Explore the fascinating journey of LGBT couples therapy as we engage in dialogue between Dr. Beth Trammel and Laurel Roberts-Meese, LMFT. As we honor the spirit of Pride Month, Laurel explains the significance of language within the LGBT community and emphasizes the role of allies in providing support while also respecting boundaries.

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Diving into the details, we discuss how roles in LGBT partnerships are uniquely shaped by each couple, and explore research that provides overwhelmingly positive support for same-sex parenting.

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[Beth] Hello, listener. Thank you for joining again on Things You Learn in Therapy. I'm your host, Dr. Beth Tremel.
I'm a licensed psychologist and an associate professor of psychology at Indiana University East, where I'm also the director of the Master's in Mental Health Counseling Program.
Today, I am really excited about my guest today because I plan to learn a lot in our pre-conversation.
Before we push record, I already learned a lot and I know y'all are going to really enjoy hearing our conversation today.
So, I have with me today Laurel Roberts-Meese. I said that right, did I say that right? Yeah, I realized, usually I ask people to pronounce it, but hopefully I'll get right.
[LRM] You got it.
[Beth] Okay, so Laurel, can you just give us a brief introduction. Tell us just a little bit about you and tell us one fun thing about you.
[LRM] Yeah, so I'm a licensed Marriage and Family Therapist and I'm licensed in California, Florida, and Pennsylvania. And I'm the clinical director of a boutique virtual private practice and we serve a lot of driven professionals.
We work with a lot of trauma and we have a particular passion for working with LGBT couples. And that's kind of become our specialty and most of the clinicians in our practice really specialize in that. So, we're going to talk a little about that today.
And something fun about me, I have spent most of my life singing in some kind of choral ensemble. And right now, I am in a women's choral ensemble in Los Angeles that is just doing some really incredible things. We commission a lot of new pieces. And I recently did a little spot for them about the link between choral singing and mental health.
[Beth] Oh my goodness, that's fun. Okay, so what did you talk about or what did you share around singing and mental health?
[LRM] Oh, just talking about how different areas of the brain get used at the same time while you're singing. And that can help you either consciously or not actually process trauma and help move through difficult things that have happened.
Particularly if you're singing with a group because you're using your language center, you're using gross and fine motor skills. And you are socially engaging with other people at the same time. And that helps prevent dissociation. It helps just kind of re-regulate your nervous system in a way that just talking doesn't.
[Beth] That's amazing. That's so cool. Okay, that's fun. That is one fun thing. That's amazing. Okay, within the LBGT community, you know, the letters have...
I feel like the letters have kind of changed and been added over the last maybe decade. Would you say that's true? So can you talk a little bit about, you know, which letters should we use? Do we always use all of the letters? How do we talk about language, particularly within this community?
[LRM] Absolutely.
You're always going to be fine just saying LBGT. That's fine. If you don't know where to start, LBGT is fine. Some people add the Q. That's also fine. So LBGT, that stands for Lesbian Gay, bisexual, transgender, and that certainly doesn't cover everyone in the queer community, but it's a good start.
So if you're saying LBGT, you're going to be fine.
[Beth] That's great.
[LRM] Yeah.
And there are a whole bunch of other letters that people add on, and that is also okay. After the LBGT, you sometimes see Q, QIA and those might stand for queer, questioning, intersex. The A people, point of dispute, does it stand for ally, or does it stand for asexual? People have strong opinions on that.
I think largely the objection to having ally in the acronym is that people who are allies and don't actually hold a marginalized identity, we absolutely want your support, but you aren't actually part of the community.
[Beth] Right, right.
[LRM] So please fight for us, support us, love us, but recognize that you're not part of the community and be respectful there.
And then another identity that you sometimes hear about is two-spirit, and this is very specific to Native and Indigenous cultures in the U.S. And there's a specific understanding in Native cultures about people who are two-spirit, and this would be a transgender person who has a spiritual experience around it in many Native cultures, people who are transgender or regarded as having the wisdom of both genders and are highly respected.
And it's a specific cultural label and experience that feels important to distinguish from the general trans community because it is highly regarded.
Now, I think the trans community should all be highly regarded, but this is a specific intersectional experience.
[Beth] That's—thank you for sharing that. All of those things are really helpful, I think, as we are trying to educate folks on what all of these things mean. Now, one thing I have also sort of seen is the plus at the end. Can you share a little bit about what that might be?
