Affirmative therapy does not assume where you are in your journey. While the preservation and support of your gender and sexual identity are integrated into the therapeutic process, it will only be as much of a focus as you want it to be. Affirmative therapists provide you with a safe space to work through any mental health challenges you have or discuss things like problems at work. We evaluated a variety of online therapy platforms on their inclusivity, paying close attention to their medical terminology, how they asked patients to prove their identity, ease of accessing affirmative therapists, and whether their technology assumed all users were heterosexual, cisgender, and monogamous. We used this information to compile a list of the best online therapy platforms suited to the various needs of LGBTQ+ individuals, including any special concerns they may have about finding the right therapist.
Engaged in ongoing independent researchMystery shopped each of the brandsContacted brands’ customer service teams to ask questions and gauge responsivenessConsulted six leading psychologists and psychiatristsBecame customers of online therapy providers ourselvesReviewed academic research about the efficacy of online therapy versus in-person therapy
Read hundreds of verified customer reviews from trusted third parties such as the Better Business Bureau (BBB) and Trustpilot Cost $240 to $360 per month Prescribes Medication No Accepts Insurance No ReGain is one of BetterHelp’s specialty sites that offers couples therapy and marriage counseling. It supports a range of gender identities, sexualities, and types of relationships, making it our choice for the best LGBTQ+ therapy for couples. During the sign-up process, ReGain asks questions to better understand and contextualize your identity to match you with a therapist. It will also ask about other qualities or preferences you want in a therapist, such as whether they are LGBTQ+ themselves. Although it lets you indicate which gender you prefer your therapist to be, it only lists male and female as options. ReGain will consider your therapist preferences, but it cannot guarantee a match that satisfies all of your requests. Some LGBTQ+ individuals may have a chosen name, different from their legal name, that affirms their identity. According to research published in March 2020 in The Lancet Public Health, having a gender-affirmative ID may lead to less psychological distress, suicidal ideation, and suicide planning. The findings also indicate that using chosen names can lead to better mental health outcomes for individuals. When signing up for ReGain, you can use whichever name you want. Your chosen name serves as your identity in ReGain’s system. In our reviews team’s April 2022 survey of 1,000 online therapy users, the top four reasons people used ReGain were:
ReGain Plan Options and Pricing
ReGain only offers one monthly subscription plan and bills every four weeks. Your cost will depend on your location and therapist preferences, but you can expect to pay between $240 and $360 per month. Every subscription includes unlimited messaging and four 30- to 45-minute therapy sessions, depending on how much time you need with your therapist. You can work out your appointment times with your therapist and can cancel your subscription at any time. If you use unlimited messaging, your therapist will respond using a dedicated online chat room. You’ll receive a notification when your therapist responds. According to our reviews team’s online therapy survey, 48 percent of ReGain users received same-day responses from their therapist. The ReGain platform does not support three-way video calls, so you’ll need to share your computer or smartphone with your partner if you invite them to your sessions.
ReGain Financial Aid
ReGain Reviews
ReGain has 3.29 out of 5 stars based on 17 reviews on the BBB. It also has an F rating for failure to respond to two complaints and is not BBB-accredited. Trustpilot gives it 3.3 out of 5 stars, with 57 reviews. Almost all of the positive Trustpilot reviews were from people who were invited by ReGain to share their opinion. Note that both BBB and Trustpilot ratings change daily, and all ratings were current on the date that this article was published. ReGain has an app on the Apple app store, where it’s rated 4.8 out of 5 stars based on more than 6,000 reviews. On the Google Play app store, ReGain has 4.5 out of 5 stars based on more than 1,800 reviews. Cost $228 to $360 per month Prescribes Medication No Accepts Insurance No Our reviews team found Calmerry to be the most inclusive and affordable platform for messaging therapy. With messaging therapy, you can exchange messages with your therapist back and forth, much like email. And on Calmerry, you can send audio or text messages to your therapist. Calmerry’s monthly messaging plan is also $48 cheaper per month than the messaging plan that Talkspace offers, making it our top pick for best messaging therapy for LGBTQ+ individuals. Calmerry also has supplementary materials to complement your messaging therapy, including tools you can use to track your mood, reflect on your feelings, and journal. When you sign up with Calmerry, you don’t have to use your legal name. Calmerry’s intake form includes a nonbinary gender option and space to self-describe your gender identity. You can also specifically request a counselor with experience in LGBTQ+ and sexuality issues. Therapists on Calmerry also list the communities that they are allies with in their profile.
