8 best online LGBTQ therapy providers, according to mental health experts

If you’re queer and struggle with mental health, you shouldn’t feel alone. In fact, if you identify as a sexual or gender minority, you may be in greater need of mental health care than those in the general population. “Research highlights a heightened need for therapy among LGBTQIA+ individuals due to increased rates of depression, self-harm and suicidal ideation, exacerbated by discrimination, inadequate health care practitioner knowledge and harmful practices like conversion therapy,” says Malasri Chaudhery-Malgeri, the senior director of content at RehabPath.

Content concerning mental health is for informational purposes only and is not intended as professional medical or health advice. Consult a medical professional for questions about your health. If you are experiencing a mental health emergency, call 911, local emergency services, or 988 (the Suicide and Crisis Lifeline).

Unfortunately, not all therapists will understand your lived experiences, and this can lead to challenges when seeking a “good fit” with a provider. “There is an undue burden faced by many LGBTQ+ individuals who seek therapy: having to endure bigotry and ignorance from incompetent providers, or being asked — implicitly or explicitly — to educate one’s therapist about one’s identities or experiences, or that of our partners,” explains Rachel Harlich, a licensed clinical social worker and a nonbinary psychotherapist practicing in New York. This burden remains heavy in the mental health field due to the historical approach of pathologizing and “othering” queer and trans people; “we are still dealing with the ramifications of this oppressive stance,” Harlich says.

That’s why it’s so important to find therapists who are, at a minimum, allies to the queer community. The good news is that the field is evolving, and there are increasing high-quality choices available. We sought out the best online therapy options for LGBTQ people by speaking with 13 psychologists, therapists and mental health experts, as well as researching over 25 companies to compile a list of the eight best mental health care providers that will validate your identities.

If you’ve ever considered settling for a therapist who is unfamiliar with your sexual or gender identity, remember Harlich’s words: “Every queer and trans person has a right to competent, safe and affirming care.” These eight online therapy providers are a great place to start.

LifeStance Health

Cost: $75-$300 per session | Insurance accepted: Yes | Time until first appointment: Varies by provider | States available: AZ, CA, CO, DE, FL, GA, IL, IN, KS, KY, ME, MD, MA, MI, MN, MO, NV, NH, NJ, NY, NC, OH, OK, OR, PA, RI, SC, TN, TX, UT, VA, WA and WI | Types of therapy offered: Medication management for children and adults, talk therapy for children and adults, couples therapy, neurological testing/evaluation, family therapy, faith-based counseling, group therapy and transcranial magnetic stimulation (in person only)

LifeStance Health offers inclusive, scientifically-backed mental health treatment that supports a wide spectrum of conditions. Unlike many online therapy services, it not only addresses anxiety, depression and PTSD, but it also supports severe needs, including complex issues like schizophrenia, substance use disorders and dementia. It also provides access to cutting-edge treatments you may not find elsewhere, such as ketamine therapy for severe depression by blending in-person treatments with teletherapy.

LifeStance Health also specializes in LGBTQ care, including guidance for coming out to family and friends, gender-affirming therapy, trauma-informed care, LGBTQ youth support and family therapy for LGBTQ couples and families.

There are a few downsides to using LifeStance Health. For one, it’s unclear exactly how much its services cost without insurance since the site says prices vary “by provider.” The range is listed as between $75 and $300 for an appointment, which may not be affordable if you’re on a budget and don’t have insurance. Furthermore, LifeStance Health isn’t available in every state and its site doesn’t address racial discrimination or other forms of oppression, so it’s hard to say whether its therapists are equipped to treat every lived experience.

That said, the breadth of the services LifeStance Health provides is a nice change for the online therapy market, particularly for the LGBTQ community.

Pros

  • In-person treatment available
  • Couples and pediatric care available
  • Accepts insurance
Cons

  • Pricing not transparent
  • Not available in every state

$75-$300 per session at LifeStance Health

Talkspace

Cost: $69-$109 per week, varies by plan | Insurance accepted: Yes | Time until first appointment: Matched with a therapist within 48 hours | States available: All 50 states and Canada | Types of therapy offered: Teen, couples, individual adult and medication management

Talkspace may be one of the better-known online therapy services, but you may not know that it offers specialty services for LGBTQ folks and veterans, two demographics at a higher risk of experiencing posttraumatic stress disorder (PTSD) than the general population. 

