Best LGBTQ+ Online Therapy and Counseling

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If you’re one of the 5.6% of people in the U.S. who identify as LGBTQIA+, your risk of depression and suicide is much higher than in people who are heterosexual and cisgender (non-transgender). Almost 74 million adults in the U.S. had a substance use disorder (SUD) or any kind of mental illness in 2020—and 17 million had both. However, in 2019, 47.4% of the estimated 11.3 million lesbian, gay, and bisexual adults in the U.S. reported having had a mental illness in the past year, almost one in five had SUD, and 12.9% experienced both mental illness and SUD simultaneously. 

The stats are even more troubling for transgender people. Forty percent of transgender respondents to the 2015 U.S. Transgender Survey reported having attempted suicide at least once, compared to the national average of just 4.6%.  

These disparities boil down to minority stress—the unique, compounding stressors experienced by people who face discrimination because of one or more parts of their identity, which add up and have a big impact on mental and physical health. That’s why it’s crucial to find a culturally competent therapist who has a solid understanding of the complexity of LGBTQIA+ identities and can help you work through the trauma you have experienced at the hands of a world that is still not fully accepting of all individuals.

Enter online LGBTQ+ counseling, bringing mental health professionals to you wherever you are. Telemedicine has been proven to be largely as effective as traditional in-person counseling sessions and comes with benefits such as privacy, scheduling flexibility, and eliminating the need to commute to a clinic. Telemedicine practitioners are also often available quickly and on weekends or later hours—97% of the respondents to our survey of users of 33 online therapy companies saw their new provider within two weeks. If you’re looking to start online therapy, read on to learn which services we chose with the LGBTQIA+ community in mind.

Best Online LGBTQ+ Counseling of 2022

Why Trust Us
55
Companies reviewed
5,775
Total users surveyed
350
Data points analyzed
We surveyed 105 users from each online therapy company and asked the companies to complete questionnaires. Then, we tested the services ourselves, conducted comprehensive data collection research, and evaluated our results with the help of three licensed therapists.
Best LGBTQ+ Online Therapy and Counseling
Best LGBTQ+ Online Therapy and Counseling

Best Overall : Pride Counseling


  • Price: $260-$360+
  • Is Insurance Accepted?: No. Offers reimbursement receipt
  • Type Of Therapy: Individual Therapy
Why We Chose It

Pride Counseling’s trained, competent providers offer counseling and therapy designed with the LGBTQIA+ community in mind.

Pros & Cons
Pros
  • LGBTQIA+ specific, though all are welcome

  • Serves the U.K. and all 50 U.S. states + D.C.

  • Subscription-based

  • HIPAA-compliant

  • Multiple communication options: video, phone, and chat

  • Unlimited messaging to your therapist included

  • Financial assistance available to those who qualify

Cons
  • Not in-network with insurance companies

  • An algorithm matches you with your therapist

  • Does not serve minors

  • Cost varies by location and therapist availability

  • Site could use more information and resources

  • You cannot request a provider who is LGBTQIA+

  • No psychiatric services or medication management

  • No therapist bios are available on the site

Overview

Pride Counseling, launched in 2017 by BetterHelp, is our overall winner because it balances availability, flexibility, and LGBTQIA+ competence. The company is one of only two online therapy services we reviewed in 2021 that cater primarily to marginalized people (the other is Ayana Therapy), making it a natural choice for this list. 

The company primarily focuses on serving LGBTQIA+ adults but welcomes non-LGBTQIA+ clients as well—which is important, considering that many go through a period of questioning before identifying as part of the community. Research has found that this time in an LGBTQIA+ person’s life can have “the highest risk for self-harm behaviors,” so a clinician’s degree of LGBTQIA+ competency could literally be the difference between life and death for many queer, trans, and/or nonbinary people.

Communication Methods

Sessions can be held at your convenience via chat, audio, and video calls, and can be conducted on a laptop or via the company’s mobile app.

The subscription also includes unlimited messaging to your therapist, who will respond at least once per business day. This is an advantage over services that allow you to message asynchronously but do not assure clients that they will receive responses between appointments.

Therapist Qualifications & Types of Therapy

Not all of the independent providers are LGBTQIA+ themselves, and Pride Counseling does not currently allow clients to request therapists of specific genders and/or sexualities; but the company notes that all specialize in the community and have a master’s or doctorate degree, state licensure, and at least three years and 1,000 hours of experience in the field. 

