LGBT people enter therapy for help with the same clinical and life issues that heterosexuals do – anxiety disorders, depression, grief, relationship difficulties, work dissatisfaction, etc. This population also has concerns that heterosexuals generally do not, including shame relating to sexual orientation, fear of losing friends and family if they “come out.” Some of the presenting issues of LGBT people have little to do with their sexual orientation while others will be intimately connected to their LGBT identity. Even when a patient’s chief complaint seems apparently unrelated to being gay, issues of sexual orientation are likely to play a role in how treatment may unfold. Consequently, a therapist is needed with specialized knowledge in order to be most helpful to the patient. This therapist has extensive experience and knowledge of the myriad of issues facing this population.