I keep waiting to find an explicitly queer model of partners therapy (I prefer "partners" to "couples" therapy, which I will address in a minute) that is akin to that of the Gottman Institute or the Psychobiological Approach to Couple Therapy (PACT) Institute, and I am growing impatient. I am grateful for the local organizations that have sprung up to provide therapeutic services for LGBTQ+ individuals, partners and families (e.g. Queer Asterisk in my county) and am craving the existence of a model for queer partners therapy that is robust in its theoretical underpinnings and the evidence supporting it. I also want to give a shout out to Esther Perel who is a master at calling out harmful dominant narratives and helping partners to re-story and re-experience their relationships and lives (and I highly recommend listening to her podcast of couples therapy sessions, which include several LGBTQ+ couples).

What continues to frustrate me about dominant couples therapy models that say, "Sure, this applies to queer folks!" is the use of inclusive language without a deeper look at how queering relational therapy would require a direct challenge to heteronormativity and a binary gender system that rests on heaps of misogyny and contracted forms of masculinity. A queer model also would confront additional, intersecting forms of oppression and domination—racism and poverty to name two—that impact people’s daily relationships with one another. To quote Addison and Coolhart’s 2015 article, “Expanding the Therapy Paradigm with Queer Couples: A Relational Intersectional Lens,”

Existing literature provides clinicians a basic understanding of queer couple and the dynamics that make them unique from nonqueer couples. However, much of this knowledge has been normed on White middle-class couples and has rarely included couples with transgender or bisexual members.

Ironically, I wrote about this very topic in 2014 and, re-reading my post today, feel like I could write the same post without much if any modification. The main difference between then and now is that I have four more years of experience as a psychotherapist and, amidst a Trump presidency as well as an upswell of the #Metoo movement, feel that time is way past due for robust, queer, justice-oriented relational models. I also am now the parent of a toddler, a role that has slapped me in the face with how life-sucking binary notions of gender identity and expression can be.

I want to own that I’m a white, cisgender, queer woman, recovering academic (which means I’ve had a whole lot of formal education, for better and worse), and licensed marriage and family therapist who by no means has a well-crafted approach to queer partners therapy tucked away in my back pocket. I do have some ideas and practices, however, that are rooted in my study and attempted enactment of justice-oriented principles. So this post aspires to move the dialogue about queer partners therapy in a deeper, more honest direction that is simultaneously appreciative of the many lessons learned from institutes like the ones named above and skeptical about the normative foundations of dominant models, which often inadvertently reinforce marginalization and reproduce a two-sex, heterosexist model. In other words, I honor the intentions of and have learned valuable practices from my mentors and colleagues. I want to focus here on mitigating the harmful impacts of normative models and generating practices that foster the flourishing not only of those with many social privileges but also of those who have been penalized for particular social identities and/or the material circumstances of their lives.

First off: partners versus couples therapy. To shift this one word acknowledges that more kinds of meaningful, intimate relationships exist than those between two people in a committed, monogamous relationship. For those individuals who have multiple romantic attachments to fellow adults, much of couples therapy literature and offerings are immediately exclusionary. With their focus on a single “primary” attachment, these models assume we as human beings in modern-day society need to rely on a nuclear family arrangement—children are optional (sometimes), but two adults need to be at the helm—to survive and thrive. Queer folks have much to teach therapists on this score, as so many are experts on the necessity of cultivating “chosen” family, having had immediate families who could not love them no matter what. My vision for queering partners therapy therefore begins with openness and curiosity about what relational ties bind people and how well they are working. The main question I have for folks is not, Who is your person? Rather, I want to know, What relationships matter to you? I also want to know if these relationships foster affirmation (of self and others, not of harmful behavior), safety (both emotional and physical), and dignity, by which I mean people’s inherent value and worth.

These more general relational questions do not mean we neglect specificities in a more comprehensive queer partners therapy model. Here are a few of the many particular necessities that may come up for a therapist working with queer partners:

• An understanding of and openness to learning more about dynamic terms, ways of identifying, and relational configurations. I especially believe that therapists need to find the resources to educate ourselves about LGBTQ+ definitions and theories rather than ask our clients to educate us. Many free, high-quality resources exist, like the Safe Zone Project’s glossary of terms. Educating ourselves does not mean we do not ask clients to tell us more about how they characterize themselves and their relationships (e.g., “What has being aromantic looked and felt like in this relationship?”). It does mean we acknowledge when we do not know something and explicitly commit to and follow through on learning more about the things that matter to our clients.

• A need to know the difference between an informed consent and gatekeeper model of therapy and clarity around where you stand on this issue, especially if you are working with someone who is contemplating a medical transition. Additionally, if one partner is actively transitioning, the non-transitioning partner(s)’ needs and desires, which often are complex and dynamic, need to be considered, too. This may seem obvious, but non-transitioning partners may stay silent about their struggles out of a desire to be supportive and/or because they have received the message that attention to their needs and desires is selfish. Knowing how and when to refer partners to individual resources (e.g. an online support forum for partners of trans individuals) versus ones focused on the relationship (e.g., Wikihow’s easy-to-use guide on nonviolent communication, which includes how it can be abused) is an ongoing art and science for any therapist meeting with partners.

