By P. Casey Arrillaga, LCSW, LCDC
The number of Americans who identify as anything else other that heterosexual, such as lesbian, gay, bisexual, transgender [LGBTQ+] has more than doubled in a little over a decade [1]. Thus, it is increasingly important to find mental health providers who are affirming and knowledgeable about these issues. This is especially vital when seeking treatment for addiction and other mental health issues, because science shows that LGTBQ+ people are more vulnerable to these conditions [2]. Even for those who don’t identify in this way, finding providers who are open and compassionate will turn out to be an advantage in recovery, for reasons we will explore in this post.
The Link Between LGBTQ+ Identity and Higher Mental Health/Addiction Risk
For members of the LGBTQ+ community, recovery often involves more than addressing substance use or mental health symptoms—it means finding a space where their identity is respected, affirmed, and understood. LGBTQ+ individuals are disproportionately affected by issues such as anxiety, depression, trauma, and substance use disorders, often due to stigma, discrimination, and social isolation. Research has shown that when people receive affirming care, they are more likely to engage in treatment and have better outcomes [3]. That’s why finding LGBTQ+-friendly treatment for addiction and mental health concerns can be life-changing and life-saving for individuals seeking healing.
How Affirming Treatment Improves Completion & Relapse Rates
Compassionate, affirming care is not just about tolerance—it’s about understanding the unique challenges LGBTQ+ individuals face. Many have experienced rejection from family, faith communities, or society at large, leading to deep-rooted emotional pain. Studies show that in treatment settings that are not LGBTQ+-friendly, clients may feel judged or pressured to hide parts of themselves, which can lead to worse outcomes including not finishing treatment [4]. Research also shows that therapists and providers who are trained in LGBTQ+ cultural competence can create an environment where healing is possible by acknowledging these lived experiences and offering care without shame or bias [4].
Family Therapy in LGBTQ+ Recovery
Family support can also be a key part of recovery, but only when it is supportive of the whole person [5]. For many family members, this is a difficult journey, especially since people in the same family may have very different and strongly-held opinions. If the family is willing to keep their minds open and increase their understanding of these issues, everyone can move forward together. In many cases, family therapy or education can help rebuild trust, reduce conflict, and strengthen the support network—especially when led by therapists who can facilitate respectful and affirming conversations.
Why Inclusive Programs Benefit Every Client
Even if you don’t identify as LGBTQ+, it’s still good to look for help from professionals who are affirming, because the fact that they are affirming says a lot of good things about them. The fact that providers are affirming of LGBTQ+ shows that they are more likely to take all aspects your life into consideration and hold these things with compassion. They are more likely to look at how you have been impacted by society and find the best ways to individualize care while taking that into account. On the other hand, providers who don’t work well with these issues may well discount important parts of your identity and care, and they are more likely to use a one-size-fits-all approach in your care.
Windmill’s LGBTQ+-Affirming Approach
At Windmill, we individualize care for every client. This includes taking all facets of who they are into account and customizing their treatment to best fit them. For LGBTQ+ clients and their families, we bring a depth of experience and understanding that goes beyond book learning or surface-level acceptance. Our diverse and experienced staff includes members who are LGBTQ+ themselves and/or who are family members of LGBTQ+. Besides the depth of compassion and dedication to helping all people that are the standard at Windmill, our staff are trained to work with a wide variety of client populations. Affirming care has thus been part of our culture from the day we opened. Seeing our clients and their loved ones find relief, hope, and connection is one of the most rewarding aspects of the healing journey for all of us. At Windmill, clients don’t need to choose between getting help and being themselves.
The Bottom Line
Choosing LGBTQ+-friendly care is a powerful act of self-affirmation. Whether you’re seeking help for yourself or a loved one, know that compassionate, knowledgeable care exists—and it can make all the difference. Recovery is not only about stopping substance use or managing symptoms; it’s about reclaiming wholeness, self-worth, and joy. When people feel seen and supported, healing becomes not just possible, but probable. And that’s a hope worth holding onto.
Take the Next Step
If you or someone you love is seeking inclusive, evidence-based treatment, we’re here to help. Our admissions team can walk you through what to expect and answer any questions. Call 830-251-5606 or contact us online.
Q: Is LGBTQ-affirming therapy more effective?
A: Absolutely! Numerous research articles show that affirming therapy is better in every sense.
Q: Do I need to be “out” to get LGBTQ-friendly treatment?
A: No. You’ll receive affirming care regardless of how you identify or where you are in your journey.
Q: Does family need to be involved?
A: A person can recover whether family is involved or not, but family education and therapy can make a big difference.
Q: Will my insurance cover this kind of therapy?
A: Most LGBTQ-affirming care is billed under standard mental health or addiction treatment services and covered by insurance.
Q: What if I’ve had a bad experience in another program?
A: That’s valid—and you deserve better. Our team is trained to rebuild trust and provide trauma-informed, respectful care from day one.
References
[1] Gallup (2024). “LGBT Identification in U.S. Ticks Up to 7.6%.”
[2] Parent, M. C., Arriaga, A. S., Gobble, T., & Wille, L. (2019). Stress and substance use among sexual and gender minority individuals across the lifespan. Neurobiology of Stress, 10, 100146.
[3] Pachankis, J. E. (2018). The scientific pursuit of sexual and gender minority mental health treatments: Toward evidence-based affirmative practice. American Psychologist, 73(9), 1207.
[4] Paschen-Wolff, M. M., DeSousa, A., Paine, E. A., Hughes, T. L., & Campbell, A. N. (2024). Experiences of and recommendations for LGBTQ+-affirming substance use services: an exploratory qualitative descriptive study with LGBTQ+ people who use opioids and other drugs. Substance Abuse Treatment, Prevention, and Policy, 19(1), 2.
[5] DelFerro, J., Whelihan, J., Min, J., Powell, M., DiFiore, G., Gzesh, A., ... & Wood, S. (2024). The role of family support in moderating mental health outcomes for LGBTQ+ youth in primary care. JAMA pediatrics, 178(9), 914-922.
About The Author
P. Casey Arrillaga is the Team Leader for Education at Windmill Wellness Ranch, and he is the author of books including “Realistic Hope: The Family Survival Guide for Facing Alcoholism and Other Addictions”.
Created specifically for those who have loved ones that struggle with addiction.