Jordan Gruenhage, a registered clinical counselor with a master’s degree in counseling psychology, explains the minority stress theory — that systemic discrimination, microaggressions and internalized queerphobia combine to increase stress, which contributes to a wide variety of health conditions for LGBTQ people, including PTSD.

Talkspace is equipped to handle the challenges that LGBTQ persons face, including the traumas that affect them. The site has a page dedicated to potential queer clients that lays out how many Talkspace providers identify as queer. 

To that end, the platform also specializes in treating veterans, and it’s impossible to ignore the reality that the intersection of the veteran and queer communities is particularly susceptible to experiencing PTSD. In fact, a 2022 study found that transgender veterans are 1.5 to 1.8 times more likely to have PTSD than cisgender veterans.

Talkspace is a financially accessible option for many people. The site accepts a range of health insurance plans and offers different pricing categories for varied services to help you find one that fits your budget and can include messaging, video sessions, weekly workshops, couples therapy, medication management and bundled services. The price structures for each can be found here. 

Pros

  • Specializes in veterans
  • Messaging available
  • Can see therapists’ bios ahead of time
Cons

  • No sliding scale available
  • No family therapy available

$69-$109 a week for therapy, billed monthly at Talkspace

Calmerry

Cost: $228-$360 per month, varies by plan | Insurance accepted: No | Time until first appointment: Within one business day | States available: All 50 states | Types of therapy offered: Individual text and video therapy for adults only

Anxiety is one of the most prevalent forms of mental illness, affecting over 19% of American adults each year. While anxiety can be a healthy human emotion, in the case of an anxiety disorder it can become debilitating. Research indicates that the LGBTQ community is more likely to experience anxiety than the general population, due to daily exposure to microaggressions and widespread macroaggressions. 

The good news is that anxiety is treatable, regardless of your identity. Calmerry uses cognitive behavioral therapy (CBT), a proven technique to help address anxiety by dispelling cognitive distortions — the illogical thoughts that can lead to negative emotions. “In research, CBT is considered the gold standard [for treating anxiety]. CBT has the most research-based support that shows its effectiveness on anxiety and depression,” says Tyler Nicodem, a therapist specializing in the intersections of LGBTQ and religious identity.

Not only do Calmerry’s providers use CBT, but the service also provides you with worksheets and digital tools, such as journaling and mood tracking, to guide you through a CBT plan. And if CBT doesn’t work for you, Calmerry has providers who specialize in a full range of therapeutic techniques, including Humanistic Therapy and Dialectical Behavioral Therapy (DBT).

The biggest downside to Calmerry is that it doesn’t accept health insurance, so it may not be financially accessible for everyone. The site’s messaging-only service, which includes messaging with a therapist five days per week and access to their digital library, costs $228 per month. If you want a plan that includes one 30-minute video session with your therapist, the cost goes up to $298 per month. It increases to $310 and $360 per month with the addition of two and four video sessions, respectively. For four video sessions without access to their digital library of services, the price drops to $250 per month. You can also try a single, one-hour video session for $150 or $120 if it’s your first time.

Pros

  • Specializes in anxiety and LGBTQ issues
  • Uses evidence-based CBT
  • Plan includes worksheets and digital mental health tools
Cons

  • Does not accept insurance
  • No couples therapy available
  • Video sessions last only a half hour

$228-$360 per month, varies by plan at Calmerry

Amwell

Cost: $95-349 per session, varies by plan | Insurance accepted: Yes | Time until first appointment: 24 hours or more | States available: All 50 states | Types of therapy offered: Individual therapy and psychiatry for adults

Brightside specializes in treating the most severe cases of depression, and the platform even offers a virtual program aimed specifically at treatment for patients experiencing suicidal ideation. Of note, if you or someone you know are experiencing a mental health emergency, call 911, local emergency services, or 988 (the Suicide and Crisis Lifeline).

According to a 2022 national survey on LGBTQ youth mental health, 45% of respondents seriously considered attempting suicide in the last year, while 14% had a suicide attempt. The risk isn’t limited to adolescents either. More than 40% of transgender adults report making a suicide attempt at some point in their lives, with studies confirming that gay, lesbian and bisexual adults are at greater risk for suicidal thoughts and actions across their lifespans.

If you’re going to seek treatment for severe depression online, you need a provider equipped to address it from all angles, including talk therapy, medication management and crisis care, if needed. Brightside is unique in this regard; the platform prides itself on using data to drive patient care, combining digitally collected information with evidence-based treatment and individualized care. 

