“There Are Not a Lot of Providers Who Look Like Me”: Identity and Therapy for Sexual Minority Black, Indigenous, and other People of Color

Research suggests that sexual minority Black people, Indigenous people, and People of Color (BIPOC) generally experience higher levels of psychological distress and depression, leading to poorer mental health outcomes (e.g., Sutter et al., 2017; Lim & Hewitt, 2018). However, little is known about how sexual minority BIPOC individuals cope and support their mental health. The purpose of this grounded theory study was to understand the various and nuanced narratives of sexual minority BIPOC in seeking mental health support, including any barriers to accessing therapy as well as other identified sources of support. Fifteen sexual minority BIPOC individuals were interviewed about their perspectives of therapy. Using intersectionality theory as a framework, the following core categories emerged: impact of identity on mental health, intersectionality/intersectional lens, mental health stigma, issues with accessibility, significance of shared identity with the therapist, hesitation with therapy/therapists because of a marginalized identity, negative therapist reactions, therapy is ineffective and/or harmful, importance of empathy, importance of attending to identity in therapy, an unmet need for therapy, and coping with community. Results of the present study suggest that therapy can be ineffective–or even harmful–for sexual minority BIPOC individuals when identity is not adequately addressed in the therapy room. Our findings prompt important directions for practice with sexual minority BIPOC individuals, including developing trainings for therapists so that they can better provide services to sexual minority BIPOC clients.