Please Don't Affirm Me

I take issue with affirming care. Generally, it's seen as the standard for compassionate, evidence-based treatment for those struggling with their sexual identity. The problem isn't that it's meant to depatholgize, promote kindness, or reduce stigma (those are good things). I’m against it because – from what I’ve lived and observed – it’s ineffective for those of us who don’t want to build our lives around same-sex attraction; it’s actively damaging. And I can think of at least three reasons why.

First, affirming care skips the root cause of our distress. When someone struggling with their sexuality meets with an affirming therapist, often times themes of shame, loneliness, or confusion are explored. The affirming approach is meant to help replace shame with acceptance, and to address the pain caused by stigma and rejection. It’s gentle in the moment, but misguided at best.

Affirming care does not dig into why those feelings are showing up. In my opinion, same-sex attraction often points to deeper emotional wounds — unmet needs for healthy same-sex connection, past hurts, or even just seasons of stress and isolation. It's the difference between viewing those attractions as an emotional barometer versus an identity to celebrate.

Affirming care coddles the feelings without asking the hard questions, like 'how do I feel about myself when I experience this?' or 'what’s going on in my emotional life that might have triggered these feelings?' Instead, it shifts the blame outward — suggesting that the root of one's emotional distress is an unaccepting society. We’re basically told, 'there’s nothing wrong with you; it’s the world’s fault.' Which in turn ends up molding a generation of people to be angry and bitter at everyone else. Real growth, and the personal satisfaction that comes from it, comes from owning what’s inside and working with it.

That leads straight into my second point: affirming care is more about advocacy than therapy. It’s built on an ideology that says same-sex attraction must be affirmed as innate and unchangeable. This means clinicians end up acting like activists, steering the client toward their predetermined conclusion instead of exploring what the individual actually wants. Law and ethics state that therapists aren’t supposed to impose their own values¹. But that’s exactly what happens here.

If I were to walk into a clinic trying to find someone to help support me with my unwanted same-sex attractions, I would more than likely be told that I have 'internalized homophobia' that needs to be unlearned. In short, affirming care disregards personal values, faith, agency, and a vision for marriage and family. They all get sidelined. And in doing so, personal agency gets stolen too — because the solution hinges on external validation, not internal work.

But I think the opposite is true: when I take ownership — through things like mindfulness, noticing my thoughts without judgment, or addressing old wounds through counseling — I actually gain control. And relief. The attractions don’t vanish overnight, but they lose their grip. And affirming care, by design, discourages that kind of agency.

Finally, and most importantly, affirming care does more harm than good. Let's look at the bigger picture. As affirming care has become the dominant approach, have we seen distress levels drop? No. Suicide attempts, depression, and anxiety among those with same-sex attraction remain at all-time highs². Yet, most of us live in a society that has never been more tolerant or accepting.

It can’t just be society’s fault. Perhaps it’s because we’re treating the symptom while ignoring the cause. In medicine we call this iatrogenic harm: treatment that actually makes the problem worse. Affirming care feels kind, but it ends up cruel and callous. It leaves the most vulnerable people — the ones desperate for real relief — trapped in a never-ending loop of validation that never satisfies.

I’m not suggesting the old ways of treatment were any better. Shame and repression only created more isolation. What I am saying is there’s a better middle ground: one that’s honest about the pain, curious about its roots, and committed to growth. For me, that’s meant seeing same-sex attraction not as an immutable identity, but as a signal that reflects my own internal state.

To summarize, the critique I'm making about affirming care is this:

• It skips the root causes of our distress, choosing validation over exploration.
• It functions more like advocacy and ideology than client-centered therapy, which can quietly rob us of personal responsibility.
• It does more harm than good by leaving the deeper work undone, so distress often stays high instead of dropping.

If you’re reading this and struggling, please know you don’t have to choose between self-hatred and full affirmation. There’s room to be honest about what you’re experiencing. And in my opinion, that's the best place to start.

Update 3/31/26: While I was editing this, the U.S. Supreme Court just handed down a ruling in Chiles v. Salazar that is especially relevant to our discussion. The Court decided that Colorado cannot ban therapists from offering talk therapy to help people who are struggling with unwanted same-sex attractions and want to explore where those feelings are coming from. In an 8-1 decision, the justices ruled that forcing counselors to only provide 'affirming care' and prohibiting other approaches violates the First Amendment.

This is great news. It protects the freedom for therapists to meet clients where they actually are — supporting their personal values, faith, and goals rather than pushing them toward a single, predetermined identity. For those of us seeking change instead of validation, the ruling helps create space for the approach I'm describing. And now it's legally safeguarded. Huge win.

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1) American Counseling Association. (2014). 2014 ACA code of ethics. https://www.counseling.org/docs/default-source/default-document-library/ethics/2014-aca-code-of-ethics.pdf

2) Wittgens, C., Fischer, M. M., Buspavanich, P., Theobald, S., Schweizer, K., & Trautmann, S. (2022). Mental health in people with minority sexual orientations: A meta-analysis of population-based studies. Acta Psychiatrica Scandinavica, 145(4), 357–372. https://doi.org/10.1111/acps.13405