Empathy in Action: Supporting LGBTQ+ Resilience
Julio J. Fonseca
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The highest expression of empathy is accepting and non-judgmental.”. Carl Rogers
“Empathy is the most radical of human emotions.” Gloria Steinem
As the geopolitical climate in the United States continues to narrow its focus on the progressive dehumanization of marginalized communities, I find hope in the small victories we can cultivate and embrace within our clinical work—moments of connection, safety, and affirmation that sustain us and our clients. As the world outside the therapy room feels increasingly stark, and with the persistence of systemic oppression, extending empathy can be vital in providing safety in our work with LGBTQ+ individuals.
The topics for this column have experienced an ebb and flow connected to current events that impact those in the LGBTQ+ community, whether we work with LGBTQ+ individuals or are members ourselves. June is Pride Month, which began with the first formal Gay Pride in 1970 and arose from the Stonewall Riots from June 28 to July 3, 1969. A police raid at the Stonewall Inn targeted the venue because of its clientele, sparking resistance and riots that lasted several nights (The Editors of Encyclopaedia Britannica, 2025). The images from Stonewall resonate with those we see today as U.S. citizens once again protest the unjust treatment of marginalized communities over 50 years later. LGBTQ+ progress is being directly and visibly undermined, especially during Pride Month.
The lack of a Pride Month proclamation, the removal of the name “Harvey Milk” from the USNS Harvey Milk vessel, and the Department of Education’s announcement that June will now be recognized as “Title IX Month”—framed as a celebration of women’s educational achievements—are not isolated actions. Together, they indicate a coordinated effort to erase LGBTQ+ visibility and foreshadow potential policy targeting. Here we are again/still. The impact of these actions, which aim to “other” and dehumanize, can feel heavy and disheartening. It is crucial to recognize the weight this carries for members of the LGBTQ+ community and how it may directly affect the nature of our work with these individuals.
Resilience is often used to describe the LGBTQ+ community; however, discussions surrounding it frequently overlook how resilience is cultivated. Research suggests that empathy may play a role in resilience for LGBTQ+ individuals. While Mandracchia et al.’s (2023) scoping review of research on LGB individuals did not find a consistent definition of empathy across the studies examined, common threads indicated that identity integration, introspection, and social support are essential precursors to empathic development. It is also important to acknowledge that invoking resilience isn’t always affirming—being told you’re resilient can feel burdensome when that resilience is continually tested by relentless attacks on one’s identity, which are designed to intimidate and exhaust. Empathy is crucial in supporting marginalized individuals, but we must go further. How can we intentionally create safer spaces, foster strong therapeutic alliances, and use empathy as both a stance and an active tool to ensure LGBTQ+ individuals feel truly seen, heard, and held? To begin, what is empathy?
The Science of Empathy
While previously referenced articles lacked a standard definition of empathy, evidence shows that empathy is not merely a philosophical ideal or therapeutic stance—it is increasingly recognized as a complex neurobiological and psychological process with measurable effects. Neuroscience research has demonstrated that mirror neurons play a critical role in our ability to experience empathy, allowing individuals to neurologically “mirror” the emotional states of others (Iacoboni, 2009). Functional MRI studies reveal that witnessing someone else’s pain activates many of the same brain regions as when one experiences pain directly, suggesting that empathy is deeply embodied. Very cool stuff, right? This biological resonance forms the foundation of emotional attunement, compassion, and prosocial behavior—capacities that are especially vital in therapeutic contexts with marginalized populations. Understanding the science behind empathy provides a framework for cultivating it intentionally, particularly as a potential resilience factor for individuals navigating systemic oppression.
Empathy as a Therapeutic Tool for LGBTQ+ Healing
With emerging science and research revealing the biological function of empathy, how can it be nurtured by clinicians to better support our clients? Wondra and Ellingson (2015) found that counselor trainees often deepened their empathic capacity when working with clients they initially perceived as difficult, suggesting that discomfort, when skillfully supported, can catalyze growth. Empathy must be actively cultivated, especially in work with LGBTQ+ clients whose identities are often misunderstood or marginalized. This development can occur through sustained engagement with diverse clients and reflective, culturally sensitive supervision. Comas-Díaz and Jacobsen (2018) emphasize that clinical empathy, rooted in cultural awareness and humanistic values, becomes a pathway for healing. In LGBTQ+ therapy, where clients may bear deep wounds from invalidation or erasure, empathy serves not only as attunement but also as a reparative presence—a moment of being seen and understood in one’s full complexity.
