Creating Safety: How We Can Truly Support LGBTQIA+ Clients
Blog Post by Contributing Editor Barry McNinch, MS, LPC
Supporting LGBTQIA+ individuals with eating disorders isn’t just about treating symptoms - it’s about seeing the whole person and affirming their full humanity. In the therapy room, this means creating a space that is warm, respectful, and intentionally inclusive.
It starts with language. The words we use matter deeply. Introduce yourself with your pronouns and invite your client to share theirs. Use language that doesn’t assume gender or sexual orientation, and be thoughtful in how you reflect back on their lived experience. Intake forms, clinical notes, and casual conversations all send messages, so make sure those messages say, “I see you, and I honor who you are.”
It’s also important to understand how LGBTQIA+ identities intersect with their eating disorder itself. Not every client is trying to “love their body,” and for those experiencing gender dysphoria, messages like “your body is perfect the way it is” can feel tone-deaf or even distressing. Likewise, celebrating the return of menstruation may be a standard marker of physical recovery in some treatment models, but for transgender and non-binary clients, it may bring up discomfort or dysphoria. Our job is to listen closely, adapt our language, and let each client define what healing looks like for them.
True support means recognizing that recovery is not one-size-fits-all. Some clients may need space to express ambivalence, process trauma, or grieve what’s been lost. Others may want to explore affirming medical care or build community connection as part of their healing. Wherever they are in the process, our role is to walk beside them, not direct them toward someone else’s version of “normal.”
Finally, we have to keep learning. As therapists, we must commit to ongoing education, advocate for more inclusive treatment models, and challenge the systems that leave LGBTQIA+ voices out of research, policy, and care. Healing doesn’t happen in isolation, it happens when communities come together to make space for all of us.
Being a therapist for LGBTQIA+ individuals with eating disorders is a privilege and a responsibility. It asks us to hold space for pain while also creating room for hope. It asks us to look beyond clinical checklists and see the human being sitting across from us. It reminds us that support, when it’s truly affirming, can be life-changing.
Whether you’re a clinician, a friend, a family member, or someone navigating your own recovery journey - know this: healing is possible. And you are never alone. We can walk this journey together, one step at a time.
Barry McNinch, MS, LPC
Rock Recovery Board Member
About the Contributor: Barry McNinch joined the Rock Recovery Board in October 2022, and has been a dedicated Rock Recovery supporter and volunteer for years. As a Licensed Professional Counselor, Barry specializes in helping young and mature adults navigate challenges related to eating disorders, substance use disorders, personality disorders, and mood disorders. He takes pride in working with the LGBTQIA+ community, and understands the need to create a space for those navigating the very complex process of connecting to our own identities. Barry excitedly uses his passion for mental health to help Rock Recovery serve more individuals in the community.