LGBTQIA+ Affirming Therapy in Seattle

Q: Do you take insurance?

We are in network with Premera . We also offer reduced-fee sessions with our supervised clinical interns. Our low cost therapy page has current details, and our insurance FAQ answers the most common questions.

You Deserve to Feel Safe, Seen, and Supported

Finding the right therapist can feel overwhelming, especially if you’ve had experiences where you didn’t feel understood or accepted. At Steffen Counseling Services, we provide LGBTQIA+ affirming therapy for individuals, couples, and families across Washington. We see clients online anywhere in the state, and in person at our Fremont and Georgetown offices in Seattle and in downtown Tacoma. Whether you’re navigating anxiety, relationships, identity exploration, life transitions, trauma, or simply looking for a therapist who will affirm who you are, we’re here to help.

Our team includes both queer clinicians and affirming allies, and we’ll work with you to find a therapist who feels like the right fit for your needs and preferences. We work with gay, lesbian, bisexual, transgender, nonbinary, queer and questioning clients. Tell us what you are looking for and our team will recommend the clinician whose specialty and approach fit, rather than booking you with whoever has the next opening.

LGBTQ+ Counseling That Meets You Where You Are

Your sexual orientation, gender identity, and relationships are important parts of who you are. But they don’t have to be the only focus of therapy.

Some clients come to us to explore questions around identity or navigate coming out. Others are looking for support with stress at work, relationship challenges, grief, trauma, anxiety, depression, or simply wanting to feel more like themselves again.

Whatever brings you here, your therapist will meet you with curiosity, compassion, and respect, not assumptions.

What Our LGBTQ+ Therapists Can Help With

Our therapists regularly support LGBTQIA+ clients with concerns including:

Anxiety and depression
Identity exploration
Gender identity and gender expression
Coming out
Relationship and family concerns
Trauma and PTSD
Religious trauma
Self-esteem and confidence
Life transitions
Stress and burnout
Grief and loss
Building healthier relationships
Transgender and nonbinary identity, transition and gender expression
Internalized homophobia and transphobia
Asexuality and questions about attraction

Whether you’re questioning your identity, confidently living as your authentic self, or anywhere in between, therapy is a place where you can show up exactly as you are.

How It Works

How Getting Matched Works

Reach out

Tell us what brings you in, what matters to you in a therapist, and any preferences you have around identity, specialty or scheduling. Get started here.

We find your match

Our team reviews what you have told us and recommends the clinician whose specialty and approach fit, instead of booking you with whoever has the next opening.

Start where it suits you

Meet your therapist in person at our Fremont or Georgetown offices in Seattle, at our downtown Tacoma office, or online anywhere in Washington.

Our Commitment

Our commitment to the LGBTQIA+ community extends beyond the therapy room. We believe in affirming care, visible support, and creating a practice culture where clients feel respected from the first interaction onward.

Using your correct name and pronouns.
Supporting identity without judgment.
Respecting your autonomy and goals.
Considering the social, cultural, and family contexts that shape your experience.
Showing up as an ally in ways that are practical, compassionate, and consistent.

Gender Affirming Care Letters

If you’re seeking gender-affirming medical care, we offer evaluations and Gender Affirming Care Letters when clinically appropriate.

We understand that this process can feel stressful, and we strive to make it as supportive and straightforward as possible. Our therapists are familiar with current standards of care and work collaboratively with clients seeking documentation for gender-affirming medical treatment.

Letters may be provided for:

Hormone Replacement Therapy (HRT)
Top surgery
Bottom surgery
Other gender-affirming medical procedures

If you have questions about the process, we're happy to discuss what to expect during a consultation.

You do not need to have everything figured out before starting. Therapy can be a place for questions, clarity, and support as you move forward.

You can also read more about what to expect from gender affirming therapy and about intimacy and connection after transition.

Our Approach to LGBTQ+ Affirming Care

We believe therapy works best when you feel comfortable being yourself.

That’s why we prioritize creating an environment where LGBTQIA+ clients feel respected, affirmed, and understood. We recognize that everyone’s experiences are different, and we don’t make assumptions about your identity, relationships, or goals.

Our therapists draw from evidence-based approaches including Cognitive Behavioral Therapy (CBT), EMDR, Internal Family Systems (IFS), Acceptance and Commitment Therapy (ACT), attachment-based therapy, and somatic interventions. Together, we’ll create a treatment plan that reflects your unique needs and helps you move toward the life you want.

