Affirming Care Isn’t Special, It’s the Bare Minimum
“To be fully seen by somebody, then, and be loved anyhow—this is a human offering that can border on miraculous.”
—Elizabeth Gilbert
We are in the thick of Mental Health Awareness Month, and it’s time to have an honest conversation about what safety in therapy really means.
Here’s the truth: affirming care is not advanced practice. It’s not a luxury. It’s not a bonus. It’s the bare minimum. And yet, for so many of us, for queer folks, trans folks, polyamorous people, BIPOC communities, disabled people, neurodivergent minds, it still feels out of reach.
Let’s name what too many people have experienced:
🌱 Being misgendered by a therapist after correcting them—multiple times.
🌱 Having your nonmonogamous relationships framed as a symptom, not a choice.
🌱 Explaining cultural values to someone who pathologizes them.
🌱 Hearing, “I don’t see race” when your trauma is racialized.
🌱 Being offered breathing techniques when you needed a space to rage, weep, or just be.
That’s not safe. That’s not trauma-informed. That’s not affirming.
It’s re-traumatizing.
In therapy, safety isn’t just the absence of harmit’s the presence of validation, respect, and relational integrity. When those are missing, the consequences are profound.
According to The Trevor Project (2023), LGBTQ+ youth who had access to even one affirming space were 40% less likely to report a suicide attempt. That’s the difference one safe space can make.
“Affirmation is not indulgence. It is the foundation for psychological safety.”
—Dr. Thema Bryant
Many clinicians believe that “neutrality” equals ethical care. But neutrality in the face of someone’s identity is not neutral, it’s dismissive.
Paulo Freire (1970) famously wrote: “Washing one’s hands of the conflict between the powerful and the powerless means to side with the powerful, not to be neutral.” When therapists ignore systems of oppression or claim “I treat everyone the same,” they often unwittingly uphold harmful norms.
Therapists must understand that clients don’t enter the room as blank slates. They come with intersectional identities that carry histories of harm and resilience. True affirming care acknowledges that. It makes room for it.
Affirming care means:
🔥 Asking someone their pronouns and using them correctly, every time.
🔥 Understanding that “family” and “partner” can look many ways.
🔥 Naming racism, homophobia, fatphobia, and ableism, not avoiding them.
🔥 Centering a client’s lived experience as expertise.
🔥 Listening with humility when you don’t understand something.
🔥 Repairing when you get it wrong, because everyone gets it wrong sometimes.
“It is not our differences that divide us. It is our inability to recognize, accept, and celebrate those differences.”
—Audre Lorde
The field has to do better. Because the consequences of bad therapy are not small. They are measurable. They are fatal.
🌱 LGBTQ+ adults are more than twice as likely to experience a mental health condition (NAMI, 2023).
🌱 BIPOC individuals are less likely to receive quality mental health care and more likely to terminate therapy prematurely (Snowden, 2001).
🌱 Trans people who encounter misgendering and invalidation in therapy report increased rates of depression, anxiety, and suicidal ideation (James et al., 2016).
So no, affirming care is not optional. It is a public health issue.
If you’ve ever left a therapist’s office feeling smaller than when you walked in
If you’ve ever said less to protect yourself
If you’ve ever become “the educator” in the room
If you’ve ever stopped showing up, because therapy felt like another place to be misunderstood
I want you to know: it was never your fault.
Bad therapy is real. And you deserve better.
You deserve a provider who respects your boundaries, affirms your identity, and honors your healing pace. Someone who doesn’t just “accept” you, but celebrates the fullness of who you are.
You don’t need to be a therapist to use this. Whether you’re a client, a clinician, or someone navigating the mental health system, this is for you:
1. When was the last time I felt fully seen in a care space? What made that moment feel safe?
2. What identities or experiences have I learned to hide in therapy, healthcare, or support systems?
3. Have I ever internalized harm from a provider and blamed myself for it?
4. What would it look like for care to truly affirm me, not just tolerate me?
5. What stories do I carry about whether I’m “too much,” “too complex,” or “not enough”? Whose voice is that?
Take your time. Be gentle with yourself. These questions aren’t about perfection. They’re about reclamation.
Affirming care starts with this belief:
You are not too much. You are not too sensitive. You are not too queer, too loud, too complex, or too real.
You are worthy of care that sees you. Hears you. Loves you in all your nuance.
If you’ve never had affirming care, know this, it exists. It is out here. And I am one of many fighting for a world where it’s not rare. It’s standard.
This Mental Health Awareness Month, let’s hold space for the stories that deserve to be told. Yours included.
Have you ever experienced therapy that didn’t feel safe? What helped? What hurt? What would affirming care look like for you?
Share in the comments. Send this to someone who’s still healing. Let’s raise the standard together.
References
Freire, P. (1970). *Pedagogy of the Oppressed*. Herder and Herder.
James, S. E., Herman, J. L., Rankin, S., Keisling, M., Mottet, L., & Anafi, M. (2016). *The Report of the 2015 U.S. Transgender Survey*. National Center for Transgender Equality.
National Alliance on Mental Illness. (2023). *LGBTQ+ Mental Health*. [https://www.nami.org](https://www.nami.org)
Snowden, L. R. (2001). Barriers to effective mental health services for African Americans. *Mental Health Services Research, 3*(4), 181–187.
The Trevor Project. (2023). *2023 U.S. National Survey on the Mental Health of LGBTQ Young People*. [https://www.thetrevorproject.org](https://www.thetrevorproject.org)