The challenges of supporting the spiritual and religious journey of lesbian, gay, bisexual and transgender clients.

by Anne Kelliher


The challenges encountered in supporting the spiritual journey of any client are myriad. For example, therapists need to have an appreciation of the elements of a healthy spirituality, of its developmental stages and of the differences and similarities between spirituality and religion (ASERVIC, 2009; Long, 2012; Kelliher, 2011). When a client is a member of the lesbian, gay, bisexual or transgender (LGBT) population, additional information and skills are needed. More importantly, an awareness of and a willingness to work through one’s own biases and inner homophobia are essential (ALGBTIC, 2009; Balkin et al. 2009).

In this article I will:

  1. 1. Give a short description of spirituality and religion.
  2. 2. Reflect briefly on adulthood and adult spirituality.
  3. 3. Specify aspects of LGBT development.
  4. 4. Detail the most common responses to religion by LGBT individuals.
  5. 5. Make some suggestion in relation to working with this client group.

Whilst my approach is theoretical, the inner turmoil experienced by many LGBT clients must never be under-estimated. Finally, this article does not allow for an exposition of issues specific to each of the groupings, or to those dealing with multiple minority exclusions, e.g., LGBT clients who belong to a minority ethnic and religious culture and who are also disabled.

Spirituality and religion

Spirituality, as here understood, refers to an awareness of the ‘More’ in life, the Transcendent. For some, spirituality includes a Divine Being, for others it does not. The former is a theistic spirituality, the latter is not. For spiritual seekers, their daily lives are given meaning and direction by their Ultimate Concern, their Transcendent. Many with a theistic spirituality celebrate their belief with others, frequently within an organised religion. Religions are belief systems which are guided by creeds, dogmas and ritual. In short, a spiritual life can occur within or outside the context of an institutionally organised religion.

Some characteristics of adulthood and an adult spirituality

The development of a healthy spirituality is dependent on the development of a healthy human being, one who can grow into psychological adulthood (Kelliher, 2007; Shea, 2005). According to Shea, adulthood, safely negotiated, has the following characteristics: the adult self is a body self, rooted and disclosed in feeling, has a felt sense of depth, has its own clear boundaries, yet lives and unfolds and has its being in intimacy and is its own responsible process of experiencing. Shea (2005) named the attaining of adulthood a ‘personal triumph’ bringing with it the possibility of reaching a spiritual maturity. For theists, spiritual maturity is marked by an ability to be open to the Divine in a deeply personal manner. In this experience, God is known at the core of one’s being as Thou, as Lover, as Freedom, as both known and not known, i.e., as Mystery, as a God of Community; in short, as Love. This knowing is an inner process, but is only real when transcribed into the mundane of everyday life and commitment.

The attaining of adulthood and an adult spirituality is no easy feat. Imagine how much more difficult this attainment must be for persons who belong to a minority population, discriminated against on many levels, including religious, due to their sexual orientation. The sexual orientation of LGBT clients is an intimate, precious and integral element of their body self – the integration of which is the foundation of development towards adulthood (Shea, 2005). Therefore, the supporting of LGBT clients in embracing their sexual identity is crucial if they are to maintain adulthood and the possibility of an adult spirituality.

Sexual identity development

Meaningful work with LGBT clients demands an understanding of their sexual identity development, i.e. the process by which they come to know, value and embrace more fully who they are. Such understanding supports the development of an effective therapeutic relationship. Cass (1979) outlines six stages in this formation:

Pre-Stage – one: Individuals have not yet considered themselves to belong to the LGBT grouping. The majority culture of heterosexuality is understood to be socially desirable and a non-heterosexual orientation is seen to be stigmatised.

Stage one – Identity Confusion: Now there is an awareness of personal thoughts and feelings that may be considered to be non- heterosexual. This awareness brings confusion. The central task of Stage one is to resolve these feelings, to lessen discomfort and to grow in acceptance of one’s sexual identity. The result of negotiating Stage one is the acceptance or rejection of this identity.

