Queering Mental Health: Microaggressions, Diagnosis, and Culture
Mental health care is never neutral. For queer people, the therapy room can be a place of healing, or a space where microaggressions, bias, and outdated diagnoses cause harm. I recently sat down with Dr. A. Jordan Wright, Clinical Associate Professor at NYU and a leading expert in psychological testing, to talk about how microaggressions, diagnosis, and cultural competence intersect in therapy.
The Hidden Weight of Microaggressions
Dr. Wright explains that microaggressions can be both conscious and unconscious, and they often go unnoticed by clinicians. These everyday slights or assumptions can compound over time, reinforcing minority stress and leaving queer clients feeling unseen or pathologized. Research shows that microaggressions in therapy undermine trust and therapeutic alliance, which are essential for effective treatment (Sue et al., 2007).
Diagnosis as Liberation and Limitation
One of the most compelling parts of our conversation was Dr. Wright’s reminder that diagnoses are social constructs that evolve over time. The DSM criteria change with cultural values, which means diagnoses can both empower and constrain. For queer clients seeking clarity around ADHD, autism, or mood disorders, a diagnosis can provide validation and access to resources. But without cultural competence, those same labels can reinforce stigma. As Dr. Wright has written, “psychological assessment must be grounded in cultural awareness to avoid misuse and harm” (Wright, 2019).
Cultural Competence and Queer-Affirming Therapy
Cultural competence is more than just knowing the right terminology, it is about humility, curiosity, and adapting care to fit the lived experiences of marginalized people. Dr. Wright’s book Essentials of Culture in Psychological Assessment emphasizes that culture cannot be an afterthought. It must guide every stage of testing and treatment (Wright & Lopez, 2020). For queer mental health, this means asking about identity, community, and systemic barriers as part of any evaluation.
Training the Next Generation
Dr. Wright also spoke about the responsibility of training future clinicians. Beyond learning diagnostic criteria, he believes graduate programs must teach cultural humility, advocacy, and the active use of privilege to support marginalized communities. His edited volume Essentials of Psychological Assessment Supervision highlights how supervisors can embed these practices in training (Wright, 2020).
Moving Toward Queered Mental Health
Queering mental health means pushing beyond checklists and labels to recognize how power, culture, and identity shape our wellbeing. For clinicians, it means integrating cultural competence into every diagnosis and therapeutic decision. For queer clients, it means knowing you have the right to therapy that sees you fully, not as a diagnosis alone, but as a whole person.
Take the Wright-Constantine Structured Cultural Interview (WCSCI) for insight into how your experiences have shaped who you are:
https://steinhardt.nyu.edu/sites/default/files/2023-08/WCSCI%20FINAL-2023.pdf
References and Studies Used in this Blog Post:
Sue, D. W., Capodilupo, C. M., Torino, G. C., Bucceri, J. M., Holder, A. M. B., Nadal, K. L., & Esquilin, M. (2007). Racial microaggressions in everyday life: Implications for clinical practice. American Psychologist, 62(4), 271–286. https://doi.org/10.1037/0003-066X.62.4.271
Wright, A. J. (2019). Conducting psychological assessment: A guide for practitioners. Wiley.
Wright, A. J., & López, S. J. (2020). Essentials of culture in psychological assessment. Wiley.
Wright, A. J. (2020). Essentials of psychological assessment supervision. Wiley.