Calmerry Plan Options and Pricing
Calmerry offers three monthly subscription plans:
Unlimited messaging therapy at $227.96 per month
Unlimited messaging therapy and one live therapy session at $297.96 per monthUnlimited messaging therapy and four live therapy sessions at $359.96 per month
Since Calmerry’s messaging is asynchronous, you are not guaranteed instant responses. Therapists respond Monday through Friday. Of the Calmerry users who responded to our online therapy survey, 45 percent received responses within a day. While Calmerry does not offer financial aid, it does offer first-time discounts. If you enter the code CARE at checkout, you will receive 30 percent off your first month’s subscription — a total savings of $68.40.
Calmerry Reviews
Calmerry is rated 4.1 out of 5 stars on Trustpilot, with 69 reviews at the time of publishing. It is not rated on or reviewed by the BBB. Its app has 2.6 out of 5 stars based on 20 ratings on the Apple app store and 2.0 out of 5 stars based on 42 reviews on the Google Play app store. (All ratings were current on the date of publication.) Cost Without Insurance $129 for 25 minutes of therapy; $179 for 50 minutes of therapy; $299 for initial psychiatry visit; $129 for every 15-minute psychiatric follow-up session Cost With Insurance Varies by plan Prescribes Medication Yes Accepts Insurance Yes If you want to use your insurance to cover your therapy, Doctor on Demand may be a good choice. Of the online therapy users who responded to our reviews team’s online therapy survey, 39 percent chose a platform because it accepted their insurance. And according to Doctor on Demand, 98 million Americans have the platform covered by their insurance or employer, making it our pick for the best online therapy for using insurance. If you use Doctor on Demand for therapy, you’ll be asked to complete a comprehensive intake form. It will ask you about any feelings you want to experience more of (calm, present, or motivated, for example), any habit changes you’ve experienced (like increased smoking or problems with your body image), and any relationship issues you might be experiencing. This thorough evaluation can help you give your therapist better insight and context from the start about how and why you want help. Doctor on Demand provides the ability to search for a therapist who specializes in LGBTQ+ issues. Each provider’s bio lists their experience, focus area, and language spoken. Our reviews team compared this platform to other pay-as-you-go services. Amwell, Sesame, and LiveHealth Online — while cheaper than Doctor on Demand — don’t give you any option to search by therapist specialty. Where Doctor on Demand falls short compared with other picks on this list is in the personal information section. It does not allow you to input your chosen name in its intake form or allow you to remain anonymous. The options for gender are also lacking: It only includes a male, female, or “other” option.
Doctor on Demand Plan Options and Pricing
Doctor on Demand offers a la carte therapy and online psychiatry. It accepts insurance, including Medicare Part B. Your insurance plan will determine how much you pay. Without insurance, expect to pay:
$129 for 25 minutes of therapy or $179 for 50 minutes of therapy$299 for an initial 50-minute psychiatry session, including medication consultation and management, then $129 for every 15-minute follow-up session
Doctor on Demand does not offer discounts or financial aid.
Doctor on Demand Reviews
Because Doctor on Demand is a full-service telehealth platform, its reviews encompass mental health and its other medical services, including care for chronic conditions, preventive healthcare, and urgent care. Doctor on Demand has a highly rated app available on the Apple app store (4.9 out of 5 stars based on more than 104,900 reviews) and Google Play app store (4.8 out of 5 stars based on more than 58,900 reviews). It has 1.23 out of 5 stars based on 66 BBB reviews and 1.7 out of 5 stars on Trustpilot, with 22 reviews at the time of publishing. (All ratings were current on the date of publication.) Negative reviews mention poor customer service, difficulty rescheduling appointments, and being charged for visits before they occur. Cost $240 to $360 per month Prescribes Medication No Accepts Insurance No Pride Counseling is a specialty site operated by BetterHelp. It can be a convenient option for individuals who want affirmative therapy outside of traditional video therapy, including phone and chat therapy options. Pride Counseling allows you to use any name you want during sign-up, so you don’t have to worry about your name matching any legal documents. You can also opt for discreet billing, so “BetterHelp” appears on your credit card statement instead of Pride Counseling. Pride Counseling offers free webinars on topics like the difference between religion and spirituality and how to incorporate the latter into your life. Your therapist will also share informational worksheets with you. With a monthly Pride Counseling subscription, you get: Four 30- to 45-minute live chat, video, or audio therapy sessions. The length of each session depends on how much time you and your therapist need. Unlimited messaging to your therapist outside of your therapy time. According to our reviews team’s survey, 44 percent of Pride Counseling users received responses within a day.
