Introduction
So many parents who contact me about this start by apologising for not knowing the right words.
You don’t need the right words. You need to be someone your teenager can talk to, which is a lower bar than it feels like, and a far more important one.
Psychological support for LGBTQI+ teens – young souls blossoming into themselves – isn’t about a therapist deciding anything on your child’s behalf. It’s about giving a young person somewhere to do the ordinary work of adolescence, which is figuring out who they are, without having to do it alone or in secret.
Why Identity Questions Are Harder
Every teenager is working out who they are.
What’s different is the audience. A teenager who is questioning their sexuality or gender is doing that developmental work while also calculating who is safe to tell, what happens at school on Monday, and what their grandmother will say at Christmas. That constant background arithmetic is exhausting, and it’s happening on top of everything else adolescence already asks of them.
This matters for how we read the research. The higher rates of anxiety and low mood among LGBTQI+ young people aren’t caused by who they are. They’re caused by what happens around it: rejection, bullying, hiding, and the effort of constant vigilance.
Which is genuinely hopeful, because the things that cause the harm are things adults can change.
The South African Picture
We finally have local data. A study published in the South African Journal of Psychiatry looked at young people attending a Western Cape gender service, the first research of its kind on the continent.
Almost two thirds had a co-occurring mental health difficulty. Nearly a third had experienced suicidal thoughts. More than half had been bullied.
One more finding is worth knowing. A quarter of the trans male participants were autistic. Neurodivergence and identity questions overlap far more often than most parents are told, and a teenager navigating both is doing two difficult things at the same time.
South African law is among the most protective in the world. Daily life in a Cape Town school is a separate matter, and your teenager knows the difference.
What Parents Can Actually Do
The single most useful finding in this whole field is also the simplest. Research by The Trevor Project found that LGBTQ young people with at least one accepting adult in their life were 40% less likely to have attempted suicide in the past year.
One adult. It doesn’t have to be a parent, although it helps enormously when it is.
In practice, that looks like:
- Following their language. Whatever name or pronoun they’re using, use it. You can get it wrong, correct yourself and move on. Effort reads as love.
- Not asking them to be certain. Adolescence is a first draft. A teenager who is allowed to be unsure is far more likely to keep talking to you.
- Never outing them. Who knows, and when, is their decision, including within the family.
- Keeping the ordinary things ordinary. Lifts, supper, arguing about the dishes. Teenagers need to be treated as a whole person and not a situation to be managed.
- Getting your own support. If you’re frightened or grieving a version of the future you’d imagined, that’s understandable, and it belongs somewhere other than in front of your child.
What Therapy Actually Looks Like
Let me be direct about what it isn’t. Affirming therapy doesn’t push a young person towards any conclusion about their identity. Anything that sets out to change a person’s sexual orientation or gender identity is harmful and has been rejected by every credible professional body in the world.
What the work usually involves is much more ordinary than parents expect. Somewhere to think out loud without managing anyone else’s reaction. Support with anxiety, low mood or sleep. Practical thinking about coming out, or not, and to whom. Repairing things at home when a conversation has gone badly. And building a sense of worth that holds when school is unkind.
I also see parents, sometimes on their own and sometimes alongside their teenager, because a family working this out together tends to get somewhere better than either side managing it separately.
And you don’t have to wait for a crisis to book. Most of this work is easier earlier.
Local Support
Triangle Project in Observatory offers counselling, support groups and, importantly, help for parents trying to understand their child. They’re on 021 422 0255. Gender DynamiX, also Cape Town based, works specifically with trans and gender diverse people and their families.
If your teenager is in immediate distress, SADAG’s 24-hour suicide crisis line is 0800 567 567.
Conclusion
Your teenager isn’t asking you to understand everything. Most of them have already decided you won’t, entirely, and they’ve made their peace with that.
They’re asking whether they’ll still be loved in the same way afterwards. That question gets answered in small, unremarkable moments rather than in one big conversation.
If you’re not sure how to start, that’s a perfectly good reason to come and talk it through.
About Me
I am Paula Marais, a registered specialist wellness counsellor based in Claremont, Cape Town. I hold an Honours in Psychology (Unisa) and a Master’s in Creative Writing (UCT), and I am registered with the Association for Supportive Counsellors and Holistic Practitioners (ASCHP).
I see adults, teenagers and children, in person in Claremont and online across South Africa. Online sessions are equally as effective as in-person sessions.
There is no pressure and no judgment. You can reach me at info@paulamaraistherapy.com or on WhatsApp at 072 633 7661.
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