Provider types include psychologists (PhDs and PsyDs), licensed marriage and family therapists (LMFTs), licensed clinical social workers (LCSWs and LMSWs), and licensed professional therapists (LPCs).

These mental health professionals can support clients with anxiety, depression, trauma, anger, grief, and specific LGBTQIA+ issues. On that note, it is possible to obtain letters of support for hormone replacement therapy (HRT) and other transition-related care, although it depends on therapists’ individual policies. 

Unfortunately, Pride Counseling does not offer psychiatric services or medication management, but if you’re looking for help learning coping skills, working through compassion fatigue, managing the mental health aspects of chronic illness, evaluating your relationships, or developing tools for life with ADHD, Pride Counseling therapists are here for you. The company doesn’t offer couples, family, or group therapy. 

Plans & Pricing

For therapy with a Pride Counseling provider, expect to pay $60 to $120 per weekly session (billed every four weeks), though the price varies depending on where you’re based and therapist availability. 

While this may not be entirely affordable for the average LGBTQIA+ therapy seeker, the cost is still less than traditional therapy. Plus, if you’re insured, you have a good chance of not paying full price. Pride Counseling is not in-network with insurance companies, but 81% of current users who responded to our survey reported receiving at least partial reimbursement for its services by submitting superbills to their insurers. 

One criticism of Pride Counseling’s pricing structure is the lack of transparency with which the price range is listed in the site’s FAQs. When prospective clients view this page, they may think the price they’re seeing is what’s shown to everyone. However, Verywell editors in different U.S. regions noticed different ranges at different times—for instance, $60 to $90 per week on the east coast and $90 to $120 on the west coast—and it’s not ideal that the company doesn’t provide your final price until you officially sign up.

Additionally, Pride Counseling says it offers financial aid to those who qualify, but the site does not indicate how much of a price reduction recipients may be able to expect. There are no free consultations or trials, nor does the website provide resources or additional information, like a blog. However, Verywell Mind readers will receive a discount on their first month of service.

User Satisfaction

Seventy-seven percent of current Pride Counseling clients who responded to our survey rated the company as overall very good or excellent, and an equal number reported considering the price as a very good or excellent value.

A full 96% told us that they were likely or very likely to recommend the service to others, making it one of the most highly recommended of all 33 online therapy services we reviewed. If you’re LGBTQIA+ and need therapy, this is a good place to start your search.

Best for Counseling : Ayana Therapy


  • Price: $140/single sessions or $290/monthly subscription
  • Is Insurance Accepted?: No. Offers bills to submit to your insurer
Why We Chose It

We chose Ayana Therapy as Best for Counseling due to its diverse staff and LGBTQIA+ and cultural competence.

Pros & Cons
Pros
  • Individual therapy with licensed professionals

  • Providers trained in BIPOC and LGBTQIA+ issues

  • Available in all 50 states

  • Monthly subscription and single sessions available

Cons
  • Not in-network with insurance

  • No psychiatry or medication management

  • Number of therapists varies by state

  • Service only available to adults

  • Currently only available via browser

Overview

Ayana Therapy was launched in 2019 by Eric Coly, a Black man who had struggled to find a therapist who could relate to his struggles. LGBTQIA+ people who are also BIPOC (Black, Indigenous, People of Color) face additional discrimination and minority stressors, making it difficult to find culturally competent therapists. 

The online therapy company’s mission is to connect marginalized therapy seekers with counselors who share their backgrounds and lived experiences. These include race, sexuality, gender identity and expression, religion, disability, and other factors that affect a person’s life and mental health. Additionally, Ayana Therapy prides itself on the anonymity it offers to clients who face cultural stigma about seeking mental health, as well as those who might be in danger if the wrong people find out about their LGBTQIA+ identity.

Ayana Therapy can help users navigate depression, anxiety, mood disorders, relationships, sexuality and gender identity, and PTSD in addition to other issues.

The company’s blog offers a wealth of information on mental illness, mental wellness, teletherapy, professional development, and minority mental health. As of December 2021, the most recent post is dated June 2020; however, blogs were posted frequently prior to that, so there are still a good number of articles to explore. 

Many other online therapy services included in our survey either had blogs that were less extensive, or no blog at all, so these posts are a great resource for educational and thought-provoking topics relevant to marginalized people.

