LGBTQ+ Affirmative · San Francisco
LGBTQ+ affirmative therapy
for San Francisco.
Your story matters here, and it gets treated that way. Our therapists are curious and collaborative, and the work is about your actual life: the relationship, the body, the family, the medical paperwork, the history, whatever is in the room. Whether you're queer, trans, nonbinary, ace, navigating polyamory, or somewhere in the middle of figuring it out, we meet you where you are. LGBTQ+ affirmative therapy for San Francisco, via secure telehealth.
Identity-aware therapy for queer, trans, nonbinary, and non-monogamous individuals and couples. Led by clinicians with formal LGBT-Affirmative and Trans Issues training.
Who we see in San Francisco
Specificity, not a template.
Good therapy for queer, trans, and non-monogamous clients is specific. We bring that specificity through how we work. We ask about your actual life rather than assuming based on your identity category. We match you with the therapist whose training fits what you're actually working on. We hold minority stress as clinically relevant without making every session about it.
What we don't assume: that the reason you're here is your identity. The breakup might just be a breakup, the anxiety might not be about being queer, a conflict with your parents might be about them, about homophobia, or both. We work whichever it actually is.
We see queer couples working on communication and intimacy, trans and nonbinary clients working on life transitions and trauma, polyamorous configurations working on jealousy and metamour dynamics, adults figuring out gender or orientation later in life, and BIPOC LGBTQ+ clients carrying layered family and cultural weight. Therapy here is collaborative and curious: you're the expert on your life, and we bring the clinical skill.
We work with clients across all San Francisco neighborhoods and anywhere else in California via secure telehealth.
How the work goes
Curious and collaborative.
The frameworks we draw from are the ones any thoughtful practice uses: Gottman and EFT for couples, EMDR and IFS for trauma, narrative therapy, ERP for anxiety and OCD, sex therapy. What matters for queer, trans, and non-monogamous clients is how those frameworks get applied. We personalize. We assume you're the expert on your own life. We bring the clinical skill to what you're actually working on.
For couples and polycules, the work is inside your relationship, not about its shape: communication, attachment, conflict, intimacy. For individuals, we work what you came in for, including anxiety, trauma, depression, life transitions, identity, and relationships, with cultural and identity context held as part of the clinical picture.
Outside reading we'd recommend: The Trevor Project for crisis support for LGBTQ+ youth, and the AAMFT LGBT-Affirmative Therapy consumer page.
Who you'd work with
The team for San Francisco LGBTQ+ clients.
Christina Mathieson
Licensed Marriage and Family Therapist (LMFT) #115093
Founder. Holds LGBT-Affirmative Therapy Certificate (AAMFT), Trans Issues Certificate, and comprehensive sex therapy training. Couples, individuals, sex therapy.
Full bio
Michelle Cortez
Registered Associate Marriage and Family Therapist (AMFT) #146795
Supervised by Christina Mathieson, LMFT #115093
Particular focus on ethical non-monogamy, polyamory, queer relationship structures. Couples work via EFT and attachment. Anxiety/OCD work via ERP.
Full bio
Jalyse Stewart
Registered Associate Marriage and Family Therapist (AMFT) #153712
Supervised by Christina Mathieson, LMFT #115093
Trauma-informed work for BIPOC LGBTQ+ clients carrying layered identity, family, and intergenerational weight. EMDR-focused and IFS-informed, with somatic practices in the toolkit.
Full bioFAQ
Common questions from San Francisco LGBTQ+ clients.
What training do your therapists have for LGBTQ+ clients?
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We've done the specific training. Christina Mathieson, LMFT #115093, holds an LGBT-Affirmative Therapy Certificate from AAMFT and a Trans Issues Certificate. Michelle Cortez, AMFT #146795 (supervised by Christina Mathieson, LMFT #115093), works particularly with ethical non-monogamy and queer relationship structures. Jalyse Stewart, AMFT #153712 (supervised by Christina Mathieson, LMFT #115093), brings specific care to BIPOC LGBTQ+ clients. The training does real work here. It shapes how we listen, what we ask, and what we're prepared for before you walk in.
Do you work with non-monogamous and polyamorous clients?
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Yes. Michelle Cortez, AMFT #146795 (supervised by Christina Mathieson, LMFT #115093), specializes in this work. We're familiar with the patterns that tend to come up in poly relationships: jealousy and compersion, scheduling and capacity, metamour dynamics, hierarchy negotiations, NRE, and the relationship-structure work that monogamous couples don't face. We can go deep on the structure when it's relevant to what you're working on, and leave it alone when the actual issue is something else entirely.
What do you work on with trans, nonbinary, and gender-expansive clients?
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The same things we work on with any client: anxiety, trauma, depression, relationships, life transitions, the parts of yourself you're still figuring out. What shifts for trans clients is the context. The specific weight of dysphoria, family dynamics around your transition, navigating medical care, work pressure, and the cumulative cost of being scrutinized. We work the clinical presentation with that context in mind, not as a separate subject. Christina holds a Trans Issues Certificate, and the team is trained in trans-affirming practice.
What if I'm questioning and don't have a label yet?
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Welcome. You don't need to know what you are before you start therapy. A lot of the work for adult clients exploring orientation, gender, or relationship structure is exactly that: the work of figuring it out, in a room where the question itself is held respectfully and without an agenda. We're not going to push you toward a conclusion or pull you away from one.
Do you work with LGBTQ+ clients of color?
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Yes. Jalyse Stewart, AMFT #153712 (supervised by Christina Mathieson, LMFT #115093), brings particular care to BIPOC clients carrying the layered weight of identity, family, and intergenerational pattern. The whole team is trained in cultural responsiveness. Cultural context is treated as clinically relevant, and we work with it directly.
References & further reading
- The Trevor Project — crisis support for LGBTQ+ youth — The Trevor Project
- APA Guidelines for Psychological Practice with Sexual Minority Persons — American Psychological Association
- APA Guidelines for Psychological Practice with Transgender and Gender Nonconforming People — American Psychological Association
- AAMFT — LGBT-Affirmative Therapy resources — AAMFT
Ready for a room where the work is actually the work?
Free 15-minute call. We'll figure out what you're working on, who on the team is the best fit, and where to start.
Book a Free Consult