What to Expect at Your First Therapy Session as a Queer Adult
Booking your first therapy session as a queer adult can feel really nerve-wracking. You have the usual questions - wondering if it will actually help, how much of a time commitment it will be, and whether it will be worth the investment.
As a queer person, there are other questions that come up too. How much explaining will I need to do about my identity? Will this counsellor understand my relationship structure? Will they see the ways that the world we’re living in is impacting my mental health? If you’ve been putting off starting therapy because these questions are swirling around in your mind, you’re not alone in that.
Let’s take some of the pressure off you for a second. Most therapists offer 15-minute free consultation calls, and I want you to remember that this first conversation is where YOU get to decide if this will be a good fit. And you’re allowed to be picky!
What happens in a free 15-minute consultation call with a therapist?
Most therapists offer a 15-minute free consultation call so you can get an idea of whether you’d work well together before committing to a first session. This is your chance to see how you feel about them, ask them questions, and figure out if it’s something that could work well. Different therapists structure their consultation calls differently, but at the end of a consultation call I’ll always ask people how they feel it went. If I’m getting the sense that its not the best fit and there’s someone else who would be better, I’m not shy about offering referrals. Whether we work together or not, what matters most to me is that you get the care you need and have a therapist that you really connect with.
Questions to ask counsellors in a free 15-minute consultation call
It can feel awkward to ask a stranger about their competency in the first five minutes of meeting them. A good therapist won't mind, though, they want that power dynamic balanced too. In my own consult calls, I usually ask why you're seeking therapy now, share a bit about how I work, and then leave space for whatever you want to ask me. I welcome questions about the identities I hold, my training, or anything else that would help you feel more comfortable in the room.
Some questions that come up a lot:
What's your experience like working with women who are coming out later in life?
Do you have personal experience with [issue]?
Have you worked with couples where one person is transitioning?
How do you help people navigate internalized biphobia?
Have you done specific training in gender-affirming care?
Notice how the answers land, not just what's said, but whether the person seems genuinely at ease with your reality.
What happens in the first session with a therapist?
If you're coming into my office in Mount Pleasant, you can take a seat in the waiting room and I’ll come and get you when I’m ready. There’s snacks on the table, so help yourself to those! If we're meeting virtually, find somewhere quiet where you know you won't be interrupted and can actually talk freely. Some people like to set the space up a bit, with a cosy blanket, a favourite hot drink, or a scented candle that feels calming. Whatever helps you feel grounded.
We’ll spend some time at the start of the session going over confidentiality and informed consent, what the limits of that confidentiality actually are, and my cancellation policy. I usually send forms ahead of time so you're not answering big questions on the spot. This means you can take your time with them and be intentional about your answers.
I'll usually ask what's bringing you to therapy, and why now. I lean on narrative therapy, so we'll talk about the different systems you're part of that shape how you experience the world, and psychodynamic therapy, which looks at how your past shows up in your present. We move between the two but they’re not the only modalities I draw from.
What queer-affirming therapy actually looks and feels like
Affirming therapy doesn't treat your identity as the presenting problem. You should be able to walk in and focus on your actual life, not spend your time in session managing your therapist's comfort level with who you are. It also means not having to brace for the moment you have to explain something, like what top surgery even is, before you can get to how you actually feel about it.
Being queer and queer-affirming myself doesn't mean I understand everything about your specific experience. What it does mean is I'll ask open questions instead of assuming, I won't judge, and I take my own learning seriously outside of sessions too. I love to read and I’m always doing some sort of training related to identity and/or relationships.
The structural stuff matters just as much as the relational stuff. Look for intake forms with space for pronouns, gender identity beyond a small dropdown list, and a chosen name that's separate from your legal name.
Signs it's maybe not the right fit
Pay attention to how you feel in the room. If a therapist gets something wrong, makes an assumption about your relationship structure or identity, and you gently correct them, watch what happens next. If they get defensive, or it stops feeling like you're being heard, that's information to consider.
You don't owe anyone continued sessions just because you've already started. I check in with my own clients every couple of sessions to see how things are going for them and I adjust based on that feedback, and any therapist worth working with should do the same. You can name the concern and see if things shift, or you can stop booking and look elsewhere. It’s really up to you, and your comfort and care is what’s most important.
Ready for your first therapy session as a queer adult?
Walking into your first therapy session as a queer adult can feel nerve wracking, especially if past experience, yours or someone else's, has made you skeptical that you’ll find a counsellor who gets it. Knowing roughly what to expect can make that first step a little easier.
If you're ready to take that step, I offer a free 15-minute consultation for queer adults in Vancouver and across BC. There’s no pressure to commit, and if I’m not a good fit I’ll refer you to someone who is!
FAQ: Your First Therapy Session as a Queer Adult
What should I expect at my first therapy session as a queer adult? Mostly intake work where your therapist gathers background information, reviews informed consent and confidentiality, and starts understanding what you want out of therapy. It's also your chance to assess whether they're the right fit for you.
How do I know if a therapist is queer-affirming before booking? Look for intake forms with pronoun and chosen-name fields, ask direct questions about their experience with queer and trans clients, and use a free consult if one's offered.
Is queer-affirming therapy session support available virtually in BC? Yes. Virtual counselling has made affirming care a lot more reachable across BC, especially if you're outside a major city or you'd rather be in the privacy of your own space.
What questions should I ask in my first counselling session as a queer adult? You can ask about their experience with queer and trans adults, how they stay current on LGBTQ+ issues, how identity gets spoken about in sessions.