Communication Methods

The service is available to everyone in the U.S., although some states may have fewer therapist options than others. Each user gets an individual portal after signup where you can pay for and schedule sessions, and interface via video with your therapist. 

As of December 2021, the Ayana Therapy app is still in the works, but in the meantime, you can easily attend video sessions and access your portal using the browser of your laptop or mobile device. 

Therapist Qualifications & Types of Therapy

Ayana Therapy does not employ its counselors; instead, the company functions as a referral network with independent providers. However, each psychologist, marriage and family therapist, clinical social worker, and licensed professional counselor is vetted and required to meet certain requirements and education. The company only works with those who have at least three years and 2,000 hours of clinical experience, state licensure, and a minimum of a master's degree—all of which are comparable with other companies we reviewed. 

In addition, Ayana Therapy also requires its independent therapists to complete cultural competency training, which teaches providers to recognize the intersecting ways that their own cultural identities—and those of their clients—affect the therapeutic process. This framework sets Ayana Therapy apart from its competitors. Its providers are knowledgeable about the various forms of trauma caused by anti-LGBTQIA+ and/or anti-BIPOC discrimination and can help clients learn grounding, coping, and communication skills.

Ayana Therapy does not offer psychiatric services, medication management, couples therapy, group therapy, or family therapy. 

Plans & Pricing

The company prioritizes flexibility in scheduling and offers sessions at two price points:

  • Single sessions: $140 each
  • Monthly subscription: $240 per month for four sessions

Ayana Therapy does not offer free consultations or assessments, nor does it accept insurance. However, 89% of surveyed clients were able to obtain at least partial reimbursement, spending a monthly average of $232. While this is not the most affordable online counseling session we reviewed, it is still less than out-of-pocket traditional private practice therapy, and 74% of our survey respondents rated Ayana Therapy’s services as a very good or excellent value. 

User Satisfaction

Of our survey respondents who were clients of Ayana Therapy, 79% told us they were either likely or very likely to recommend the company to someone like them.

If you’re a member of the LGBTQIA+ community and haven’t felt safe opening up to previous therapist(s) about mental health struggles—or have received culturally insensitive treatment in the past—Ayana Therapy might be the service for you.

Best for Couples : Couples Therapy Inc

Verywell's Rating
3.5

  • Price: $159 to $250 per couples counseling session; $119 to $199 for couples coaching; $2,500 to $5,000+ per weekend intensive retreat
  • Is Insurance Accepted?: No
Why We Chose It

Couples Therapy Inc. is a solid choice for LGBTQIA+ people in need of couples/relationship therapy or coaching. While not quite as affordable as other companies that provide this service, most of our respondents were still able to receive partial out-of-network reimbursement.

Pros & Cons
Pros
  • Offers couples therapy and coaching to clients 18+

  • Serves 37 states (and D.C.); pending in five states

  • Offers specialized relationship and sex therapy

  • Video and in-person sessions available

    LGBTQIA+ and polyamory-inclusive

  • Thorough assessment and therapist attention

  • Some providers have training in neurodivergence

Cons
  • Not in-network with insurance companies

  • Does not provide individual mental health therapy

  • Intensive retreats are expensive

  • Site has some conflicting information

  • No payment plans offered by the company

  • No app

Overview

If you want to work closely with a highly trained relationship therapist—on your own or with your partner(s)—consider Couples Therapy Inc.’s couples counseling or weekend intensive retreats. Therapists at this company are trained and utilize The Gottman method, a heavily studied form of couples counseling that helps partners and spouses of all sexualities build trust and manage ongoing life stressors and conflicts with less hostility and defensiveness. They also found that the method can lead to significant results for LGBTQIA+ couples. For this reason, Couples Therapy Inc. is Verywell Mind’s choice for those who are interested in online LGBTQIA+ relationship therapy. 

Couples Therapy Inc.’s sessions and intensive retreats have used clinically proven techniques to help people improve their relationships since the company began as an in-person clinic during the late 1980s. Its online component was added decades later but has since made Gottman method-based couples therapy more affordable and accessible to people around the U.S., as well as in Puerto Rico, Ireland, Australia, and the Canadian city of Vancouver.

As of December 2021, the service is actively available in 37 states and the District of Columbia; it is pending in five other states. The remaining eight states do not have any providers who can offer couples therapy, but residents of these states are eligible to use Couples Therapy Inc.’s coaching services. 