Stage two – Identity Comparison: Individuals have begun to accept that they may not be heterosexual. This new self-image may be viewed positively or negatively. The challenges of being different, of feeling alienated, of dealing with the sense of incongruity in their lives is now paramount. Strategies differ, with some focusing on what is positive in their new self-identity. Others retreat, becoming invisible and devaluing of who they are for fear of social rejection, including familial rejection (HSE, 2009). This strategy is further intensified for many who belong to religions which denounce all or some aspects of being LGBT. This may result in individuals feeling distant from their God, even rejected by the Divine, at the very time they yearn for God’s comforting presence most. This deeply felt isolation is due to their inability, at this time, to navigate successfully the emotional, psychological and philosophical divide between their religious and sexual identities. I believe that successful navigation requires the sense of positive self-acceptance and integration which can only come at a later stage in one’s personal development. Others in this grouping see religion as irrelevant to them, or move to an alternative, inclusive religion when possible, e.g., The Metropolitan Community Church.

Stage three – Identity Tolerance: Individuals now acknowledge their sexual identity, though it may be tolerated rather than embraced. The exploration and fulfilling of sexual, social and emotional needs associated with being LGBT is begun. This stage includes disclosure of their identity, normally within the lesbian, gay, bisexual or transgender community. Some wish to continue to own a personal spirituality and others want to continue to express this within a formal religion. Frequently, due to the negativity towards religion by the very individuals who are welcoming them into the LGBT community, this aspect of their lives can be silenced. Counsellors need to be extremely cognisant of this fact, and be all the more welcoming should clients wish to explore their spiritual identity in the counselling room.

Stage four – Identity Acceptance: In early Stage four, individuals continue to have different perceptions as to how acceptable their self- identity is. With on-going contact with other LGBT persons, a stronger and more accepting sense of being lesbian or gay normally develops. This allows individuals the freedom to ‘come out’ to selected heterosexual persons. The core work of Stage four is the owning and positive acceptance of one’s sexual identity as an integral and wholesome part of one’s self.

Stage five – Identity Pride: Tension between individuals’ self- acceptance as LGBT and the cultural/social rejection of same, characterises Stage five. Individuals immerse themselves more fully in the LGBT community, seek out supportive heterosexual persons and rejection of those less tolerant occurs. Pride in one’s own identity combined with anger at society’s intolerance empowers individuals to be ‘out and proud’. Strategies to pass as heterosexual are increasingly abandoned.

Stage six – Identity Synthesis: Individuals now reconcile the tension between social rejection and self-acceptance. Integration of the whole person may follow, with an appreciation that their sexual orientation is one part of a bigger whole/self. Reintegration into mainstream society becomes increasingly possible.

Attitudes towards spirituality and religion

The place given by LGBT individuals to religion and spirituality is varied (Clarke, 1996) but mainly influenced by the negativity of many religions in their regard. That there is a growing divide between the ‘official’ stance and the lay/congregational stance has not yet impacted in a meaningful manner (ACP, 2012). The following categories of LGBT expression towards traditional and non- traditional religion have been suggested by MacDonald (2006):

Spirituality/religion is personally irrelevant: Individuals self-identify as atheists, secularists or humanists. Whilst some people continue to suffer the debilitating after effects of religious-based condemnation of their sexual orientation, little or no energy is wasted on religious issues.

A religious and spiritual moratorium: Spirituality and religion are actively rejected. This may be a counter-rejection to former and possible future rejections from their own religious tradition. Negative psychological and emotional energy is directed towards spirituality and religion. Such unresolved anger may be a block to individuals honouring and owning of personal experiences of a spiritual dimension in their lives.

The adoption or creation of alternative spiritualities: Individuals in this category actively foster their inner life through association with new or traditional religions seen as more accepting of their lifestyle. Many may be working towards a healthy integration of their spiritual and sexual identity. Normally, this demands that one be at Stage Five or Six of Cass’ (1996) developmental model. Therapeutic support may be sought as one negotiates the myriad of feelings and unresolved issues brought to light by the shedding of one’s allegiance to one’s former religious tradition.