Pride Counseling Financial Aid
During the sign-up process, Pride Counseling asks questions about your income and other factors for financial aid. It uses a sliding scale to determine eligibility and also asks questions about whether you are:
A veteranActive-duty militaryUnemployedA caregiver with multiple children or dependentsA student
Pride Counseling does not provide specific details on how it determines financial aid eligibility.
Pride Counseling Reviews
Pride Counseling’s app has 4.6 out of 5 stars based on more than 1,200 reviews on the Apple app store and 4.5 out of 5 stars based on 605 reviews on the Google Play app store. Pride Counseling has an A- rating and 5 out of 5 stars based on two customer reviews with the BBB. It gets 3.8 out of 5 stars on Trustpilot with two user reviews — both invited by Pride Counseling to leave reviews on Trustpilot. (All ratings were current on the date of publication.)
Experience Hannah Daniels, a licensed professional clinical counselor in private practice in Minneapolis, says to ask your therapist about their experience working with LGBTQ+ individuals, as well as the first step they would take with your problems.
Whether They Make You Feel Safe When you share with your therapist, no matter the issues, you should feel supported and respected. “Unconditional positive regard is a big part of helping clients feel safe and seen in treatment,” says Rachel Davidson, a licensed professional counselor associate and therapist in private practice in Houston. “For many people in this community, the therapist could be the only person they have to turn to.”
Whether They’re LGBTQ+ Themselves Are you looking for someone who is familiar with LGBTQ+ issues or someone who is LGBTQ+? Roma Williams, a licensed marriage and family therapist in private practice in Houston, is a cisgender, heterosexual Black woman who treats clients who are LGBTQ+. “They may come to me because of my relational focus or how I address their issues with stress and trauma, or because I am a woman of color,” she says. “All of those have been true.”
She adds that, while it may be comfortable to see a therapist who shares some of your identities, whether you see a therapist who is LGBTQ+ themselves is ultimately up to your preference. “Finding a therapist can be a lot like dating,” she says. “Sometimes you have to get out there and try until you find what you like.”
Whether They Understand Your Needs A therapist who’s well-versed in providing culturally competent care will be educated and compassionate enough to understand the needs of LGBTQ+ people, according to the Suicide Prevention Resource Center (PDF).
We spoke with Karla Fleshman, LCSW, a gender therapy and trauma specialist in private practice in Wilmington, Delaware, about how therapists can best serve LGBTQ+ individuals. She recommends three key actions:
Whether They’re a Good Fit Emily Falcone, LCSW, a counselor in private practice in Elsmere, Delaware, says to consider developing screening criteria for your potential therapist. What does a good therapist feel like to you?
Whether They Can Provide Intersectional Care Intersectional care, according to research published in November 2020 in International Journal for Equity in Health, acknowledges how stigma can intersect with the oppression from other inequalities, like poverty and race, in a person’s life. The study emphasizes the pressing need in healthcare to know and understand the multidimensionality of individuals, including how these overlapping identities and conditions can lead to more discrimination, marginalization, and alienation.
As a therapist, Falcone prioritizes intersectional care by acknowledging the differing experiences of intersecting communities. “Each person’s life experience shifts the way they experience their queerness and how their queerness is experienced by others,” she says. “And minority stress increases with more intersecting identities.” Williams takes a similar approach. “I like to ask about their stories and histories with race, culture, family of origin, and sexuality.” She takes special considerations for her LGBTQ+ clients, especially about their coming out story and their experiences in life living with how they identify. Calmerry is our review team’s pick for online messaging therapy because it is one of the most affordable messaging therapy services, especially compared with Talkspace. It also includes complimentary text-based programs that help you track and understand your moods and experiences. For an inclusive online relationship therapy option that’s also affordable, take a look at ReGain. You can also reach out to the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 800-662-HELP (4357). The SAMHSA help line is a free, confidential, 24/7, 365-days-a-year treatment referral and information service for individuals facing mental or substance abuse disorders.