Communication Methods

Therapy at Couples Therapy Inc. is done in-person or via live video only. It does not offer audio, messaging, or live-chat options. 

However, it stands out from competitors because it offers two free consultations. First, you can chat with a member of the client support team and get answers to questions during a 20-minute phone call. The team can help you decide on a therapist or coach who’s available and best suited to help you and your partner(s). Next, you’ll speak to that provider for 15 minutes so that you can get a sense of how well their philosophies and approach mesh with your needs. If you don’t like them, you’re under no obligation to begin sessions.

It’s easy to schedule your appointments, communicate with your provider, and attend sessions and retreats virtually using your private portal. There’s flexibility in scheduling when it comes to sessions and modified intensive retreats (which spread out a weekend’s worth of therapy over several weekly two-hour appointments). Intensive retreats appear to be booked far in advance, as the site’s terms and conditions state that there is a policy that all retreats canceled with less than 60 days' notice are not eligible for a full refund of the deposit.

The company also offers free and paid ebooks and self-guided courses, which can be used as part of your therapy or on their own, even for those who do not become clients. However, its main draw is “The Big Big Book,” a lengthy relationship assessment developed by Couples Therapy Inc. based on EFT and the Gottman method. More analytical-minded clients may appreciate this thorough, methodical approach to couples therapy, while others may find the process too rigid, formulaic, or mentally laborious—so be sure to consider this before paying for services.

Therapist Qualifications & Types of Therapy

All of Couples Therapy Inc.’s clinicians have a minimum of a master’s degree and are skilled in emotional freedom therapy (EFT), a technique used to create stronger emotional connections between couples. 

They also all have advanced training in The Gottman Method. In fact, eight of its staff members are certified Gottman therapists—impressive, considering the site’s claim that there are only 350 total worldwide. 

Other types of clinicians Couples Therapy Inc. has available include licensed marriage and family therapists (LMFTs,) professional clinical counselors (LPCCs), mental health counselors (MHCs), clinical social workers (LCSWs), and clinical psychologists (PsyD).

Couples Therapy Inc. does not offer individual, family, or group therapy, nor does it offer medication management or psychiatric services. It only offers therapy to individuals over the age of 18.

Plans & Pricing

Couples Therapy Inc. offers several tiers of services:

  • Couples coaching: $119 to $199 per session, depending on whether you see a licensed therapist or a relationship coach 
  • Couples therapy (for couples and individuals): $159 to $250 per session 
  • Weekend intensive retreats: $2,500 to $5,000 or more, depending on the location and therapist credentials. This cost does not include lodging or food, and there does not appear to be a price reduction for virtual retreats.
  • Modified intensive retreats: $238 to $438 per session, depending on your location and provider

Couples Therapy Inc. does not work directly with insurance companies, because couples therapy is only considered mental health treatment when the focus is on one person’s mental health. 

However, 95% of our respondents reported being insured, and of them, 81% received at least partial reimbursement from their insurers after submitting superbills. Couples Therapy Inc. told us that this is most likely to occur when the insurance code 90847 (“couples or family therapy with the client present”) is used.

User Satisfaction

Seventy-six percent of client respondents to our survey rated the services as overall very good or excellent, and an equal amount considered said services to be a very good or excellent value.

Best for Group Therapy : Circles


  • Price: $79 per month
  • Is Insurance Accepted?: No
  • Type Of Therapy: Peer Support
Why We Chose It

Looking for a group setting rather than individual therapy? Circles is an affordable option with licensed therapists and certified life coaches who facilitate Circles, or groups, of people going through similar issues.  

Pros & Cons
Pros
  • Topic-specific therapy Circles led by professionals

  • Offers free Circles on certain topics

  • Available in all 50 states

  • Therapist and group facilitator bios posted on site

  • Unlimited messaging with leader and group members

  • Clients are billed weekly rather than monthly

Cons
  • Offers supportive group therapy only

  • Seems to focus on grief and relationships

  • Does not offer medication management services

  • Does not accept insurance

  • Site could use more details and resources 

  • Group therapy is less flexible in scheduling

  • Some negative reviews about app glitches

Overview

Launched as “7 Chairs” by Irad Eichler and Dan Landa in 2018, Circles’ goal has always been to bring quality group therapy right to clients’ living rooms. Eighty percent of our survey respondents felt the company’s services were either very good or excellent—one of the highest rankings of all 33 companies we reviewed—so that mission appears to have been a success. 

