Care Without Conditions: Rethinking Who Gets a Seat on the Couch

Accessible mental health care is something I care deeply about. Everyone deserves support that feels safe, respectful, and free of judgement, yet many people still face barriers when trying to access it. In my work, many of the people I’ve supported are members of the 2SLGBTQ+ people and/or sex workers, who often encounter stigma or limited options for affirming care. There are many other groups who also remain under-served, and this continues to shape how I think about my role as a therapist. My approach is grounded in the belief that care should meet people where they are and recognize the full complexity of their experiences and identities.

Rethinking Who ‘Deserves’ Care

When we ask who deserves support, the honest answer is everyone, yet access to mental health care is far from equal. Many people continue to face financial, social, and systemic barriers that make it difficult to find consistent, respectful support, and for marginalized communities, these barriers are often even greater. As a psychotherapist and registered social worker, I believe that care should not depend on privilege or circumstance, but rather that everyone should have access to therapy that is safe, affirming, and grounded in understanding.

In my practice, I have considerable experience working with 2SLGBTQ+ people and sex workers, and both of these groups often face overlapping challenges that impact mental health, including stigma, discrimination, and instability. Yet, too often, mental health professionals approach these communities as if they are uniform groups with shared needs and identical experiences, which can lead to care that misses the individuality of each person and fails to see the full picture of who they are.

Understanding the Diversity Within Communities

There is no single 2SLGBTQ+ experience. For example, a nonbinary person navigating family rejection, a queer newcomer facing cultural barriers, and a trans person seeking safety at work each carry different stories, strengths, and needs. While many clients I’ve worked with identify as 2SLGBTQ+, none of them have had the exact same lived experiences, need, or perspectives, but approaching therapy in a way that embraces and affirms queerness as an important part of someone’s identity and experiences can be crucial.

The same can be said of my experience working with sex workers, whose lives, experiences, and reasons for doing their work are incredibly diverse. Each person brings their own story, shaped by many intersecting parts of who they are. As a therapist, my role is not to judge or make assumptions, but to offer a space where people can feel seen, respected, and supported in whatever they choose to share. For many, their work may not be the central part of their identity (as with any career), and therapy is a place where all aspects of life and self can be explored with care and without stigma.

For both of these communities, there are undeniable elements of these identities that can be incredibly challenging to hold and navigate, but this also does not mean that these identities are necessarily central to their reasons for seeking mental health support. In fact, for many of my clients, these identities may not be central elements of our work together, but rather, can be important lenses in understanding their experiences, perspectives, and unique challenges they may encounter.

One of the most important elements of finding a therapist is finding someone you can be comfortable with, be your whole self, and to be able to speak openly without feeling pathologized or ashamed. Instead, I believe that respectful care starts with curiosity and a willingness to understand the nuances of each person’s experience, without judgement or assumption.

A Commitment to Compassionate, Individualized Support

Accessible therapy matters because it allows people to be seen in their full complexity. It gives space for healing that recognizes the intersection of identity, experience, and circumstance. When care is individualized and inclusive, it can help people feel grounded, valued, and capable of change on their own terms.

In my experience working with these communities, I have seen such incredible resilience and insight. My role as a therapist is not to define their experiences but to listen and to support their process in ways that reflect who they truly are. I believe everyone deserves care that respects their individuality and honours the many parts that make them whole.

If you are looking for a space where your experiences are respected and your whole self is welcome, I invite you to reach out, and together, we can explore what support looks like for you and work toward healing that feels authentic and sustainable.