[LRM] Yeah, the community is so diverse, and there is not an acronym long enough to truly capture everyone's experience. There are some people that the word that they choose to describe themselves is pansexual, which they feel is very different than bisexual, and everyone has the right to pick language that feels authentic to who they are. And the plus basically says, yes, if you are someone with a marginalized orientation or gender identity, you are one of us.
[Beth] Yeah, I love what you just said, that it's such a diverse community that there aren't enough letters.
[LRM] Yes, right.
[Beth] We just can't quite capture everybody in just these letters. It doesn't really tell our whole story.
[LRM] No, when I was in college, we had an organization that I think they just called themselves Alphabet Soup…because they really did not want to make anyone feel excluded by having only a set of letters. But again, if you don't know where to start, LGBT is fine.
[Beth] Yeah, okay, so let's say we are a therapist who wants to either start getting into this work or maybe we're even a veteran therapist who has an intake coming up with somebody who identifies within this community. How do we start, right? Talking about language. And what do we say?
I know we were kind of talking a little bit that some people are just so worried they're going to offend someone and they don't know what to say, and so they just don't say anything. And I don't think that's what we're really hoping happens.
[LRM] No, no, no, you can, I mean, I ask everyone that comes into our practice, ”what are your pronouns?” And then because we don't want to assume, but in terms of other identity words, you can just say, you know, what words feel good to you to describe your experience?
Yeah, I already mentioned that there might be some people that are sensitive around the word queer.
There are also going to be some people who love the word queer because it is a really broad umbrella term. That some people feel captures all the letters.
[Beth] Yeah, yeah, yeah.
[LRM] But using whatever language the client feels comfortable with, and it's okay to ask. Cultural humility means being curious. And if you do say something that offends someone, you want to apologize quickly and say, “thank you so much for telling me” if they are saying, yeah, that word's offensive.
And then move on because you don't want to ask them with assuring you that it's okay. That's not their job, right? “I'm so sorry. Thank you for telling me. Can you please continue with your story or whatever you were talking about?”
[Beth] Yeah, I love that you just said that, you know, I think sometimes we as helping professionals, we get really concerned that we have really offended them and really hurt them. And we don't want to continue any kind of stereotype or discrimination. And so we're like, oh my gosh, are you okay? I'm really sorry. I'm so sorry. How did that feel? Are you okay?
[LRM] Yeah.
[Beth] And I love that you shared, hey, apologize, take responsibility, thank them in, you know, like genuine gratitude that they were brave enough to confront you and then move on. Like don't make it their job to make sure you're okay.
[LRM] Yeah, don't make it about you.
Mm-hmm.
Yeah.
[Beth] That's, that's so good.
Okay.
Uh, so you, um,
you have this group practice that kind of specializes in doing LGBT couples work, right?
So can you talk a little bit about why someone would want to see somebody who specializes in LGBT couples work, right?
[LRM] Yeah.
[Beth] Why would someone want to do that?
[LRM] Well, there are a lot of ways that LGBT couples work is different than straight couples work. There are a lot of ways that they're the same.
[Beth] Yeah.
[LRM] And some of the modalities that a therapist might use, those are going to be the same. But there is some really essential content.
[Beth] Yeah.
[LRM] That an LGBT couple, they probably don't want to spend a whole bunch of their precious therapy time educating their therapist about.
[Beth] Yeah. Yeah.
[LRM] So I want to talk about, um, there are kind of six major, um, talking points here, six major elements that are that show up in therapy for LGBT couples that for straight couples, it doesn't really show up.
[Beth] Great.
[LRM] The, the first of these is issues around coming out and here even some stages of development around coming out. Now this is kind of the obvious one. I think when you think about LGBT stories in the media, it's often a coming out story and often a rejection story, right?
But coming out is not a single event. It's not something that we do once. It's something that we do over and over again. So there may be real pivotal moments in someone's coming out journey such as telling family or coming out at work or something like that. But coming out is a daily choice.
You know, do I hold my partner's hand as we're walking down the street in this neighborhood we don't know? Or do I tell a specific medical provider that I'm trans or do I mention to someone that I'm bisexual But then they may not know because I'm partnered with someone of the opposite sex, right?