Circles is available in all 50 states. Its 580 groups and 120 facilitators cannot provide true psychological advice, but they are there to create a safe place for you to get everything off your chest and be supported while doing so, all for an affordable fee. 

Communication Methods

You will attend video sessions and communicate with your Circles leader and fellow group members using your Circles portal or app.

No one is required to divulge any personal information—you can even use your preferred name or nickname in Circles you attend. If you’re an introvert, are anxious during video calls, or otherwise cannot contribute audibly, you can keep your audio off entirely. However, Circles does require clients to keep their cameras on during groups for accountability. 

You also have access to free content such as self-help exercises and webinars once you’ve subscribed.

Therapist Qualifications & Types of Therapy

The majority of professional facilitators at Circle are licensed therapists with graduate degrees and at least 1,500 hours of experience in the field, but there are also trained life coaches and business coaches. 

Circles cannot provide diagnoses or medication management, but the service is a terrific option for people who want support from multiple people and a trained professional, rather than just the latter. This format may be especially helpful for those in remote areas or who do not have a local support network. 

If you’re looking for help working through grief, separation or divorce, or relationship problems, you’re sure to find a suitable group for your needs. During each Circle, your therapist will help coach you and five to seven other clients through expressing feelings and emotions, developing skills for building resilience, and identifying possibilities for personal growth. 

Plans & Pricing

It costs $20 to attend each 60-minute Circle video session. You can join more than one Circle (and some are free), but you have to be approved by the company to do so. Unlimited messaging with other group members and facilitators is included in the cost of each session, and your first Circle is free.

When you sign up, you’ll answer a few questions that help Circles match you with the group and facilitator that might help you the most. If the weekly appointment time doesn’t work for you, there are other Circles to choose from, unlike at some other online services and in-person therapy groups. Contact customer care to switch Circles at any time. 

Circles is not in-network with insurance, but 84% of our Circles respondents reported being at least partially reimbursed after submitting an out-of-network claim to their insurance companies. A few past examples include:

  • Coping Circle for dealing with grief after losing a child
  • Support Circle for navigating through separation or divorce
  • Support Circle for loss of a loved one
User Satisfaction

Seventy-three percent of Circles respondents told us they considered the company’s services to be a very good or excellent value, and a full 90% of users were likely or very likely to recommend Circles to someone like themselves.

For LGBTQIA+ folks who are dealing with grief, relationship, and trauma issues and want to connect with others, consider Circles for its targeted support groups.

Best for Insured : Teladoc Health


  • Price: $99 per therapy session, $209 for initial psychiatry appointments, and $109 for follow ups (without insurance)
  • Is Insurance Accepted?: Yes
Why We Chose It

Teladoc is widely available through EAP programs, and many major insurance companies cover some or all of the cost of telemedicine through the service, making it the most affordable and convenient choice for LGBTQIA+ people with insurance.

Pros & Cons
Pros
  • Very affordable with insurance

  • Video and phone sessions

  • Appointments available seven days a week

  • Offers therapy and medication management

  • Also provides access to medical doctors

  • Serves teenagers and adults in all 50 states

  • Choose your own provider

Cons
  • Not as affordable without insurance

  • No couples, family, or group therapy options

  • Cannot see provider bios before account creation

  • No discounted bundle services available

  • No free consultations

  • Does not offer text-based sessions

  • Lack of LGBTQIA+ content on website

  • Negative reviews about app and customer service

Overview

Teladoc is our top pick for insured LGBTQIA+ therapy seekers. When it was founded in 2002, it was one of the first telehealth companies in the U.S. Teladoc has since served millions of people around the world. Though is not LGBTQIA+ focused, the company offers therapy, medication management, and medical care, which could still make it an affordable one-stop-shop for many. 

The service is a good contender when it comes to therapy and psychiatry for LGBTQIA+ people coping with anxiety, depression, loss, chronic pain, PTSD, and/or addiction

Communication Methods

Appointments take place by video or phone call but not live chat, which could be a disadvantage for anyone who simply prefers typing, or an actual barrier to some disabled people who are d/Deaf or hard of hearing, are nonspeaking, or have other accessibility needs.

Services are available in all 50 states and the District of Columbia, and the company has mental health appointments available from 7 a.m. to 9 p.m. local time, seven days a week, which only increases the convenience factor. You can communicate with your provider anytime and schedule appointments using your client portal.

