In the Circle: Why LGBTQ+ Group Therapy Matters

There is something particular about entering a room and discovering that, for once, you do not have to explain the basic architecture of your life: translate your relationships, anticipate assumptions about sexuality or gender, or decide how much of yourself is safe to reveal. For many LGBTQ+ people, these calculations become part of how we move through the world. This is why I believe group therapy can offer something especially valuable to LGBTQ+ people. Individual therapy provides a unique and important relationship between therapist and client; a group adds a small relational world in which we encounter ourselves through other people. It can reduce the burden of explanation while allowing us to discover not only what we think and feel, but how we approach closeness, difference, conflict, vulnerability, belonging and being seen.

Irvin Yalom described universality as one of the fundamental therapeutic factors within groups: the discovery that experiences we imagined were uniquely ours are also carried by others (Yalom and Leszcz, 2020). For LGBTQ+ people, that recognition can be profound. Shame frequently survives through isolation. An experience that feels unbearable when held privately can begin to change when somebody else says, in effect, I know something of that too.

LGBTQ+ lives do not develop outside their social context. Meyer’s minority stress model describes the psychological burdens created by prejudice, discrimination, expectations of rejection, concealment and internalised stigma (Meyer, 2003). Affirmative practice asks therapists to understand identity alongside stigma, minority stress and wider systems of privilege and oppression (American Psychological Association, 2021). Trans and gender-diverse people may also encounter particular barriers to care and social inequity (American Psychological Association, 2015).

I would not want an LGBTQ+ therapy group to be organised only around what has wounded us. Queer lives are also characterised by creativity, humour, desire, friendship, chosen family, resistance and extraordinary capacities for reinvention. Our communities have repeatedly created ways of belonging where none were offered to us. In the Circle, the LGBTQ+ therapy group I facilitate in Hastings and St Leonards, holds both realities. It is a confidential space for LGBTQ+ adults exploring identity, relationships, belonging, grief and authenticity. It is not a support group requiring a shared experience or conclusion, and LGBTQ+ identity is not treated as requiring therapeutic intervention. Affirmative practice understands sexual and gender diversity as ordinary human variation rather than pathology (American Psychological Association, 2021). The group may be useful for people curious about how they relate to others, who feel isolated or want to explore recurring patterns where difference can be spoken about rather than silently managed. Because group therapy is not right for everyone at every moment, I meet prospective members individually to consider readiness, expectations and fit.

Instead, I am interested in the person each of us has had to become in order to belong. For some LGBTQ+ people, this reaches back into childhood. Some sense a difference before finding words such as gay, lesbian, bisexual, trans, non-binary or queer; others understand themselves later. A child who perceives that parts of them may not be welcome can become highly attentive to the emotional environment: what is acceptable, what invites ridicule, and which parts receive love or discomfort. Winnicott’s true and false self offers one way to understand how adaptation can organise personality (Winnicott, 1965). We may present what the environment tolerates while protecting something more vulnerable underneath. These adaptations are not weaknesses; they may once have been intelligent ways of surviving. Yet what protects us at fifteen can constrain us at forty-five. The person who never appears vulnerable may struggle with intimacy. Someone who learned to entertain may be enjoyed but rarely known. Someone who avoided notice may still find visibility dangerous.

A therapy group brings these patterns into relationship. Yalom and Leszcz (2020) describe the group as a social microcosm: patterns carried elsewhere appear in the room. We may seek approval, withdraw, caretake, fear disagreement, compare ourselves or assume we are unwanted. In a carefully held environment, these experiences become available for curiosity rather than unconscious repetition. My role is not to be the expert on somebody else’s identity, but to protect conditions for genuine encounter: clear boundaries, attention to power and difference, curiosity when tension arises, and intervention when safety or dignity is at risk.

My relational, integrative approach draws on Psychosynthesis, humanistic and psychodynamic traditions, the body, and what happens between people in the present moment. Rogers located psychological change in relationships characterised by empathy, congruence and unconditional positive regard (Rogers, 1961). Psychosynthesis adds that we contain many parts and possibilities, and can gain freedom in how we relate to them (Assagioli, 1965). This may resonate for LGBTQ+ people who have negotiated between family expectations, cultural permission, partners’ desires and a privately sensed self. The group can become somewhere those different selves meet.

The group also keeps difference within LGBTQ+ experience visible. There is no single queer story: age, race, class, disability, neurodivergence, gender, sexuality, relationships, culture and generation shape lives in intersecting ways. Good LGBTQ+ therapy resists replacing one set of assumptions with another. Affirmative guidance therefore emphasises intersectionality and critical reflection on therapists’ identities, assumptions and privilege (American Psychological Association, 2021). This is vivid across generations. An older gay man shaped by HIV/AIDS may sit beside somebody born into a different landscape. A bisexual person may feel peripheral to heterosexual and gay communities; a trans participant may bring experiences of visibility unfamiliar to others. Difference does not automatically strengthen a group: it can evoke misunderstanding, defensiveness or unequal exposure. Met with care, accountability and curiosity, working through those tensions can become therapeutic.

There is also grief: ordinary losses of parents, partners, friendships, health and ageing, and less easily named losses—the adolescence not fully inhabited, a hidden relationship, acceptance that never arrived, years spent hiding, communities lost, or selves that might have developed differently. But therapy cannot only ask what happened to us. Eventually it must also ask: who might I become now?

Therapy, for me, is not about correcting a defective self. It is about meeting ourselves honestly, recognising patterns that once protected us, and gaining freedom over which we continue to carry. This is where the circle becomes meaningful. Nobody occupies its head; we see and are seen by one another. Over time, trust, recognition and belonging without sameness can develop. For LGBTQ+ people, belonging is more than a pleasant idea. Our communities have created families, friendships and connection when conventional structures excluded us. A therapy group draws on that history while inviting us to notice who we become with others, experiment with being known differently, and discover that hidden parts may no longer need to remain outside the room.

Sometimes individual therapy asks us to look inward. Group therapy adds a relational question: what happens when I allow myself to be fully present with others? For those of us who have spent portions of our lives wondering where we belong, there can be something quietly transformative about entering a circle as ourselves – unfinished, contradictory, vulnerable and alive – and discovering that we can remain there.

References

American Psychological Association (2015) ‘Guidelines for psychological practice with transgender and gender nonconforming people’, American Psychologist, 70(9), pp. 832–864.

American Psychological Association (2021) Guidelines for Psychological Practice with Sexual Minority Persons. Washington, DC: American Psychological Association.

Assagioli, R. (1965) Psychosynthesis: A Manual of Principles and Techniques. New York: Hobbs, Dorman & Company.

Meyer, I.H. (2003) ‘Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: Conceptual issues and research evidence’, Psychological Bulletin, 129(5), pp. 674–697.

Rogers, C.R. (1961) On Becoming a Person: A Therapist’s View of Psychotherapy. Boston: Houghton Mifflin.

Winnicott, D.W. (1965) The Maturational Processes and the Facilitating Environment. London: Hogarth Press.

Yalom, I.D. and Leszcz, M. (2020) The Theory and Practice of Group Psychotherapy. 6th edn. New York: Basic Books.