Good queer couples therapy is often described as a matter of goodwill: find a therapist who is LGBTQ+ friendly and the rest will follow. New research suggests goodwill is only the starting point. A 2026 study in the Journal of Marital and Family Therapy asked LGBTQ+ clients about their experience of emotionally focused couple therapy (EFCT), a well-researched, evidence-based approach to relationship counselling. Their answers show that a therapist can be supportive in intent and still leave a couple feeling like outsiders.
The finding surfaced unexpectedly during a broader project on adapting EFCT, and the authors gave it a paper of its own. It speaks to anyone seeking LGBTQ+ couples counselling, and to every therapist who offers it.
Why couples therapy models need to fit queer relationships
Most established models of couples therapy were developed and tested with heterosexual, cisgender couples. EFCT has a strong evidence base for easing relationship distress, yet published research on how it works for LGBTQ+ couples remains thin. The same research team published an earlier paper in 2025 gathering LGBTQ+ clients’ recommendations for adapting EFCT. This newer paper reports on something that came up alongside those recommendations: experiences of othering.
Othering describes treating a person or group as different from an assumed norm in a way that pushes them to the margins. In therapy it is often subtle. It might be a stereotype offered as insight, or an assumption that a client’s sexuality or gender must sit at the root of the couple’s difficulties. Earlier research links these kinds of microaggressions in therapy to poorer client outcomes.
What the study did
Researchers at Michigan State University recruited 35 people who identified as LGBTQ+ and had attended at least six EFCT sessions with a partner of one year or more. Most participants were White and lived in the United States, and a few lived elsewhere, including Australia. Nearly all of them (95 per cent) said they were satisfied with their therapy.
Participants joined online focus groups that ran for about two hours. They talked about their own experience of therapy, then watched two segments of an EFCT training video in which an expert therapist works with a gay male couple and a lesbian couple. They discussed what felt safe in each and what did not.
Because othering emerged during analysis rather than from the original plan, the authors used a method called negative case analysis, which examines findings that run against researchers’ expectations. They had expected participants to welcome open discussion of identity in therapy, as earlier research supports. Many did, but some did not, and their reasons form the heart of the paper.
What LGBTQ+ clients told the researchers
Every participant wanted a therapist with experience working with LGBTQ+ communities. Beyond that shared starting point, their preferences diverged in ways that matter for anyone practising or seeking queer couples therapy.
When identity is inflated
Some cisgender participants said that if their therapist had focused on their sexuality, they would have felt singled out. For them, a therapist who treated their relationship like any other relationship signalled acceptance. Several said the problems that brought them to therapy were unrelated to their sexuality, and that they felt secure in who they were.
Two trans and non-binary participants described a different version of the same problem. In an individual session, their therapist focused entirely on one partner’s trans identity and assumed it was causing difficulties with attachment. The non-binary partner’s identity went unacknowledged. Neither partner felt those sessions related to their relationship at all.
When the client becomes the teacher
Participants often chose a therapist experienced with LGBTQ+ clients so they would not have to explain queer life. Having to educate a therapist felt like one more version of a familiar burden, and one pointed out that they were paying for the privilege. One participant’s words gave the paper its title: “I’m not here to teach you how to be gay.”
The training video sharpened this point. When the expert therapist expressed surprise at an experience common among gay men, several participants felt the focus of the session shifted from the couple to the therapist’s own learning. Visible shock, one participant observed, can itself be othering. Yet participants also valued therapists who were curious about their lives. Curiosity felt affirming when it served the couple, and othering when the therapist’s own learning took over the session.
When identity deserves more depth
For other participants, the problem was a lack of depth. Some appreciated a therapist who asked about pronouns and raised identity early. Participants of colour said that exploring how race shaped their relationship was essential to feeling safe.
Watching the training video, participants pointed to missed opportunities. A client mentioned the risks of coming out at work, and the therapist repeated his words without exploring them. Coming out can be a milestone that carries both joy and fear, and participants felt it deserved space within the attachment work.
One genderfluid participant described deciding with their partner to stop trying to help their therapist understand their gender, and to let the therapist treat them as a straight, cisgender couple. They found later sessions more useful after setting those nuances aside, a gain that came at the cost of leaving part of who they were out of the work.
What affirming couples therapy looks like in practice
The authors conclude that there is no single right way to handle identity in therapy. They suggest beginning with minimal discussion of identity and following each client’s lead on whether sexuality and gender belong in the work. When identity does come up, the conversation should go deep enough to mean something to the client.
They also recommend a change in technique. EFCT relies heavily on reflections, where the therapist names a client’s experience back to them. With LGBTQ+ clients and others from marginalised groups, the authors propose leaning more on evocative questions, which let clients define their own experience. A therapist who tells a queer client what their life is like risks speaking over them, while a well-placed question hands that authority back.
Cultural humility sits at the centre of their recommendations. It describes a therapist who stays open and non-defensive about the limits of their own knowledge. Broaching sits beside it, meaning a consistent willingness to raise questions of identity and power, offered with consent and at the client’s pace. Both depend on training and supervision, and the authors encourage EFCT therapists to seek out both.
The authors also cite earlier research, including an Australian study, that links concealment of sexual identity with lower relationship satisfaction. A client’s wish to keep identity out of therapy deserves respect, and a skilled therapist can honour it while leaving the door open for later.
Finding queer couples therapy that fits
If you are looking for a couples counsellor, a few questions can help you judge fit early on.
Ask about the therapist’s experience with relationships like yours, including trans and gender-diverse partners or non-monogamous arrangements.
Notice whether they ask how you would like identity to feature in your sessions, rather than deciding for you.
Pay attention to whether you leave sessions feeling understood as a couple or treated as an example of a category.
If something feels othering, it is reasonable to raise it. A good therapist will welcome the conversation and work with you to repair the rupture.
At Progressive Therapeutic Counselling, we offer online couples counselling across Australia, with specialist experience in sexuality, kink, gender and relationship diversity. You decide how much your identity features in our work together, and we bring the knowledge so you do not have to. To talk about couples counselling, get in touch with PTC.
About the research
This is a small qualitative study, so its findings point to themes rather than rules. Most participants were White and based in the United States, and the training footage they discussed is more than a decade old. The researchers also had no way to confirm how closely each participant’s own therapist followed the EFCT model.
The full article is open access and free to read:
Edwards, C., Dwanyen, L., Wittenborn, A. K., & Allan, R. (2026). “I’m Not Here to Teach You How to Be Gay:” LGBTQ+ client experiences of othering in emotionally focused couple therapy. Journal of Marital and Family Therapy, 52(3), e70141. Free full text is also available on PubMed Central.