So all of this is this process of coming out is ongoing.
[Beth] Yeah.
[LRM] And their partners are maybe and are likely at different stages of that. And there's a certain kind of developmental element there that can really put a strain on the relationship. In some ways, in some ways, it's kind of analogous to having an age difference in a relationship where there are just some things that are a little more difficult for a couple within age difference.
But in this case, it's something that is kind of ongoing and the level of visibility of the relationship also can be impacted if one partner is “less” out. Or we're not going to upset old conservative grandma by telling her. But that means that you can't be fully out with your partner in front of extended family and that that really can be a strain.
And then kind of in this same category of outness is issues around intimacy and sex. And just level of comfort and experience, the same way that in a straight relationship, if there might be a partner that's more experienced or more comfortable with sex. But there's an added element here of identity and intimacy issues that can lead to feeling like there's a mismatch.
So that's one topic and that's a very broad topic, right?
[Beth] Yeah, I mean, I'm just imagining when you have these, you know, kind of differences in, you know, how public we're going to be. Does it become a challenge that we as therapists have to kind of help this couple through to say, hey, they're not necessarily choosing grandma over you. Even though it kind of feels like I'm choosing grandma's feelings over your feelings, right? Like do issues like that come up kind of within this category.
[LRM] Yeah. Yeah.
In many relationships, there's a real genuine safety element here. And to have to choose between expressing affection and love for your partner and in some cases, your safety, that's a really tough choice. And even if there isn't a immediate safety issue, it's quite possible that at one point, one partner experienced, they're being a safety issue and they are hyper vigilant for it. And may not be as comfortable being affectionate or even being out at work or something like that.
[Beth] Yeah. Yeah.
I can imagine that this kind of first point that you're talking about really does, I mean, there's a lot of focused time in therapy I could imagine. And so I guess for for any clients or any, you know, folks who are listening, if you're struggling in your relationship with these things, that makes sense.
[LRM] Yeah.
[Beth] And you're saying this is the very, this is one of the first things that maybe not the first things, but just one thing that comes up a lot. And so it sounds like though it, though it sounds really hard, it's kind of a normal part of this process.
[LRM] It's also not an issue for all LGBT couples. There are some people that have really well matched, you know, stages of coming out and similar comfort levels with being out. And so it might not come up at all. And as a therapist, you don't want to assume that this is a major issue for every LGBT couple. But it should be on your radar.
[Beth] Yeah.
But that's really good.
That's really good.
Yeah, yeah, that's great.
That's great.
Yeah.
[LRM] So the second element of how LGBT couples are different, this might actually surprise people, but John Gottman, who is, you know, a huge name in couples therapy, he's, he founded Gottman couples therapy, you know, modality.
And he did a 12 year study on same sex couples, which same sex couples don't usually get that kind of longitudinal research. And the results of this study were fascinating that LGBT couples generally have a more egalitarian dynamic. And they use more humor and affection when they are in conflict.
Their communication is actually often better than their straight counterparts. This is particularly true in couples of two women. That they're really going to, there's going to be a lot of healthy communication. There's going to be a greater ability to self-soothe as well as soothing their partner. And, and that being said, there are still four big pitfalls around communication that all couples experience.
[Beth] Yeah.
[LRM] And those are the four horsemen, and that is criticism, contempt, defensiveness, and stonewalling. So if you are in an LGBT relationship and you're experiencing some of those things that's totally normal, and there are some great antidotes to those things that couples therapist can help you in your partner walk through.
So the great news is communication seems to be a little bit better in LGBT relationships.
[Beth] You know, researchers spend a lot of time doing research on folks who are in privileged majority-based groups. And so I love that we have some good research that tells us some really promising things. But then also these things still apply, right? The four horsemen still apply. And that gives us some place to start, some place to sort of focus our treatment, which is great.
Yeah, 12 years. I'm a researcher and I don't think I can stay focused on anything for 12 years.
[LRM] Yeah, it was really, it was really great that there was that study.
[Beth] Yeah, yeah, that's great.
[LRM] Okay. So the next element that would come up with LGBT couple is around family planning and parenting. There are going to be some unique challenges here.
If this is a couple where either no one has the ability to gestate a child or two people have the ability to gestate a child, but there is not a way to have a biological child. There are going to be some logistical, medical and financial roadblocks in family planning. So adoption is always an option, but that can be really expensive and a really long process. And there are, there is plenty of discrimination in the adoption process for same-sex couples or for couples where a member is trans or something.