Assimilation within a traditional religion while affirming one’s sexual identity: Perceived cultural or family obligations are frequently the basis of this stance. This perception may be so blinding that there is, for some, a lack of awareness of other choices. Alexander and Preston (1996) emphasised that spiritual inertia can result from the stress of continuous marginalisation. A crucial part of therapy is to support these clients to clearly name the damaging consequences of their stance, and to make conscious choices of how to proceed in a more life giving manner (Davidson, 2000).

Others more positively carry the tension of holding dear many aspects of their religious heritage despite that tradition’s continuous rejection of an essential aspect of their being. Many of these individuals are well read on matters of religion and spirituality, have a deep personal relationship with the Divine, and know themselves, in all aspects of their being and lives, to be in God’s loving care. They know that they are the beloved of God.

An accommodation of their sexual orientation to the moral tenets of traditional religions intolerant of their sexual identity: This accommodation may take place by suppression, compartmentalization or rejection of their sexual orientation. Some keep their sexual identity a secret. Others engage in conversion therapies aimed at changing their sexual orientation (Maguire, 2012). This stance is fraught with psychological and spiritual mine-fields. It is my belief that in all cases where religion isolates LGBT individuals from their core value system, especially a personally held belief system that includes a relationship with the Transcendent, a spiritual violation or abuse occurs:

“Religious abuse occurs when a religious or spiritual leader uses coercion, manipulation, and threats to gain control over LGBT individuals and force the leader’s values on another… The effects… often include shame, guilt and poor self-esteem… the development of individuals in their spiritual domain… Often the three significant components of religiosity are affected: the individual’s beliefs, practices of faith, and participation in a faith community. Nonetheless, it is vital that counsellors develop an ability to define, identify, and address the issues of religious abuse while working with the LGBT population.”

Super and Jacobson (2011:194)

Counselling Suggestions

The following are invitatory ways of working with LGBT clients who wish to explore their sexual identity and their spiritual stance.

The Circle of Self: This exercise was created by McGrady and McDonnell (2006). The circle represents the client, and within it the client names the factors that influence how they see and experience themself, how they interact with others, with a keen focus on what contributes to their spiritual or religious worldview. The exploration which follows is highly dependent on the trust and depth of the therapeutic relationship, and the skills and knowledge of the therapist.

Spiritual Journey Mapping: Spiritual journey mapping may be as simple as a timeline specifying what clients see as significant to their spiritual or religious story. It can be given as homework, or can be an integral part of a session.

Creative Dialogue: This is a creative means of exploring the conflicts of clients’ internal and/or external worlds. It is used to invite the two or more parts or people in the conflict to dialogue – the dialogue is between the ‘top dog’ and the ‘underdog’ in Gestalt terminology. The use of client’s own art work, of pre-bought figurines or those made by clients’ pottery sculpting may enhance the dialogue.

Photographs: Photographs are another helpful means of developing the dialogue or of supporting adult clients to re-connect with their younger selves, e.g., the fifteen-year-old as she awakened to her sexual identity and the ensuing religious dilemma experienced; the twenty-one-year-old who rebelled and now wants to re-look at religious decisions made.

Left hand and right hand writing: This is another means of exploring the vying feelings and voices experienced by the client. The client’s dominant hand is used for the strongest voice, and the non-dominant hand for the voice or feeling that is beginning to make itself known. In this manner, the emerging self or awareness is less likely to be curtailed. As these exercises are client driven, there is great safety of pace.

Novels: This medium allows individuals to be both ‘in’ the situation explored, yet sufficiently ‘out’ of it to learn new ways at looking at their own context. LGBT novels are a safe means of seeing others negotiate the various stages of sexual and religious identity development. It is important to have a sense of age and context appropriate novels for each individual client. (See Appendix).

Movies and TV programmes: Again these media support objective exploration. Their introduction may be client or therapist driven. Clients may choose to look at part of a movie in a session or may request the therapist to look at a movie they found helpful and want to explore within the therapeutic context. (See Appendix).