Brightside also has a one-of-a-kind crisis intervention treatment plan for those at risk of hurting themselves. The plan uses the evidence-based Collaborative Assessment and Management of Suicidality (CAMS) framework, which is a research-supported approach for suicide intervention. 

Brightside doesn’t only treat depression. Its providers can also assist you if you are navigating panic disorder, insomnia, bipolar, posttraumatic stress disorder (PTSD), anxiety, postpartum depression, premenstrual dysphoric disorder (PMDD), OCD or phobias.

The only downside to Brightside is that it doesn’t appear to specialize in LGBTQ care. That said, the Brightside blog features content about the queer community. So while it might not offer specialized solutions if most of your mental distress hinges on queer issues, Brightside can help if you are experiencing clinical mental illness.

Pros

  • Specializes in severe depression and suicidality
  • Medication management available
  • Combines data-driven care with personalization
Cons

  • Doesn’t specialize in LGBTQ care
  • Cannot read provider profiles ahead of time
  • Expensive without insurance

$95-$349 per session at Brightside

Octave

Cost: $170-$275 per session, depending on location | Insurance accepted: Yes | Time until first appointment: Roughly 24 hours | States available: CA, CT, FL, NJ, NY, TX and District of Columbia | Types of therapy offered: Individual therapy, couples therapy, family therapy and workshops

While queer couples face many of the same struggles that nonqueer couples do, there are specific issues that may come up in queer relationships that online counseling can help with. According to Halle Thomas, a licensed professional counselor with Chicory Counseling, these issues include experiencing discrimination based on sexual orientation or gender identity, navigating your partner’s gender transition, the costs of fertility treatments or adoption if you want to start a family and concerns related to integrating religious beliefs while still affirming your queer identity. 

Nicodem agrees that queer couples often face additional challenges in their relationships, “especially if the couple is religious or lives in a conservative area of the country,” he says. “Queer couples have all the complexities of being in a relationship, but have the added stressors of being part of the LGBTQIA+ community.” 

Octave providers are well-versed in the science of couples therapy and the specific stressors that impact LGBTQ people. In fact, many of the therapists on Octave have training in research-supported, couples-specific treatment approaches, such as the Gottman Method, emotionally focused couples therapy and integrative behavioral couples therapy (IBCT).

Another major advantage to Octave is that you can read profiles of its providers on the website before you sign up. Each profile includes information about the therapist’s approaches, background, hobbies and availability. This is especially helpful for LGBTQ clients, who can make sure their provider is comfortable treating queer couples before pursuing therapy. The website even makes it easy to search for therapists based on their interest in serving the LGBTQ community, and the transgender community as well.

Pros

  • Therapist bios available on website
  • Family therapy available
  • Evidence-based care
Cons

  • Not available in every state
  • No subscription plan available
  • Expensive without insurance

$170-$275 per session, depending on location at Octave

Thriveworks

Cost: $160–$240 per session | Insurance accepted: Yes | Time until first appointment: Varies by provider | States available: All 50 states and District of Columbia | Types of therapy offered: Individual therapy, couples therapy, pediatric therapy, family therapy and psychiatry

When teenagers, regardless of their identity, experience mental health challenges, their behavior can affect the entire family. Thriveworks recognizes this and offers care for teens and their close family members so that everyone has a higher likelihood of success.

LGBTQ teens are at greater risk for mental illness than their peers. “The CDC did a study in 2021 that [showed that] 69% of LGBTQIA+ students felt feelings of hopelessness or persistent sadness in the past year compared to only 35% in heterosexual students,” says Nicodem. According to Alyson Resnick, licensed professional counselor and mental health clinician at Tree of Life Counseling Center in Princeton, N.J., this increased risk is often associated with factors like interpersonal stigma, harassment and bullying from peers, discriminatory laws and policies and emotional distress related to identity concealment. 

Thriveworks understands these challenges and has a cohesive platform to address them from numerous angles. Not only does it feature therapists who treat teens and specialize in queer care, but Thriveworks’ range of services means it supports the family from every angle. For example, if your teen comes out as transgender, they can get individual therapy from a Thriveworks provider, while you can also receive therapy to help you adjust to your child’s transition. You can even elect to participate in family therapy so everyone is on the same page about what the transition means. 

If your queer teen is struggling, choosing Thriveworks can give you and your family the support you need to thrive together.