• An understanding of and openness to learning about the myriad layers of becoming a queer parent if you are working with partners interested in conceiving, adopting, and/or otherwise parenting a child. For example, states still vary in how accepting they are of LGBTQ+ parents adopting or fostering children. Additionally, for partners wanting to pursue donor conception, significant issues arise for consideration, such as the impact on children of being donor conceived and the decreased likelihood of maintaining donor anonymity in light of technological advances, like the growing availability of genetic information through companies like Ancestry.com. Any time queer people have to engage with social institutions, like a fertility clinic or adoption agency, they may face subtle and overt forms of discrimination and marginalization. Becoming familiar with some of the roadblocks on the path to becoming a queer parent as well as the resources available to overcome those barriers can go a long way toward helping queer clients feel validated and supported.

Returning to my appeal for an affirming, justice-oriented approach to queer partners therapy, I would be remiss not to elaborate on how the numerous “isms” in our society impact every intimate relationship, not just the queer ones. I am grateful for resources like the Dear Sugars podcast, which acknowledged how the inequitable distribution of emotional labor tends to negatively affect queer partnerships, too. Patriarchy’s numerous, unwieldy tentacles do not stop at the household and bedroom doors of queer relationships. If we really do aspire to transform relationships into equitable, mutually beneficial adult partnerships, we have our work cut out for us, as we are bombarded with messages about some people’s superiority and some people’s inferiority from the time we are conceived until the moment we die. Moreover, institutionalized power imbalances act as titanium reinforcers of these pervasive messages.

In some ways, the pressure can feel more intense on queer partners to break dominant rules since a common assumption is that LGBTQ+ people have deviated from what’s “normal.” For example, outsiders may presume a lesbian couple has equality in their relationship when, in reality, the two partners are living out patterns from their childhoods that are very much rooted in the patriarchal idea of a dominant, controlling father and submissive, nurturing mother. None of us swims around in this fishbowl of unequal power relations without getting wet. With regard to the rampant sexism in this society, in particular, Julia Serano has some brilliant insights for all of us:

The greatest barrier preventing us from fully challenging sexism is the pervasive antifeminine sentiment that runs wild in both the straight and queer communities, targeting people of all genders and sexualities. The only realistic way to address this issue is to work toward empowering femininity itself. We must rightly recognize that feminine expression is strong, daring, and brave - that it is powerful - and not in an enchanting, enticing, or supernatural sort of way, but in a tangible, practical way that facilitates openness, creativity, and honest expression. We must move beyond seeing femininity as helpless and dependent, or merely as masculinity's sidekick, and instead acknowledge that feminine expression exists of its own accord and brings its own rewards to those who naturally gravitate toward it. By embracing femininity, feminism will finally be able to reach out to the vast majority of feminine women who have felt alienated by the movement in the past.

A queer partners therapy model that gets to the heart of issues is going to address our conditioning in this culture and what we need to unlearn as well as embrace if we are going to forge relationships that are more humanizing, creative, and just than those of previous generations.

As for addressing intersecting oppressions and identities, Jeff Baker, a queer therapist of color, has poignantly tackled the requirements of a therapist if they are going to work effectively with minoritized communities. Baker argues that in addition to recognizing our blind spots and implicit biases, therapists with a genuine commitment to realizing social change will invest in learning about theoretical orientations that affirm their clients, such as intersectional feminist and critical race theories. Instead of burdening the client with “unpacking the historical context around myriad forms of internalized oppression, as well as nuanced intracommunity issues,” such a therapist will demonstrate an understanding of how structural oppression impacts clients, including on an emotional level. As Baker so eloquently wrote to the women of color and LGBTQ+ people of color who are seeking a therapist,

…a therapist who cannot separate their work from your work, especially your anger, is not mature or skilled enough to engage with you about oppression in healthy and affirming ways. Holding space for you should always be a therapist’s first priority, even if leaning into the discomfort of their privilege means leaning into your rage.

In summary, a deep, meaningful approach to queer partners therapy will not shy away from tackling the most micro-level internal bodily sensations to the most macro-level external forces. A tall order, to be sure, and a worthwhile endeavor that promises wholeness, not perfection. Many people think of psychotherapy as a form of individual and/or interpersonal therapy. I think of it more as a stone dropped in the pond. If we are able to break old, violent, harmful relational patterns that we have inherited through our families and societies and replace them with dynamic practices that strengthen our capacity for peace, joy, and love, that energy ripples outwards. Although we cannot know how that outward map will look, we can draw on J. Krishnamurti’s words to trust that “[a]ction has meaning only in relationship; without understanding relationship, action on any level will only breed conflict. The understanding of relationship is infinitely more important than the search for any plan of action.” 

On that note, may this post contribute to the creation of queer partner therapy models that have the power to transform individual lives, relationships, and the institutions in which we live, play, and work. Having written it, I feel inspired to pursue the creation of a queer partners workshop in my local community. We shall see…