Music: Music truly supports some clients in expressing their frustration, anger, happiness, etc. Sometimes it means listening with them to their favourite CD of the moment. Other times clients find it more liberating to make their own music. It can be most helpful to have a variety of small musical instruments in one’s therapy room.

Journaling: Journaling is a wonderful means of nourishing client self- awareness. Insight into individuals’ stories and processes of personal and spiritual development is thus supported.

At all times during the therapeutic encounter, attention must be given to the language most comfortable for clients, as many are not comfortable with traditional language. For example, for some, the word ‘God’ carries negative connotations and the therapist and client must co-create a language that is meaningful to the client and comprehended by both parties.

Counsellor training

Presently, there is a dearth of training in relation to working with the LGBT population in Irish-based recognised courses. This deafening silence is global, and stems from a wider social issue – the uncomfortableness of many cultures in dealing wholesomely with sexual matters in the heterosexual population. As a result, to consider homosexual behaviour in an open, healthy and honest manner is almost unthinkable, and in some circles generates hostility, aggression and contempt. Professionally, this has resulted in a paucity of research in relation to LGBT matters and an absence of LGBT content in training courses.


This article has skimmed the surface of the challenges met by LGBT clients and their therapists as they, as a client body, journey towards personal identity, including sexual identity, and sexual and spiritual integration. The external challenges can differ in severity given the societal and religious context clients have personally encountered. These affect individuals’ perceptions regarding self, the world, and the Transcendent. Counsellors need to be ready and able to work with clients in any of these areas (Hermann & Richter Herlihy, 2006). This demands basic and on-going training (Pearson, 2003).

Anne Kelliher Ph.D., M.A., Masters in Counselling, is a psychotherapist, supervisor and trainer. She practices in Tralee and Cork. Anne is contactable at

Examples of sources for clients
Boisvert, D. L. (2000) Out on Holy Ground: Meditations on Gay Men’s Spirituality. Cleveland: Pilgrim Press.
Dececco, J., Jensen, K. L. (1999) Lesbian Epiphanies: Women Coming Out in Later Life. London: Routledge.
Gilligan, A.L. and Zappone, K. (2008) Our Lives Out Loud: In Pursuit of Justice and Equality. Dublin: O’Brien Press.
Kauffman, G., Raphael, L. (1996) Coming Out of Shame: Transforming Gay and Lesbian Lives. New York: Doubleday.
Shallenberger, D. (1998) Reclaiming the Spirit: Gay Men and Lesbians Come to Terms with Religion. New Brunswick NJ: Rutgers University Press.
Tigert, L.M. (1996) Coming Out While Staying in: Struggles and Celebrations of Lesbians, Gays, Bisexuals in the Church. Cleveland OH: Pilgrim Press.


Baldwin, J., (2001) Giovanni’s Room. London: Routledge.
Bauden, D.S., (2008) Tomahawk’d. Los Angeles CA: Intaglio.
Calhoun, J., (2008) Roomates. Tallahassee FL: Bella Books.
Shay, K., (2010) The Perfect Family. Valley Falls NY: Bold Strokes Books.


Albert Nobbs (2011) Director: Rodrigo Garcia. DVD (2012). USA: Lionsgate.
Brokeback Mountain (2005) Director: Ang Lee. DVD (2006). UK: Entertainment in Video.
Change of Heart (1998) TV movie. Director: Arvin Brown. DVD (2007). Los Angeles: Infinity Media.
Claire of the Moon (1992) Director: Nicole Conn. DVD (2002). London: Millivres Multimedia.
Cloudburst (2011) Director: Thom Fitzgerald. USA: Sidney Kimmel Entertainment.
Serving in Silence: The Margarethe Cammermeyer Story (1995) TV Movie. Director: Jeff Bleckner. DVD (2006). USA: Sony.


Alexander, M.B. and Preston, J. (1996) We Were Baptised Too: Claiming God’s Grace for Lesbian and Gays. Louisville KY: Westminster John Knox Press.
American Psychological Association. (2010) ‘Guidelines for Psychotherapy with Lesbian, Gay and Bisexual Clients’. Retrieved 1 November 2010 from

Association of Catholic Priests (2012). Contemporary Catholic Perspectives. Irish Survey commissioned by the ACP. Dublin: Amárach Research.

