20 Seconds: Coming Out to a Client By Alex Stitt, LMHC on 10/9/20 - 5:32 PM

“Were you in the Olympics?”

               The statement gave me pause. Just as I was looking to build rapport, my client was earnestly wanting to know more about me. He was, of course, referring to the rainbow rings dangling from my pride necklace.

A delicate moment.

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I’ve been out and proud long enough not to worry too much about casual disclosure. When I was younger, I protected my gender identity, and even my sexuality, as something precious and fragile. Fast forward through a decade of resilience, self-actualization, mindfulness and graduate school. I’m an affirmative therapist with a rainbow necklace.

My client however was a blatantly straight young man. His priorities were football scholarships, drinking buddies and hot babes, in that order. Like a lot of hyper-masculine dudes I’ve worked with in therapy, he was reluctant to tackle his emotions, but self-aware enough to acknowledge his tendency to self-sabotage. Depth was sidetracked by sexual humor, vulnerability was hidden by pride and as our sessions progressed, he liked to deflect from himself by trying to “bro-out” with me. This of course, also revealed his deep desire to connect, as he valued fraternity a great deal. It’s only natural to hunt out similarities and differences in order to relate to someone, and he was doing that now. In his world, colorful rings meant sport.

Typically, I recommend LGBTQ+ therapists tack on a little about themselves in the very first session. A brief statement in your informed consent paperwork describing your office as a safe space can make a natural segue. Cisgender and heterosexual therapists have a unique privilege here, as they need not address issues of gender or sexual orientation with their client on day one. It is largely a non-issue. LGBTQ+ professionals, however; often have to contend with a delicate but necessary balancing act, as not everyone is comfortable having a queer counselor. For some, there may be a moral, religious or cultural objection to our identity. For other prospective clients, our “outness,” which is to say our open authenticity, maybe too challenging for where they’re at in their process, especially if they’re wrestling with issues of denial. Admittedly, this can be disappointing but it’s important to maintain a sense of unconditional positive regard. We have to meet a client where they’re at, which is why I believe in goodness-of-fit, first and foremost. If a client is not comfortable, I find it’s healthier for all parties involved to refer them out.

I usually give a quick twenty second nod to who I am noting how “as a nonbinary person, I understand the importance of confidentiality” or “as an active member of the LGBTQ+ community, I value emotional safety.” This is usually enough, and if I do forget to mention it in our first session, my rainbow necklace is a decent clue. With my young adult clients, a nonbinary pin or a pansexual T-shirt is like carrying a little safe-space bubble with me wherever I go.

Regrettably, I’d missed my twenty seconds in our first session, and now my client thought I was an Olympian.

Having dropped into our first session red hot and fuming, we had to regulate his rage and prioritize his pain. He was angry at his parents, his coach, his ex-girlfriend, himself and that had consumed the hour. Obviously, we addressed safety and confidentiality, but we’ve all had that fiery intro where the paperwork has to be set aside momentarily for crisis management. Addressing the nuances of who I am simply wasn’t relevant at the time, as the only thing that mattered was my ability to hold a safe container for his process. Round one was damage control. We didn’t even identify any long-term therapeutic goals until round two. Now, in round three, he was opening up and showing his curiosity.

Keep in mind, LGBTQ+ therapists don’t go around introducing our sexuality or gender any more than heterosexuals walk around saying: “Hi, I’m Straight Robert but my friends call me Vanilla Bob.” Sure I market myself as a Queer Counselor, and sure I published ACT for Gender Identity: The Comprehensive Guide, but my gender and sexuality aren’t the fulcrum of my identity. Important, yes, but not my every waking thought. So when my client asked about my necklace, I found myself scrambling, for the first time in years.

I have learned that it’s important for LGBTQ+ therapists not to hide who we are as our lived experiences are incredibly valuable to clients in need of personal insight, relational connection or a rainbow role model. These days, because of my reputation, people tend to seek me out when they’re wrestling with genderqueer liminality, transgender self-actualization, shame, shame, and more shame, queer trauma, queer euphoria and the excited limerence of forbidden love. Being out and proud, I kind of expect people to know who I am and that was my mistake.

