“Do I Share or Stay Silent?”: Navigating Sexual Identity in Therapeutic Settings

Individuals identifying as a sexual minority are at a greater risk of experiencing mental health difficulties, more likely to access mental health support, and less likely to have their needs met with current therapeutic practices than their heterosexual counterparts. This study aimed to understand the experiences of sexual minorities in therapy and factors that contributed to the sharing or not of their sexuality with their therapists. We recruited participants (N = 23) and asked them to share their experiences of discussing their sexuality in therapy. Using reflexive thematic analysis, three major themes were identified. Service-level factors, which refer to the ingrained heteronormativity in services and how therapist factors influence sharing; individuals’ identities and understanding of therapy, which refer to the journey of sexuality exploration and integration; experiences and understanding of mental health and therapy affect sharing; and intersectionality; and the influence of relational factors, which refers to experiences of sexual minorities outside of therapy and how relational roles are replicated in therapy. Findings from this study provide support for existing literature and novel perspectives on factors that influence the sharing process between sexual minorities and their therapists, with recommendations for improving recognition, conversations, and needs for sexual minorities in therapy.