• It’s my responsibility as a mental health professional to remember the history of the American Psychiatric Association’s diagnostic manual. Sexual orientation and identities were considered diagnoses that came with stigma and suffering. Homosexuality was considered a diagnosis until 1973, and until 1987, the diagnostic manual included Ego-dynastic Homosexuality. The World Health Organization diagnostic manual still contains this diagnosis. Trans individuals are challenged with a “gender dysphoria” diagnosis, which may be destructive to self-esteem.

    The process of coming out as lesbian, gay, bisexual, trans, or questioning can be challenging and may be a significant part of the work done in therapy. There may be a virus in human DNA - a shadow - of marginalization and prejudice that creates this challenge. It is not due to any sort of disorder. Your gender and identity are a part of you, and therefore a significant aspect of your psychotherapy. Coming out may lead to great resources, as it involves a leap in self-awareness and openness and sensitivity to yourself and to others.