Finding Queer-Affirming Mental Health Support: A guide for QPOC Abroad

If I had a penny for every time in all of the 5 years I’ve spent as a mental health provider, that someone said “I’ve never had a queer provider before” or “I’ve never had a queer and black/African provider before”… I’d probably never have to work again. Unfortunately, it looks that way on my end as a provider as well. Where I’ve found Queer spaces, I am the only Black person. And when I’ve been lucky enough to find other black providers, of course I was also the only Queer person.

I have no doubt we exist, it has just been incredibly challenging to know where.  I’ve worked abroad and in South Africa providing Mental Health care for over 5 years to expats, folks in the US and Queer POC on the African continent. If I’ve learned the importance of anything in this work, it is the value of feeling understood and seen.

We take for granted that mental health care has been built on and prioritizes straight, cisgender, white, middle to upper class experiences. It leaves out the lived experience of having multiple identities like Queer, Transgender, Black, Immigrant, Disabled and Poor among others. Mental health care is not just about treating disorders. It is also about building resilience in community, offering familiarity and value alignment so folks feel heard in their experiences and feel capable of pursuing the care they deserve.

So if you’re in the market for a provider and are interested in feeling more aligned in identity with that person, here are some thoughts on how to get that ball rolling.

So, What Does it Mean to be Queer-Affirming and Culturally Competent?

At its most simplest form, Queer-Affirming care means approaching your mental health with the knowledge that Queer identity is not a curse, a choice, or a disadvantage. It is respecting pronouns without question, engaging with gender identity and sexual orientation with care rather than pity or fear and finding out what it means for that person.

Our identities are not a spectacle.

A provider who is culturally competent will understand the intersections of identities like queerness, African identity, experiences of migration or displacement and disability. A provider competent in this realm is already engaging with power dynamics and the social, psychological and mental impact of them.

Why does this matter you ask? Part of engaging with providers who are knowledgeable about your identities reduces medical racism and transphobia, it combats internalized shame, and most importantly it acknowledges the impact of colonialism, religion and family dynamics on queer African identities.

Where to start your search

Online Directories & Networks:

• There are some platforms that exist globally that can provide you with a good starting point for your search. Examples are Psychology Today, Therapy Route, OutCare Health, International Therapist Directory or the World Professional Association of Transgender Health (WPATH)

• Queer African-Specific Resources are in limited supply, though some that do exist include: OUT LGBT Well-being (South Africa), The Initiative for Equal Rights (Nigeria), GALZ (Zimbabwe), Coalition of African Lesbians

• Expat and Immigrant Support Groups: Use social Media! Potentially looking for local queer organizations in your host country that can direct you to provider resources

Word of Mouth:

• Another resource is to ask your community. Don’t have one? Find some online forums in your area; WhatsApp groups, community meet ups. Heck! Try reddit responses in your host country and see who other folks have seen!

• LGBTQ community center referrals! If you happen to live in a country that has a resource like this, a community center can be incredibly helpful for finding referrals resources. If you’re in University, a school mental health center is also likely to have these resources.

Questions your provider should be able to answer

• Have you worked with LGBTQ clients before?

• How do you support clients navigating gender and sexuality?

• Have you worked with clients experiencing ____ in collectivistic/individualistic?

• What are your views on Gender affirming care?

• How do you work with cultural displacement in therapy?

Red Flags to Watch out for:

• Providers who minimize or dismiss LGBTQ identities

• Persistent misgendering of you or others despite correction, assuming heteronormativity, or using outdated language

• Application of individualistic cultural/family values and structures despite cultural difference

• Minimal awareness about racial trauma, colonial histories and their impact 

• Suggesting conversion therapy, religious "healing," or heteronormative family reconciliation as solutions

Affordability and Accessibility

Once you’ve found a resource or started searching, the nagging piece that comes up and likely makes you abandon your search is the possibility for affordability. It’s quite shit that we exist in a world that folks need to fight for what can be life-saving healthcare (and yes, queer affirming care IS life-saving care). Check in with your insurance/medical aid if there is cover of LGBTQ affirming mental and physical healthcare

For many people, the privilege of a doctor or mental health care near by is not accessible let alone one that is queer or gender affirming. Public health spaces tend to be more affordable, though also have longer wait times, both for mental health and medical care. Consider private health spaces and ask for pro-bono or reduced fee spaces/services that can span across borders (like locationindependenttherapists.com). There’s no harm in asking! Also consider LGBTQ+ health grants and support organizations for financial assistance (i.e Loveland Foundation in the U.S)

Living in countries that render affirming care inaccessible doesn’t have to be a barrier!

Self-Advocacy Tips:

As much research and care as we may put into finding providers that align with us, they are in short supply and we can’t guarantee affirming care at all times. If you find that someone you are working with or end up working with isn’t quite as affirming as you’d hoped that’s not your fault.

Consider where you are in your personal journey and whether this is a space you are prepared to exist in for the benefit you receive (assuming there is one). This is a personal choice. Seeing a Black, Queer or Trans or otherwise identity diverse provider also does not guarantee understanding.  If it’s a mental health provider who you are seeing particularly to work through concerns around relationships, sexuality or gender, it might make more sense to move onto someone who can hold all those things. 

Understand your rights in different healthcare systems and use LGBTQ+ advocacy groups along with community for legal and social support!

You deserve care that feels safe and comfortable enough for you to exist fully in. Whatever that means for you and whatever the work you intend to do is. Particularly if you find yourself in countries and spaces that are not safe or can’t guarantee you affirming care, remember that physical and mental healthcare are one resource that serve a specific reason. Community is an expansive resource that can be an incredible way to transcend the harm, and challenge of healthcare.

Please share resources or experiences in the comments to help others in the Queer Village and beyond! (Resources linked)