Pros

  • Medication management available
  • In-person therapy available
  • Educational resources available
Cons

  • No messaging available
  • Available services vary by location
  • Website can be difficult to navigate

$160-$240 per session at Thriveworks

Talkiatry

Cost: Varies based on insurance | Insurance accepted: Yes | Time until first appointment: Within days | States available: 42 states and Washington, D.C. (not available in AK, DE, HI, ID, NM, ND, SD, WY) | Types of therapy offered: Individual, couples and teen therapy, medication management children (5+) to seniors

Talkiatry is one of the few online medication management platforms that offers care similar to what you would receive from an in-person psychiatrist. The platform also makes it easy to select a provider who is compassionate and culturally competent about the queer community, as you can peruse provider profiles to identify those who are queer-supportive.

While Talkiatry doesn’t accept patients with a history of suicide, the platform’s psychiatrists and therapists treat a range of diagnoses, including ADHD, PTSD and bipolar disorder. The fact that its providers are cleared to prescribe controlled substances, including stimulant medication for ADHD, means that Talkiatry can address your mental health needs in ways many other online psychiatry providers can’t.

Keep in mind that Talkiatry requires health insurance to enroll and doesn’t accept Medicaid. Still, if your insurance covers psychiatry, Talkiatry’s inclusive and expansive treatment model makes it the right choice for many LGBTQ patients.

Pros

  • Can prescribe controlled substances
  • Accepts insurance
  • Pediatric care available
Cons

  • Cannot treat suicidality
  • Insurance required for treatment
  • Not available in every state

Varies at Talkiatry

MDLive

Cost: $0-$284 per session, depending on services and insurance | Insurance accepted: Yes | Time until first appointment: Less than a week | States available: All 50 states and Puerto Rico | Types of therapy offered: Individual psychiatry and therapy for children and adults

MDLive isn’t only a mental health care company. It provides telehealth services, including primary care, urgent care and dermatology. Even if you don’t use these other services, you do benefit from the fact that MDLive knows how to provide care quickly, meaning that you don’t have to wait more than a few days for an appointment. MDLive also offers appointments in the evenings and on weekends, so even if you work an inflexible day job, you can still find an appointment time that works for you.

MDLive keeps its pricing as transparent as possible, making it easy to see the cost of a session on the site (up to $108 for talk therapy or $284 for psychiatry). There are also no additional service fees or unexpected payments, like the cost of a workshop you didn’t even sign up for.

It’s also an intentionally LGBTQ-friendly platform; under its list of specialties providers address is “LGBTQ+ support.” You can choose your therapist (you don’t have to be matched by the platform), and you can switch at any time. So if you discover your provider isn’t familiar with your identity, you can always change to another therapist.

MDLive doesn’t come with many of the bells and whistles of other platforms, but if you want a no-nonsense, efficient mental health treatment platform, MDLive is a good bet. 

Pros

  • Choose your own therapist
  • Other medical care available
  • Comparatively low prices
Cons

  • No subscription available
  • Full list of accepted insurances not available before sign-up

$0-$284 per session, depending on services and insurance at MDLive

If you’re looking for a therapist who specializes in LGBTQ care, there are a few key qualities to keep in mind. Halle Thomas, a licensed professional counselor with Chicory Counseling, says you should ask the following questions before selecting a provider or service:

  • Is the therapy provider clearly LGBTQ-affirming?

  • Has the provider had specific training in working with the LGBTQ community?

  • Is the provider also a member of the LGBTQ community?

  • Does the provider incorporate any religious ideology in their therapy work?

Michael Grey, a licensed marriage and family therapist and founder of Grey Insight in Brooklyn, N.Y., also emphasizes the importance of interviewing the therapist beforehand. “I always suggest that people have a list of questions that are important to them. You want someone who has worked with your population, concerns you want to address and if they are affirming,” he says. As long as someone is licensed to practice therapy in your state, there are no hard-and-fast rules about what makes a good LGBTQ therapist. Mainly, you want someone who has the experience you need in terms of your identities and specific challenges.

Online therapy is not a recommended resource if you’re having thoughts of suicide or self-harm. Contact or visit the following for immediate help and support:

  • Call 911

  • Go to the nearest emergency room

  • Contact the Suicide and Crisis Lifeline by calling or texting 988

  • Contact the Crisis Text Line by texting HOME to 741741

  • Contact the Trevor Project suicide prevention and crisis intervention hotline for LGBTQ youth by calling 866-488-7386, texting START to 678-678 or sending a confidential instant message to a counselor through TrevorChat

If you identify as LGBTQ, then finding a therapist who specializes in queer issues is vital. The real question is whether online therapy is a good fit for you. Gruenhage explains, “If you find that you have difficulty feeling connected and communicating with someone over video calls, in-person therapy may be a better fit.”