And then if there if no one has the ability to gestate or no one wants to gestate, there is the option of having a surrogate. That's also quite expensive.
And then if there is someone that can gestate a child, there's IVF and IUI and those also are very expensive and not all insurance plans cover.
[Beth] Yeah.
[LRM] And it's just, it's, there are, for couples where there can't be a surprise baby. There's really a lot of steps and a lot of really intense emotion around family planning. And that being said, we also have research that shows that children of same-sex couples tend to be better adjusted, tend to do really well in school. They know they are very wanted, and they were very intentionally brought into the world and their outcomes socially and developmentally are really good.
[Beth] Yeah.
[LRM] And then there's just the last issue around family planning and parenting is navigating the school system.
[Beth] Yeah.
[LRM] There can be a lot of discrimination and some stumbling blocks there and hopefully couples are not met with that, but discrimination is a reality of the world we live in.
[Beth] Yeah. I mean, I, I just think about how many additional obstacles, same-sex couples face, or couples within this community, right? Okay, so now we have to not just even the getting pregnant, but then after the baby's here, then I just am picturing some maybe or maybe not well-intentioned people that then ask intrusive questions.
[LRM] Yeah. Absolutely.
[Beth] What are we supposed to do with that, Laurel?
[LRM] Well, I think that if you as a therapist, you're not sure where to start. If you are wanting to be clear on specific logistics around family planning, you can ask a very broad question. You can say, you know, what have you two discussed and planned around family planning? And then they'll be like, oh, we're going to adopt. Okay, great. Then we don't need to talk about medical issues, right?
[Beth] Yeah.
[LRM] Often LGBT people, particularly trans people are really reduced to body parts or a stereotype of being hyper sexualized. And sex and our specific body parts and ability to gestate or not, is really not the most interesting part about the LGBT community, like everyone in the world has a body and every most people in the world are sexual. So the fact that the community often gets reduced to either being hyper sexual or this fixation on genitals or how people have sex. That's really dismissive of much broader issues.
I mean, the emotional journey of bringing a child into the world is intense for most people. Even if you don't have medical or legal, logistical challenges around family planning. So it's really not our business to be asking medical questions as a therapist. If they are relevant to the therapy, the client will tell you.
[Beth] Yeah, I love that. I love that. That's great.
[LRM] So the next thing that's a little bit different, a lot different with LGBT couples is there are no predetermined gender roles. Right? Now, I've heard some really cringy stories about therapists saying, "Okay, so which one of you is the man?"
And it's like, "Well, either we're both the man or that's not the point, being in an LGBT relationship can be incredibly liberating because you get to self design."
[Beth] Yeah.
[LRM] Who takes care of certain elements of the relationship, right?
Now, in most relationships, there is going to be one person who maybe takes on the car maintenance and one person who does the grocery shopping and one person who does maybe a little more of the domestic labor. But that never has to fall across gender lines.
And in an LGBT relationship, you get to really decide, "Okay, who's going to take care of what?" It's a very silly example, but in my relationship, my job is to kill the spiders.
[Beth] Yeah.
[LRM] Right? And so that's one small, never time-consuming thing.
But in an LGBT relationship, there needs to be really clear intentional conversation around how just the tasks of daily living get divided up. And that there isn't any resentment coming up there, that there isn't a default to one partner or the other, because in all couples, there should be no default.
[Beth] Yeah.
[LRM] Sadly, there is, but that's one element that is different and in some ways, much better than in straight relationships.
[Beth] Well, I can imagine, you know, even...I'm just even thinking about conversations I've had with either clients or people in my personal life, where my bias, right, because we are continually flooded with gender norms, right? Like, this is what this gender does, this is what this gender does, like in our culture.
And so I think this is such a good reminder for all of the therapists listening to make sure you fix your face, make sure you realize, like, you know, very intentionally when you are talking about, you know, the everyday sort of things. That we're not letting our biases just sort of creep out, you know, unintentionally.
[LRM] Yeah, yeah. There's a great book called Fair Play by Eevrodzky, and I believe it is intended more for straight couples, but anyone can read it. And it really is about, like, how do you get rid of these programmed gender roles around who does what in a household and actually create a life that both partners really love?