Plans & Pricing

Teladoc has a simple price structure for its clients who are paying out of pocket: 

  • $99 per therapy session
  • $119 per follow-up psychiatric appointment ($299 initial)
  • $75 for general medical visits

With insurance, however, you may pay as little as $0. Seventy-six percent of surveyed Teladoc clients told us that they considered the amount they paid per month to be either a very good or excellent value. Teladoc is not only in-network with many insurers, it is also the platform used by many insurance companies’ portals to provide telehealth appointments to their clients 24/7.

The company is also one of the few we reviewed that participates with some Medicare Advantage and Medicaid managed care plans (but not Medicare fee for service or Medicaid fee for service). Note that there are no free consultations or assessments. 

Therapist Qualifications & Types of Therapy

Teladoc’s mental health providers are required to be appropriately licensed and/or certified by the state of their residence. Their qualifications and the quality of service they provide appear to be appreciated by clients, as 36% of current users we surveyed were happy with the first provider they were matched with. This is impressive considering that our survey overall found that only 8% of users of all 33 services had only seen one mental health professional at their respective companies. 

Teladoc psychiatrists can prescribe some controlled substances (see the FAQs for a non-exhaustive list of medications), but they cannot offer medical management of bipolar disorder or schizophrenia, as both of these conditions generally require medications that need regular lab testing and monitoring. As of December 2021, prescribers can offer several nonstimulant ADHD meds and a chemical dependency drug.

User Satisfaction

Teladoc users who responded to our survey overall appreciated the service’s convenience and have found the app easy to use: Seventy-one percent rated Teladoc’s services as either very good or excellent. 

A full 95% of respondents told us they would be likely or very likely to recommend the company to someone like them. Therefore, due to the price and types of services available, the company is a good option for insured LGBTQIA+ therapy seekers who have smaller budgets.

Compare the Best Online LGBTQ+ Counseling of 2022

Overall Rating Best For
Price
Is Insurance Accepted?
Accepts Hsa Or Fsa
Type Of Therapy
Communication Options
Reset All
Pride Counseling Best Overall $260-$360+ No. Offers reimbursement receipt N/A Individual Therapy Audio, Messaging, Video Chat Learn More
Hide, not for me
Ayana Therapy Best for Counseling $140/single sessions or $290/monthly subscription No. Offers bills to submit to your insurer N/A N/A Messaging, Video Chat Learn More
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Couples Therapy Inc
3.5
Best for Couples $159 to $250 per couples counseling session; $119 to $199 for couples coaching; $2,500 to $5,000+ per weekend intensive retreat No N/A N/A Video Chat Learn More
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Circles Best for Group Therapy $79 per month No N/A Peer Support Messaging, Video Chat Learn More
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Teladoc Health Best for Insured $99 per therapy session, $209 for initial psychiatry appointments, and $109 for follow ups (without insurance) Yes N/A N/A Audio, Video Chat Learn More
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Final Verdict

If you identify as LGBTQIA+ and are seeking therapy, there are many online services to choose from, but not all are appropriate for your particular needs as a client. A great overall option is Pride Counseling due to its focus on the community. Ayana Therapy is another good choice; although a bit more expensive, its diverse therapists specialize in marginalized identities. For couples or group therapy, Couples Therapy Inc. and Circles are both good options.

Frequently Asked Questions

How Much Does LGBTQ+ Competent Online Therapy Cost?

Online therapy tends to be much more affordable than traditional behavioral health services. Many companies offer flat monthly fees that include four weekly appointments while some are pay-as-you-go. 

Your final cost will depend on factors like location, insurance coverage, appointment type, and provider qualifications. For groups, Circles ranges from $20 to $30 per group session and a weekend intensive couples’ retreat with a highly-trained Couples Therapy Inc. counselor runs up to $5,000. Some therapy services also offer free self-guided courses and ebooks, as well as sliding-scale fees.

Does Insurance Cover Online Therapy and Counseling?

Many, but not all, insurance policies include behavioral health benefits for in-network treatment of an official DSM diagnosis; contact your insurance provider to find out the details of your policy. Remember, however, that non-individual therapy is not generally covered unless it can be coded on your bill as “couples or family therapy with the client present” (meaning the focus is on just one person’s mental health).