My client wasn’t the sort to read my website. He was here because his parents—the architects of his academic career—were also the architects of his mental health journey. His mom literally drove him to and from our sessions. To my amazement, he didn’t know anything about rainbows or transgender people, and for a second my closeted inner child wanted to lie. I should just tell him I used to throw the javelin. What am I saying? Just tell him you like gymnastics!

I was finding out first hand how hard it can be to check my own transference as a queer therapist working with a very straight client. In twenty seconds, his inquiry had brought up all my outdated evasion tactics so I answered his question with a question. Rather than simply out myself, I asked if he’d ever been to a pride parade. This roundabout response was a defense mechanism designed to gauge his open-mindedness while shifting myself away from the focal point. If this maneuver seems contradictory to being out and proud, just know that I, like a lot of queer people have spent a lifetime being bombarded by unsolicited opinions and inappropriate questions. When our very existence is deemed politically polarizing, we have to develop little ways to gauge safety and evade conversational traps. On the street, that’s quite easy as we can be fierce and forward, but in professional settings?

We’re ten seconds into this exchange now.

In no uncertain terms he told me about spirit day, back in high school, and how everyone wore colors, because that’s what he thought I meant. School pride.

We’re just getting muddled.

When I finally found my community after years of isolation, I wrapped that sense of belonging around me like a cozy blanket. My social circles marched and still do with me so I honestly hadn’t encountered someone this sheltered in a very long time, nor had I ever had to deal with it in session. My rainbow references had no power here. My wink and nod meant nothing, and in our short back and forth I worried about alienating my client. Would our differences present a divide too vast to bridge? Was our budding rapport doomed from the start? Did he open up to me so readily because, in his eyes, I looked like a man? Would my authenticity jeopardize our ability to work with each other?

So much happens in twenty seconds of conversation. So many thoughts flit by when we have to assess disclosure. My task is not to give my client a crash course on Queer studies, nor counter his views of the world, however contrary they may be to my own. This makes labels and micro-labels tricky, as they can sometimes spur more questions than answers when people have never encountered them before. If I tell him I'm nonbinary, we may spend way too long defining what that means. Yet, as both a person and a professional, my authenticity is paramount, as it is the authenticity within the therapeutic relationship which is so healing.

So as not to get bogged down in lingo, I told him that I never really connected with school pride, and that I was a part of the LGBTQ+ community.

“Oh, so you’re like a fag.”

I corrected this in my ally-trainer voice. If you’re unfamiliar with the tone, pay attention the next time someone asks a diversity trainer a wholly uninformed question and note how diplomatically they answer. My client wasn’t trying to be offensive. In his world that’s what people like me are called, yet I must also humanize myself, so I told him quite simply how disrespectful the term was.

And he apologized. And he flip-flopped. And he gave me his two-cents, telling me about a friend of his who came out last year, but how he was definitely straight himself, in case anyone was wondering. I asked if it would be an issue. He said no. In the long run, the details of my sexual and gender identity were irrelevant to his process, but not the disclosure itself. We would refer back to this moment a few times during the course of our work together, as an example of giving someone the benefit of the doubt, of reaching across the aisle, and of connecting with people very different from ourselves. For my client, struggling with his sense of anger and impulsivity, this brief exchange exemplified compassion, curiosity and how to make amends.

Given all my therapeutic concerns pertaining to disclosure, I sometimes have to remind myself that it’s the authenticity of the therapist that encourages the authenticity of the client. Mental health professionals have to navigate the ethics of disclosure on a case-by-case basis, and there are many effective approaches one can take. I know some masterful person- centered therapists who become pure mirrors for their client, just as I know a few gestalt therapists with very vibrant personalities. In kind, I know a few affirmative therapists who share anecdotal stories to normalize and humanize their client's lived experiences just as I know a few affirmative therapists who prefer a more psychoeducational route so as not to get too personal. Yet regardless of our therapeutic approach, people will inevitably react to who we are whether we like it or not. And in just twenty seconds of disclosure, one can gain a great deal of insight, not just about the client, but about the whole therapeutic relationship itself. Curiosity, distinction, concern, alienation, alliance, amends and acceptance can all happen concurrently just as we may not understand someone, but still like them anyway.   

File under: The Art of Psychotherapy, Musings and Reflections