Association for Lesbian, Gay, Bisexual and Transgender Issues in Counselling (ALGBTIC) (2009) ‘Competencies for Counselling with Transgender Clients’. Association for Spiritual, Ethical and Religious Values in Counselling (ASERVIC) (2009) ‘Competencies for Addressing Spiritual and Religious Issues in Counselling’. Interaction. 10(1): 3.

Balkin, R.S., Schlosser, L.Z., Heller Levitt, D. (2009) ‘Religious Identity and Cultural Diversity: Exploring the Relationship between Religious Identity, Sexism, Homophobia, and Multicultural Competence’. Journal of Counselling and Development. 87: 420-426.

Brauner, R. (2000) ‘Embracing Difference: Addressing Race, Culture and Sexuality’. In Neal, C. & Davis, D. (eds) Issues in Therapy with Lesbian, Gay, Bisexual and Transgender Clients. Buckingham: Open University Press.
Cass, V.C. (1996) ‘Sexual Orientation Identity Formation: a Western Phenomenon’ in R.P. Cabaj and T.S. Stein (eds.) Textbook of Homosexuality and Mental Health, pp.227-252. Washington DC: American Psychiatric Press.

Cass, V.C. (1979) ‘Homosexuality Identity Formation: A Theoretical Model’. Journal of Homosexuality. 4(3): 219-235.
Clarke, J.M. (1996) ‘Gay Spirituality’ in P.H. van Ness (ed.) Spirituality and the Secular Quest, pp.335-355. New York: Crossroad.

Davidson, M.G. (2000) ‘Religion and Spirituality’ in R.M. Perez, K.A. Debord and K.J. Bleschke (eds.) Handbook of Counselling and Psychotherapy with Lesbian, Gay and Bisexual Clients, pp.409-433. Washington DC: American Psychological Association.

Hermann, M.A., Richter Herlihy, B. (2006). ‘Legal and Ethical Implications of Refusing to Counsel Homosexual Clients’. Journal of Counselling and Development. 84: 414-418.
HSE (2009) LGBT Health: Towards Meeting the Health Care Needs of Lesbian, Gay, Bisexual and Transgender People. Report and findings from a Mapping Exercise undertaken for the Health Service Executive National Social Inclusion Governance Group.
Kelliher, A. (2007) Topic: Wellness in Adulthood. International Conference on Counselling: Promoting Wellness across the Lifespan. N.U.I., Cork, Ireland. 9-13 July. Kelliher, A. (2009) ‘The model approach to spirituality: Implications for counselling’. Eisteach, 9(3): 15-19.
Kelliher, A. (2011) ‘Spirituality: A faith development approach: Implications for practice’. Inside Out. 65: 44-52.
Long, A. (2012) ‘Spirituality in Counselling’. Eisteach. 12(1): 4-7.
MacDonald, S.V. (2006). ‘Spiritual Journey Mapping with Lesbian, Gay and Bisexual clients’. The Therapists Notebook for Integrating Spirituality in Counselling. 11: 177- 187. Hawthorn Press. Maguire, J. (2012) ‘Gay conversion ads to appear on London buses’. In Irish Examiner on 13 April 2012.
McGrady, M.L., McDonnell, K.A. (2006) ‘Helping lesbian and gay clients work toward positive spiritual health’. The Therapists Notebook for Integrating Spirituality in Counselling. 11: 163-175. UK: Hawthorn Press. Pearson, Q.M. (2003) ‘Breaking the silence in the counsellor education classroom: A training seminar on counselling sexual minority clients’. Journal of Counselling and Development. 8: 292-300.

Shea, J.J. (2005) Finding God again: Spirituality for Adults. New York: Rowman and Littlefield.
Super, J.T., Jacobson, L. (2011) ‘Religious Abuse: Implications for Counselling Lesbian, Gay, Bisexual, and Transgender Individuals’. LGBT Issues in Counselling. 5: 180-196.