Children may also struggle with digital care. Nicodem rarely recommends online therapy for anyone under the age of 13, “Children typically do better in therapy settings that allow for interaction such as play therapy,” he says.

Though it may not be suitable for everyone, Grey points out a few key advantages to digital care: “For people who want to seek services, online therapy may be helpful if you don’t have the ability to physically get to an office, or if the therapist is in a different part of the state.”

Online therapy is an accessible option for most people. So while you should consider carefully if it’s right for you, you shouldn’t be afraid to try it.

To sort out which companies provide the best mental health care for the queer community, we looked at several factors. First, we made sure each company explicitly states it treats LGBTQ people. We also prioritized platforms that accept health insurance, so they are more financially accessible. All the platforms exclusively hire licensed therapists, not life coaches or other professionals without solid credentials.

We researched 27 online therapy providers and spoke to 13 licensed mental health professionals before choosing the best online LGBTQ therapy platforms.

Online LGBTQ therapy is psychotherapy that takes place via the internet for those who identify as LGBTQ.

“LGBTQIA+ therapy is therapy but with a depth of knowledge of issues, concerns and challenges that may be present for [queer] clients,” explains Samantha Adjekum, a licensed clinical professional counselor with Clarity Clinic in Mokena, Ill. She emphasizes that from the therapist’s standpoint, it’s being dedicated to creating a safe space for clients, being supportive and committed to learning and constantly checking personal biases. “It is therapy for a human who is no different than others but may face different challenges,” she says.

Queer people are humans. Humans sometimes need therapy. And queer people deserve therapy meant specifically for them. Online therapy for LGBTQ individuals is simply a virtual way to receive this care.

Generally speaking, yes.

Therapists and therapy platforms are required to maintain rigorous standards of privacy protection, thanks to the Health Insurance Portability and Accountability Act (HIPAA). HIPAA guarantees your right to keep your health information private under most circumstances. The Department of Health and Human Services advises patients to use only telehealth services that require you to click on a secure link and/or enter a password to use them.

That said, there have been concerns about online mental health care services and privacy. This includes breaches to therapists’ email accounts and apps selling information to third parties. The Federal Trade Commission filed a complaint against popular therapy provider BetterHelp for doing just that in July 2023. So, when using any online therapy service, ask to read its privacy policies and make sure you understand them before agreeing to them.

Even if your data is perfectly secure, keep in mind that there are exceptions to therapist/patient confidentiality. Grey outlines the fact that, online or in-person, there are specific times when a therapist must disclose information about a client. For instance, if you’re experiencing active suicidal ideations, or your therapist deems you pose an imminent danger to yourself or others. Also, he says if you’re using insurance to pay for therapy, the insurance company has access to your charts, which includes data entered within the charts.

It’s important to be aware of the potential risks to your privacy.

Online therapy makes mental health care accessible to queer people who may not be able to find a therapist in their area who can meet their needs. “If you’re a queer person in rural Appalachia, where I’m from, it can be difficult finding a therapist who claims to be LGBTQIA+ competent and affirming,” says Lindsey Brown McCormick, a professional counselor with licensure in Ohio, Kentucky, West Virginia and Pennsylvania and owner of Women Thrive Counseling & Consulting. “If someone is, they might specialize in disordered eating when you want to work on previous trauma. Online therapy can improve options so you can find a therapist that meets your needs.” Plus, online therapy allows you to log in to therapy sessions from anywhere, reducing added stress and barriers to access, such as transportation.

Most of the experts we spoke to believe that online therapy is as good as in-person treatment, citing studies indicating that online therapy can be used to effectively treat anxiety and depression, PTSD and substance use disorders.

However, there are exceptions to this rule, especially for patients with severe mental illness. “The research [indicates] that online therapy is usually as effective as in-person therapy, especially when cognitive behavioral therapy is used. With this said, the research is fairly young. If online therapy is your only option, you should do online therapy. If you have the option to do in person, I have found that it typically creates a better experience,” says Nicodem.

In short, no. That said, your health insurance may cover the entire cost of therapy, and even some Medicaid plans don’t have copays. You can also check with individual providers as some therapists do pro-bono work. Outside of these exceptions, you’re going to have to pay for therapy.

If you struggle to afford mental health care, you can check out the Open Path Collective, a nonprofit option that offers therapy to people for as low as $30 per session.

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