirming LGBTQ+ identities as well as kink, polyamory, and relationships.

1. What unique challenges do LGBTQ+ individuals face when it comes to exploring and affirming their identities, and how do you tailor your therapy approach to address these specific challenges?

The unique challenges faced by LGBTQ+ clients includes but isn’t limited to imposter syndrome, constantly having to “come out”, fears around safety and acceptance, coming to terms with religious identity, and disruptions in familial relationships. Part of my job as a nonbinary clinician raised in a religious, conservative environment is to hold space for my clients and create safety in shared lived experiences. I work with clients to explore autonomy and self advocacy. My clients are encouraged to find their own path and listen to their own intuition. I offer empathy and understanding that clients may or may not have experienced previously. Living authentically is often a primary goal for my clients AND that goal looks and is defined differently by each individual. I utilize IFS and mindfulness tools to assist clients with understanding the root of some of these challenges as well as to improve their schools with tuning into their Self.

2. Can you share a success story or an example of a breakthrough moment you’ve experienced with a client who was struggling with their LGBTQ+ identity, and how your therapeutic approach contributed to their personal growth and self-acceptance?

I recently worked with a client who was not able to find a term that they felt matched their sexual identities. Having language to describe their experience, for some clients can provide a sense of belonging and acceptance. I assisted this client with exploring their sense of not belonging or imposter syndrome that arose from the lack of language to describe their experience. I simply offered this client the freedom and permission to not have to have their label “figured out”. I validated and affirmed the client’s experience and encouraged them to take the opportunity to continue to explore. I also offered the permission to find terms that feel close to the client’s experience and redefine those terms for themselves. While some of this sounds small, this freedom to be valid and exist outside of predefined boundaries was a huge weight off this client’s shoulders. I have also supported clients with coming out to family and friends but the confidence to do so often begins with creating an internal sense of self esteem with clients.

3. How do you approach therapy when it comes to discussing and exploring topics like kink and polyamory with your clients? What steps do you take to ensure an open and non-judgmental space for these discussions?

I think the first step is that I am regularly in community, personally and professionally, with folx who are kink or ENM or are clinicians who have experience working with these clients. I am in a book club and consultation group to ensure I am up to date and learning and growing in my knowledge as well as the therapeutic approaches and tools available for working with this population. Since I work with individuals my work is primarily geared towards communicating, navigating these lifestyles, and offering an open and non-judgmental space. The steps I take towards that include building my own knowledge but also showing up as myself in the therapy “room”. I advertise as working with this population as a way to let folx know this is a space for them. I familiarize myself with the language so that clients do not have to continuously define terms and teach me about their lifestyles. This goes a long way towards creating supportive spaces for these clients.

4. What are some common challenges or misconceptions you’ve observed among your clients who are involved in kink or polyamorous relationships, and how do you help them navigate these issues during therapy?

One challenge that others may not realize is that much like with my LGBTQ+ clients, my kink and ENM (ethically non-monogamous) clients also have to continuously come out to friends and family. I assist clients with building self-esteem and the communication skills to have these conversations with loved ones while knowing they have the support and tools to cope with whatever the outcome. Learning and growing more skills around communication and consent culture is a large part of navigating kink and ENM relationships. The communities these folx are a part of are already doing the work to teach these skills and I am an added support in honing these skills with clients. I think a misconception that arises and is often reinforced in these communities is the idea that there is a right and wrong way to live a kinky or ENM lifestyle. While there are definitely MUSTS such as communication and consent, there are some unspoken rules that need not apply to everyone. I enjoy affirming clients and encouraging them to find their own path within these lifestyles. A book that I love to recommend around this topic is The Anxious Person’s Guide to Non-Monogamy by Lola Phoenix.

5. How do you approach trans affirmation therapy to create a supportive and validating environment for transgender and other LGBTQ+ clients? What specific techniques or practices do you employ to help them explore and embrace their gender and LGBTQ+ identities?

My strongest tools for working with trans clients are my own lived experience, parts work, mindfulness, and community building. One of the first things I do for my clients is encourage them to build community with other gender expansive folx. I encourage learning more about and growing in their identity, including historical examples. I utilize IFS based parts work to assist clients with gaining the confidence to be their most authentic selves by learning to trust and empower their Self. My lived experience as a nonbinary clinician offers a sense of support and validation through shared experiences. I utilize self disclosure when appropriate to remind clients they aren’t alone and that this journey can be hard and worth it. I acknowledge, particularly for my nonbinary clients, that imposter syndrome is real and that their identities are valid even if they shift, even if they never come out, and even if it doesn’t fit the picture of the poster child nonbinary person. Often I find that receiving permission and validation to define their experiences for themselves and live in the discomfort of the unknown from another person within the community increases a sense of ease for clients. Much like with my kinky and ENM clients, simply being knowledgeable and knowing the language so that clients don’t have to constantly explain themselves is a big step I take towards creating a safe space for my trans clients to land. I am trained in WPATH standards for writing Gender Affirmation Surgery letters which is another tool I offer clients who are seeking the support and validation they need to feel safe in their bodies.

6. Transgender individuals often face significant challenges related to societal acceptance, family dynamics, and personal identity. How do you address these unique hurdles in therapy and help your trans and LGBTQ+ clients build resilience and self-empowerment?

Initially I utilize the therapeutic alliance to help client feel validated and supported in their experiences. I address the idea of imposter syndrome early on and utilize tools from IFS to flesh out other parts that may be creating a barrier towards resilience and self-empowerment for my clients. I utilize a liberation and antiracist focused approach to acknowledge the impact of societal norms and large systems on each client’s challenges around societal acceptance, family dynamics, and personal identity. I explore the impact of religion on these experiences and affirm clients who both are and aren’t religious. I encourage client to build community with other trans folx so that they have others with shared experiences to rely on outside of therapy. I regularly affirm, validate, and normalize my clients’ experiences. I encourage clients to advocate in therapy towards building the skills to advocate for themselves outside of therapy. I offer unconditional positive regard towards clients when they get frustrated in therapy and I remind them that anger and frustration are valid emotional responses to some of their challenges.

7. In the context of trans affirmation therapy, how do you collaborate with your clients to develop personalized goals and milestones? Can you share a story of a particularly transformative journey of self-discovery and affirmation that you’ve witnessed in your practice?

I offer a supportive space and encourage clients to advocate for themselves in therapy. I often find that clients want to feel comfortable in their own skin and live authentically. I allow clients to identify their own goals while sometimes assisting them with the language to articulate those goals. I celebrate milestones when they happen and regularly give permission for goals to shift and ebb and flow. Identifying one story of a transformative journey of self-discovery and affirmation is a challenge because I am constantly in awe of all of my clients. The way I watch my clients grow into their authentic selves and move boldly and bravely in the world is inspiring. The fact that I get to be a support along their journey is honestly transformative for myself. I watched clients come out, learn to accept themselves as enough, learn to self advocate in multiple spaces in their lives, and seek the necessary surgeries to affirm their identities. I find value and inspiration in all of their experiences.

Relationships, Gender Identity

by Susan Joyner

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