Beyond Stigma: Understanding, Negotiating, and Implementing Queer-Affirmative Mental Health Practice in a Southern Philippine City

Abstract

Aim. Queer-affirmative mental health practice is increasingly recognized as an important approach to supporting LGBTQIA+ individuals. However, little is known about how this approach is enacted in the Philippine context, particularly in Davao City, where progressive legal protections coexist with enduring religious, cultural, and institutional influences. Guided by Langdridge's Gay Affirmative Therapy and the Systems Theory Framework, this study explored how mental health practitioners understand and implement queer-affirmative mental health practice and perceive its therapeutic outcomes among LGBTQIA+ clients. Methods. Using an exploratory-descriptive qualitative design, seven Filipino mental health practitioners participated in semi-structured in-depth interviews. Participants were recruited through purposive volunteer sampling, and the data were analysed using reflexive thematic analysis. Results. Four themes emerged: (a) building affirming therapeutic environments; (b) navigating cultural and ethical complexities in providing affirming care; (c) tailoring integrative interventions to clients' diverse needs; and (d) strengthening therapeutic engagement, trust, and client outcomes. Across these themes, participants described affirmative practice as a culturally responsive, ethically grounded, and flexible process that promotes psychological safety, identity affirmation, and meaningful therapeutic relationships. Conclusions. Queer-affirmative mental health practice in Davao City extends beyond affirming identities by requiring practitioners to navigate the city's sociocultural, religious, and institutional realities while maintaining ethical and client-centred care. The findings provide context-specific insights that may inform practitioner education, professional development, and efforts to strengthen LGBTQIA+-affirming mental health services.