I’ve seen enough LGBT youth now in my private practice to unfortunately have heard many times, “Yeah my last therapist just didn’t want to get involved.”

Here’s the story.

I see people for therapy and/or medication management. When I see clients for medication management I still do a thorough assessment. I ask all the tough questions and find out why someone is really depressed or anxious or whatever. I poke and pry because I don’t want to prescribe medication if there is actually a deeper issue that just won’t respond to medication.

Case in point- every LGBT youth whose family is not accepting of their sexuality. That would make me depressed too. And anxious. Because they fear that if they are “out” their parents will kick them out, stop supporting them financially, but most of all they fear their parents will stop loving them.

I tell my patients that no amount of medication I prescribe will take that fear away. Then I ask how we can address this issue with their family. They usually look at me through tears and tell me no previous therapist wanted to insert themselves into this issue in the family.

For a little bit I started questioning if I was doing the right thing. But then I saw their relief, and I’ve met with parents and processed their fears and feelings around their children’s sexuality. I’ve never met with parents without extensive processing with the kids first, and I’ve never done it in a way that would out my client if they do not want me to do that. I am extremely respectful of their boundaries and where they are at in their own journeys.

But I can’t ignore the elephant in the room. I can’t continue to increase an anti-depressant dosage knowing the depression comes from feeling rejected and not address that in some way.

As a therapist and as a nurse I feel it is my duty to provide support not only to my client but to the family system. And my teens and young adults are grateful to have someone speak up for them and be heard in ways by their parents that maybe as “the kid” they cannot be. It’s a fine dance to be sure though. Balancing where my client is at and where their family is at and what each needs from the other in the moment.

Therapists are in a position to be incredible advocates for LGBT youths. Why would we not seize the opportunity? And if you are not comfortable for whatever reason to do the family work then refer them to someone who is.

Many clients come to me feeling stuck. The best part of the work is helping to unstick them from the fear and secrecy and move their whole family forward into the light.

It’s incredibly difficult and requires good supervision as a clinician and continuing education specific to the LGBT community. But it’s doable and as difficult as it is it’s the most rewarding aspect of my work. Too many LGBT youth face high rates of depression and higher rates of suicide to ignore this issue and to not insert ourselves.