Empathy is not just a therapeutic stance—it is a foundational element of gay-affirming clinical practice. In a study examining mental health professionals, Love et al. (2015) found a significant relationship between practitioners’ levels of empathy and their engagement in gay-affirming behaviors. These included validating LGBTQ+ identities, confronting heteronormative assumptions, and demonstrating openness to understanding the lived experiences of sexual minorities. The findings suggest that empathy is not merely an abstract quality but a measurable and essential skill that informs ethical and affirming care. For LGBTQ+ clients—many of whom have been harmed by pathologizing or dismissive care—this alignment between empathy and affirmation can foster a corrective emotional experience. It tells clients, “You are not just safe here: you are seen.”
Considerations in the Practice of Empathy
Empathy, while demonstrated as a valuable tool and experience with our clients, has potential costs. Watson et al. (2025) emphasize that therapists may experience empathy fatigue—a form of emotional depletion resulting from the sustained absorption of others’ suffering, particularly when working with marginalized populations. For LGBTQ+-affirming clinicians, this burden is often magnified by the current sociopolitical climate, where they are not only witnessing their clients’ distress but are themselves navigating similar systemic stressors. Epstein (2023) offers a powerful reframe: love, not as sentimentality but as a form of committed presence, can counter burnout. When therapists engage their work with love, defined as attuned presence and ethical dedication, they create relational spaces that are mutually sustaining. In times of escalating hostility toward LGBTQ+ lives, this ethic of presence is not merely reparative—it is radical.
Path Forward
While research on the impact of empathy on the LGB community is emerging, it is both noteworthy and troubling that existing studies pay very little attention to transgender communities. As researchers and clinicians, we must acknowledge this omission and commit to rectifying it. Dedicated, informed research examining how empathy is experienced, cultivated, and challenged within trans experiences of identity, trauma, and healing is not only overdue—it is essential.
Empathy must be cultivated in clinical practice as a natural stance and a sustained, boundary-aware discipline. Supervisory and training frameworks should emphasize reflective practice, cultural humility, and emotional regulation to build sustainable empathy. These skills are especially critical when working with communities under persistent political and social threats, where clinicians may themselves be directly impacted. Empathy in this context becomes more than a clinical posture—it becomes a moral orientation.
The Nature Mental Health (2025) editorial reminds us that during times of escalating anti-LGBTQ+ rhetoric and legislative rollback, affirming care must extend beyond the therapy room. We are called to care and advocate, ensuring our practices resist complicity by refusing silence. In this context, empathy becomes both a reparative act and a strategy of resistance: a means to interrupt erasure through presence and transform detachment into solidarity. Furthermore, empathy can alter the trajectory of our clients’ lives—not only by supporting them in their survival but also by helping them reclaim agency, dignity, and connection.
Love takes off the masks that we fear we cannot live without and know we cannot live within. James Baldwin
References
Comas-Díaz, L., & Jacobsen, F. M. (2018). Ethnocultural empathy in psychotherapy: Promoting presence and attunement. In E. M. Altmaier (Ed.), Best practices in counseling across the lifespan (pp. 45–60). Springer.
Epstein, M. (2023). The Zen of therapy: Uncovering a hidden kindness in life. Penguin Books.
Iacoboni, M. (2009). Mirroring people: The science of empathy and how we connect with others. Picador.
Love, M. M., Smith, A. E., Lyall, S. E., Mullins, J. L., & Cohn, T. J. (2015). Exploring the relationship between gay affirmative practice and empathy among mental health professionals. Journal of Multicultural Counseling and Development, 43(2), 83–96. https://doi.org/10.1002/j.2161-1912.2015.00066.x
Mandracchia, F. J., Raghavan, A., & Gonzales, L. (2023). Empathy as a resilience factor in lesbian, gay, and bisexual individuals: A scoping review. Journal of Gay & Lesbian Mental Health. Advance online publication. https://doi.org/10.1080/19359705.2023.2239725
Nature Mental Health Editorial. (2025). Cultivating community and centering support for LGBT+ mental health. Nature Mental Health, 1(6), 411–413. https://doi.org/10.1038/s44220-025-00455-x
The Editors of Encyclopaedia Britannica. (2025, June 5). Stonewall riots. Encyclopaedia Britannica. https://www.britannica.com/event/Stonewall-riots
Watson, T., Waters, R., Watts, L., & Hodgson, D. (2025). Exploring the challenges of empathy in a therapeutic context: An interpretative phenomenological analysis. Qualitative Health Research, 35(3), 411–423.
Wondra, J. D., & Ellingson, T. J. (2015). The empathic development of counselor trainees working with difficult clients. Counselor Education and Supervision, 54(3), 177–190. https://doi.org/10.1002/ceas.12015.
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