We offer this care as individual therapy, couples counseling for relationships of any structure, and family therapy.

Where We See Clients

We are fully telehealth across Washington, with in-person offices in three neighborhoods:

You do not have to live in Seattle to work with us. If you are anywhere in Washington, telehealth is available.

Meet Your LGBTQ+ Affirming Therapists

Bella Goss

Paul Brown

Grace Sheffield

Hunter Hansen

Bree Mirus

Jessica Emerson

Sage Robins

Anna Stevens

Tristen Mills

Hailey Clum

Brittany Steffen

Aishleen O’Brien

Alyse Bradway

Callie Houk

Alisha LeBeau

Lindsay McCue

Our team includes queer clinicians and affirming allies with a range of specialties and approaches. You can meet all of our therapists and read what each of them works with.

Frequently Asked Questions

Do I have to be out to start therapy?

Not at all. Therapy can be a place to explore your identity, ask questions, and move at your own pace. You never have to share more than you’re comfortable with.

Can I request a queer therapist in Seattle?

Yes. Our team includes both queer clinicians and affirming allies. If working with a therapist who shares aspects of your lived experience is important to you, let us know when you reach out and we’ll do our best to make the right match.

Do you provide Gender Affirming Care Letters?

Yes. We provide gender affirming care evaluations and letters when clinically appropriate. We’ll explain the process and answer any questions you have before getting started.

Is therapy only for LGBTQIA+-related concerns?

Not at all. Many clients choose an affirming therapist because they want to know they’ll be understood and respected. Therapy can focus on whatever is most important to you, whether that’s anxiety, trauma, relationships, work stress, or personal growth.

Do you offer online LGBTQ+ counseling in Washington?

Yes. We work with clients throughout Washington by telehealth, and we also see clients in person at our Fremont and Georgetown offices in Seattle and in downtown Tacoma.

What is gender affirming therapy?

Gender affirming therapy is care that takes your gender identity as a starting point rather than something to be questioned or treated. In practice that means working on whatever you came in for, with a therapist who does not need you to justify who you are. It can also include gender affirming care letters for medical treatment when that is clinically appropriate.

Do you take insurance?

We are in network with Premera. We also offer reduced-fee sessions with our supervised clinical interns. Our low cost therapy page has current details, and our insurance FAQ answers the most common questions.

Will I have to explain basic LGBTQ+ or trans terms to my therapist?

No. Our therapists work with LGBTQ+ clients regularly and keep current with affirming practice, so your sessions can go toward what actually brought you in rather than toward teaching.

What are the signs a therapist is not a good fit for LGBTQ+ clients?

A few things to watch for: treating your identity as the automatic cause of whatever you came in for, needing you to explain common terms, avoiding the subject entirely, or framing your relationships or gender as something to be resolved. Affirming care takes who you are as the starting point and gets to work on what you actually asked for.

Begin LGBTQIA+ Therapy in Seattle

You deserve a therapist who sees you as a whole person, not just a diagnosis or a label.

Whether you’re looking for support during a difficult season, exploring your identity, strengthening your relationships, or seeking gender-affirming care, we’re here to help.

Contact Steffen Counseling Services today to schedule a consultation and find the LGBTQ+ affirming therapist who’s right for you. We see clients in person in Seattle and Tacoma, and online anywhere in Washington.

LGBTQIA+ Affirming Therapy in Seattle

You Deserve to Feel Safe, Seen, and Supported

LGBTQ+ Counseling That Meets You Where You Are

What Our LGBTQ+ Therapists Can Help With

How It Works

How Getting Matched Works

Reach out

We find your match

Start where it suits you

Our Commitment

Gender Affirming Care Letters

Our Approach to LGBTQ+ Affirming Care

Where We See Clients

Meet Your LGBTQ+ Affirming Therapists

More on LGBTQ+ Mental Health

What Is Internalized Homophobia, and How Can Therapy Help?

Sex After Gender Transition: Making Space for Discovery

Gender-Affirming Therapy Seattle: How We Create an Inclusive Therapy Experience from Intake to Follow-Up

Pride Month and Mental Health: LGBTQIA+ Affirming Therapy in Seattle

Celebrating International Asexuality Day: Affirming Asexual and Aromantic Identities in Therapy

Welcoming Aishleen O’Brien Back to SCS as a Full-Time Clinician

Frequently Asked Questions

Begin LGBTQIA+ Therapy in Seattle

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