Services that are not in-network with insurance may be able to provide superbills that you can submit to your insurer for out-of-network coverage. Eighty-two percent of all 3,497 respondents to our survey reported receiving at least partial reimbursement for online services.

Can Online Therapy or Counseling Help the LGBTQ+ Community With Mental Health and Trauma?

LGBTQIA+ competent therapy can lead to discovering patterns in your life that have you stuck, gaining insight into your relationships, and identifying ways you want to change your life in order to live it more fully. For many, this may mean finally embracing an LGBTQIA+ identity, socially and/or medically transitioning, doing trauma work, or learning how to set healthy boundaries.

While more and more people have openly sought therapy and psychiatric medication in recent decades, there are still many layers of stigma to navigate when it comes to mental health. Many identity groups have cultural values that discourage members from seeking therapy. For instance, many Asian, Native American, and Black communities deal with increased pressure to manage mental health privately; similarly, social pressure to conform to masculine norms of stoicism and independence contribute to lower rates of men seeking therapy compared to women.

Certain mental illnesses are also more stigmatized than others—just a few examples include schizophrenia and borderline personality disorder. Addiction carries stigma as well. In fact, a 2013 review of 36 studies found that conditions like these are seen by the public as more “dangerous” than depression or ADHD, which may dissuade people from seeking help for these issues.

This stigma can even make it difficult or unsafe for others to know you’re seeking therapy and/or psychiatric medications. Receiving online counseling in the privacy of your own home can be much more discreet than going to appointments at a clinic or hospital where you risk seeing someone you know who might judge you for being there. This is especially relevant for people who are currently privately exploring gender presentation or transition but are not yet “out” to the world. 

Even when you do decide to start counseling, a May 2021 report found that people in the United States had to wait an average of 48 days between scheduling their initial appointments and actually seeing their new providers, which is a long time to struggle with mental health issues alone. Additionally, only 17.6% of state-approved addiction facilities and 12.6% of approved behavioral and mental health clinics in the U.S. have programs designed specifically for therapy seekers in the LGBTQIA+ community.

Online counseling with competent clinicians can help provide much-needed treatment to queer, trans, and nonbinary people who otherwise may have access to mental health care—and you’ve got a much better chance of seeing your new provider(s) within a week or two, rather than months.

Who Is LGBTQ+ Online Therapy Best for?

Online therapy is a great option for LGBTQIA+ people who are busy, live in rural areas with few therapists or other places with long waiting lists to see local providers, are too disabled to safely in person, or prefer text-based therapy (though this is not available through all companies).

Unfortunately, many online therapy companies do not treat certain conditions—for instance, psychosis and bipolar disorder—via telemedicine, because the medications used to manage them often require in-person monitoring. However, there is growing evidence that teletherapy can, for instance, help significantly reduce symptoms of paranoid schizophrenia, so clinicians who practice online may begin expanding their offerings as more online treatment options are developed.

Online therapy is never a substitute for emergency care during times of mental health crisis. If you or someone around you is in danger, seek local emergency services, and/or call your doctor’s office, if it is during business hours.

Is Online LGBTQ+ Competent Therapy Right for You?

While satisfaction with individual services will no doubt vary, many LGBTQIA+ people can benefit from the accessibility, discretion, and affordability of online therapy. 

While most of the providers with these services cannot treat all conditions (particularly psychosis, active addiction, and bipolar disorder), telemedicine has been found effective at treating depression and anxiety. It’s also beneficial for trauma and stress. 

Therapists can also help with more specific issues like relationship problems, communication skills, and grounding techniques.

LGBTQIA+ affirming providers are still few and far between in many geographical locations. This affects LGBTQIA+ people in conservative rural areas that have few in-person clinics and those in large cities that have shortages of therapists taking new clients alike. Online mental health professionals can bridge that gap either temporarily or permanently if you are comfortable using telemedicine. 

All of the companies we reviewed are less expensive than the typical out-of-pocket fees for traditional, in-office therapy sessions. Some services work directly with insurance, while others can provide superbills for you to submit for possible out-of-network reimbursement.

While all of the companies we evaluated are HIPAA compliant, it’s important to read the terms and conditions and privacy policy before providing private health information to any therapy service. This helps you understand how your data will be used. If either of those documents fails to mention encryption, we suggest that you don’t use the service. 

Also, note that none of the companies we reviewed are suitable for emergencies. If you are in active crisis or otherwise feel unsafe, please consult local emergency services for immediate attention.

