From secrecy to discretion: The views of psychological therapists' on supporting Chinese sexual and gender minority young people

Objective Little is known about how to best meet the mental health needs of sexual and/or gender (SG) minority young people who are also an ethnic minority (i.e., double minority youth). We aimed to explore the views of mental health providers (hereafter ‘therapists’ for brevity) on the needs of Chinese SG minority youth in a Western nation (New Zealand) and the therapeutic approaches to best address these needs. Method Semi-structured interviews were conducted with eight therapists (including medical practitioners, counsellors, a psychotherapist, and a social worker). All were providers of talking therapies or counselling, experienced in working with Chinese and/or SG minority youth. A general inductive approach to qualitative data analysis was used to identify themes. Results Four categories of mental health needs emerged. These were needs for love and acceptance; migration and Chinese cultural needs; managing cis-heteronormativity and coming-out needs; and intersectional needs of ‘double rejection’. A ‘double-minority-specific’ therapeutic process was identified. This process suggests therapists successfully engage young people through three phases of therapeutic engagement: from exploration of a SG minority orientation; via segmentation of identity and cautious coming out practice; to a sense of accepted and managed, but often discrete identities. Dimensions of therapy to support Chinese SG minority youth prioritized relational, individually-tailored, holistic approaches that attend to potential barriers. Conclusion The results suggest that therapists perceive intersectional challenges for Chinese SG minority youth in a Western context. Tailored therapeutic approaches are advocated to support double minority young people