[Beth] Yeah.
[LRM] Right, how do you divide up the emotional labor of building a life with another person? And if that includes children, the tasks quadruple, right? And we don't want it to default all to one partner. So Eevrodzky's book, Fair Play, and there's also a card game that she has that goes with it, gives people tools for, like, how do we scrap everything that we've been programmed?
And just, like, you know what? Actually, I really love doing the car maintenance. So I'm going to do that even if I am a woman in a straight relationship.
[Beth] Yeah.
[LRM] You know, why does it have to be one partner over the other? It doesn't.
[Beth] Yeah. And I mean, I love bringing up kids, you know, that I would love for my own kids to realize that it doesn't have to be the way the world sort of tells us it's supposed to be.
[LRM] Yeah.
[Beth] I would love to show them other ways.
[LRM] Yeah. Design your own life. That's right. That's right. Yeah.
[Beth] Yeah. That's great. Okay. We're on number five. I'm keeping track.
[LRM] Okay. So, so I think the last couple here are family of origin issues. If there has been any family rejection or in lack of acceptance, this can strain the relationship because it tends to come up and be most noticeable during times that are supposed to be most joyful. Yeah. So…weddings, holidays, holidays, celebrations, and around grieving and end of life.
And that can make joyful holidays, tinge with a bit of sadness and a reminder of loss or rejection and can make, you know, tragic holidays and grieving processes even more painful. So it really does color the experience for some couples. And again, not all couples are going to deal with all of these issues.
[Beth] Yeah.
[LRM] But it's something to keep in mind.
[Beth] I think that's great. I love that you even, you know, you frame it around this idea that, you know, these issues may be present all the time. Right. And it comes back to the coming out process that we talked about at the beginning here. But yeah, these moments, these, you know, significant events with our family of origin. They're supposed to be fun and nostalgic and connecting and then it's like, well, this may be, it may feel kind of unfair that these things come up again during these supposed to be joyful times.
[LRM] Absolutely. Yeah.
And that's a perfect segue into the, the final element that's different. And that is the presence of homophobic violence and internalized homophobia. So homophobic violence is everything from slurs to being discriminated against, you know, not getting a job or even being physically assaulted.
LGBT couples continue to face risk of blatant homophobia, unprovoked violence. And as much as it would be great to say, oh, yeah, homophobia went away with the marriage equality when that became a reality in the US—It simply did not go away. The same way racism didn't go away when we elected our first black president.
[Beth] Right. Right. Right.
[LRM] It's very much alive. And when you have experienced that or even just heard about it throughout your whole life, people often start to internalize the homophobia. So there can be shame, there can be fear, there can be a real conflict within the self that then bleeds out into the relationship where you maybe don't treasure your partner as much because they're a constant reminder that you are and feel different.
And that can be in at some levels really toxic to a relationship when someone has an element of internalized homophobia. So that's something to be on the lookout for. And if you're a therapist and that's coming up, you might encourage a partner to get individual therapy or maybe do some trauma processing to really address that internalized homophobia because it's going to strain the relationship.
And again, not all LGBT couples have to deal with this, right? There are some people who have worked through that internalized homophobia or they have had a traumatic incident of violence and they have processed that trauma and they are okay now.
So all of these are things to keep in mind, but don't apply, don't apply to all couples.
[Beth] Yeah, it doesn't mean that all six of these things, we've got to do all of them in order and can't get passed, you know. But they're all just things to kind of keep on the radar as part of an LGBT couples therapist.
[LRM] Yeah, and you know, if you're a therapist, not have your client educate you broadly, but really educate you specifically on their experience. And if you're a client and you're feeling like, “God, I'm spending so much time explaining these basic concepts to my therapist”, well, you might want to actually find someone who is more experienced with LGBT couples, right?
[Beth] Yeah, I think that's, I think that's great. I know the research that we have on sort of client therapist matching, says that for the most part, it really, it doesn't have to be, you know, you don't have to directly identify in all the exact same ways, right?
And our identity as a therapist doesn't have to directly match the identities of our clients.
[LRM]No.
[Beth] It's really about the connection you have with that individual therapist, that individual client, right?
It's like a goodness of fit doesn't have to be exactly the same.
[LRM] Absolutely.