What Should I Consider When Looking for Online LGBTQ+ Counseling?

There are many factors that come into play when deciding which company may be best suited to your needs. 

Consider the following:


Available plans: How much does each plan cost and what services do they include? 

Ease of use: How easy is the site to navigate and use? Is it designed with accessibility in mind? This is especially important for blind people and those with low vision or color vision deficiency, as well as those using assistive technology like text-to-speech software and screen readers, which can help sighted people who have auditory processing differences, dyslexia, ADHD, and other reading-related issues as well.

Inclusivity: Does the company’s website indicate cultural competency? LGBTQIA+ folks experience discrimination from medical and mental health professionals of all kinds, so look for specific LGBTQIA+ affirming policies, if possible.

Accepts insurance: If you’re hoping to have your visits covered by insurance, look for online therapy sites that clearly state which insurance companies are in-network. If you can afford to pay out of pocket up-front, many therapy platforms will provide superbills that you can submit to your insurer for possible reimbursement.

Scheduling/flexibility: Are appointments available at convenient times? This is especially important when seeking online group therapy or couples therapy, and general availability may vary widely by state. The more providers the website shows in your state, the better your chances of finding someone who can accommodate your schedule.

Therapist availability: In general, therapists must be licensed by a state in order to see clients who reside in them. Not all companies’ services are available in all places due to legal restrictions and/or provider availability.

Communication options: Does the company allow for the kind(s) of communication you prefer, such as texting/chatting, audio, phone, video, and/or in-person? If a service is only available as video sessions, and you don’t wish to appear on camera due to anxiety or dysphoria, you may decide to eliminate that company from your search.

Option for free consultation/assessment: Services that allow you to try a session for free or a discounted rate are fairly rare, but this can help you make a more informed decision before committing.

Therapist reputation/merit: Does the company employ and train its providers, or is it a referral network of independent contractors without oversight? Are the therapists required to be licensed/board-certified or have other specific credentials? (Note: In the U.S., religious counselors are not obligated to have any academic training or qualifications.)

Privacy policies: Does the company clearly state its policies regarding user privacy and data safety? Some companies are more transparent than others, and some have histories of data misuse.

Methodology

Our methodology for evaluating online therapy companies is comprehensive and data-driven. To review the best online therapy programs, we sent questionnaires to 33 companies, most of which are not LGBTQIA+ specific but still offer services that would be valuable to the community, and surveyed 100 current users of each. This allowed us to directly and fairly compare services offered by gathering qualitative and quantitative data about each company and users’ experiences of the sign-up process, quality of therapy offered, cost, value for money, and more. 

Not every therapy seeker will have the same success with a particular online therapy company, but in light of survey responses and our own research, some of the 33 online therapy services we evaluated appear to be better equipped to support the LGBTQIA+ community than others.  

Multiple factors were taken into consideration: Does the company’s website mention LGBTQIA+ specific issues or at least note that individual providers have this specialty? Does the company prioritize accurate but inclusive language? This could include using the singular “they” in place of the binary “he or she” when applicable; allowing clients to use nicknames for privacy, or the preferred names, rather than their legal names; and offering specific competency training to providers who are with the company.

Also very important was the question: Does the mission statement or other promotional materials state a commitment to providing competent therapy to LGBTQIA+ people? This was particularly relevant when evaluating the Christian counseling services included in our survey. 

None of the 33 sites offer conversion therapy, which has been rejected by medical experts and human rights activists, but the Christian counseling services we evaluated all demonstrated conservative views of gender and sexuality. Several of these services advertise that their clinicians abide by the mission statement of the famously anti-LGBTQIA+ organization, Focus on the Family, which defines marriage and sex as a sacrament between a cisgender woman and a cisgender man. A few sites suggested their LGBTQIA+ clients practice total abstinence while in therapy. 

Finally, as one out of five LGBTQIA+ people in the U.S. are living in poverty, we made a conscious effort to prioritize affordability whenever possible.

Best Online LGTBQ+ Counseling

Verywell Mind / Design by Amelia Manley

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By Ray Finch
Ray is an editor and editorial producer with over five years of experience. They have offered editorial support to a variety of digital publications, including Upworthy, GOOD Magazine, The Bold Italic, Elemental, Everyday Feminism, and Let’s Queer Things Up! 

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