[Beth] I'm wondering if, you know, you're, we have someone listening who's like, yeah, I'd really love to have an LGBT couples therapist: How would they go about finding them and does the therapist have to be within the LGBT community?
[LRM] Yeah, great question. So no, I don't think they need to be within the LGBT community. In my practice, Laurel Therapy Collective, we have a clinician who is not a member of the LGBT community. And she does incredible work with LGBT couples and it is one of her specialties. And she has, you know, the right amount of cultural humility and experience and training that she really is, honestly serving the community really beautifully.
[Beth] And if you are looking for like, where do I start looking for a therapist?
[LRM] One of my favorite directories is Therapyden.com. Therapy Den is a more progressive option compared to the psychology today is it's not quite progressive. And you can actually filter by therapist identity if that's something that is important to you.
Like you said, it doesn't, you do not have to have an LGBT therapist. But if that's something that's really important to you, then you deserve that, right?
So Therapy Den is a great place to look. There's also Inclusive Therapists is another directory listing. And that also that directory listing also caters specifically to people of color. So if you're looking for a LGBT person of color therapist, that intersectional identity, that would be a good place to look as well.
[Beth] That's great. That's really helpful. And, you know, clients should get to choose.
No, it will matter to some folks that, you know, my therapist is in the community. It matters that they're a Christian. It matters that they are, you know, they identify as a male. Like, you know, I think, you know, we often allow clients to choose some pieces of that, right?
[LRM] That's right.
[Beth] Why wouldn't this matter also? Why wouldn't we let clients choose there also?
[LRM] Yeah, absolutely.
[Beth] That's great.
[LRM] I wanted to briefly talk about some ways that LGBT couples therapy is the same.
[Beth] Yeah, that's great. Yeah.
[LRM] But the, I already talked about the common pitfalls, those four horsemen, right? Yeah.
You're also going to run into the same issues around the transition out of the honeymoon phase into companion that love. That can be really rocky and people can be like, “oh my gosh, I'm not feeling that passion, that spark all the time”. That must mean there's something wrong. “I thought this person was, you know, perfect.” “We would never have problems and now we're having conflict.” And that transition from the honeymoon phase to companion that love, it can be rocky. It's also really normal. Yeah.
So LGBT couples experience that in a very similar way and often it's similar kind of similar time anywhere from six months to two years into a relationship that you would experience that.
And then the basic modalities of how a therapist would work with a couple, the three kind of big ones are Gottman couples therapy, EFT, which stands for emotion-focused therapy in the couples setting, which is the work of Sue Johnson.
And then Imago couples therapy is another modality. It's lesser used, but still very much present.
If you're looking for a couples therapist, you do want someone that probably has training in one of those three.
[Beth] Yeah, one of those three. Okay, that's great.
[LRM] Those are the ones. The first two are evidence-based. So like really have some research behind them that showed that they're effective. And Imago is in the process of being kind of evidence-based. They're in that process.
[Beth] That's great. Anything else you wanted to share before we sign off?
[LRM] I think that's about it, but if you are wondering if couples therapy is right for you, if you're looking, and you we have a little quiz on our website.
And that is laureltherapy.net/couples.
And there is a quiz there that you can take that kind of will tell you how you're doing. And if therapy might be a good fit for you. And while you're there, you can look at some of our resources because we've got a lot of content about couples therapy.
And maybe if couples therapy isn't something you want to access right now, or there are certain roadblocks to it, you can still get some good information there.
[Beth] I love that. I was going to end with asking you to tell people how they can find you.
And you did it on your own. We didn't even plan that.
[LRM] Laureltherapy.net.
[Beth] I love that. I am so grateful that you came and shared all of these things.
I mean, all of these points, I mean, I took two pages of notes and I will definitely be sure to kind of share these notes as sort of an outline for folks. But then also link to all of the resources that you also shared because I think there may be listeners who are like, oh, I really want to do that quiz or oh, I'm really not sure.
Even therapists who are listening to say, I really want to look into some of these things. And so you coming today has just been so invaluable. So thank you so much for saying yes to being here.
[LRM] Absolutely. Thanks so much for having me and happy Pride Month.
[Beth] That's it. I love it. I'm so glad it worked out that this, that we could get together.
[LRM] All right. Thanks so much.
[Beth] All right. We'll talk to you next time.
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