Every counsellor has a moment where a client's needs edge past what they can competently offer. Handling that moment well is a clinical skill in its own right. It is also one that training programs rarely spend much time on. With LGBTQ+ clients, the stakes of getting it wrong are higher than average. A clumsy referral can replicate the exact experience of rejection that may have brought the client into therapy in the first place.
This is a working guide to doing it well.
Scope of competence versus scope of practice
Scope of practice is what your registration permits you to do. Scope of competence is what you can actually do well, based on training, supervision and experience. The two overlap but are not the same, and the gap between them is where referral decisions live.
A registered psychologist in Alberta may be permitted to work with a wide range of adult clients. That does not mean every psychologist is competent to work with a trans client navigating medical transition, a client in a polyamorous relationship structure, or a young adult whose family has cut contact over their identity. Competence here is not about attitude. It is about whether you know the terrain well enough that the client does not have to map it for you.
The honest self-assessment is this: if this client's identity-related context came up in supervision, would I be describing it accurately, or would I be guessing?
Signs a client would be better served by an affirming specialist
You find yourself researching terminology after sessions to keep up.
The client is spending session time explaining their community, relationships or identity rather than working on their presenting concern.
The client's needs touch systems you do not know how to navigate: gender-affirming care pathways, legal name and gender marker changes, workplace disclosure protections.
You notice your own discomfort, and it is shaping which topics you follow and which you let pass. Our post on countertransference looks at how a therapist's own reactions can shape the work.
The client has asked, directly or indirectly, whether you have worked with people like them, and your honest answer is "not really."
None of these means you are a poor counsellor. They mean this client would get more from someone who has already done the learning you would need to do on their time.
How to make a referral that does not feel like rejection
The referral conversation should be framed around what the client will gain, not what you lack. Three principles:
Name it early. The longer you wait, the more the referral reads as "I have decided I cannot handle you." Raising it within the first few sessions, framed as fit, lands very differently from raising it after three months.
Offer a specific person or practice, not a category. "You might look for someone who specializes in this" transfers the work to the client. "I would like to connect you with a practice I know does this well, and I can send an introduction" keeps you in the role of support.
Offer continuity where appropriate. In some cases a warm handoff, a brief overlap, or an open door to return for unrelated concerns later preserves the relationship rather than ending it.
Building a referral list: directories worth bookmarking
The hardest part of referring well is having somewhere good to refer to. Generic directories are weak here because "LGBTQ+-affirming" is a self-selected checkbox. Community-maintained lists are stronger because they are curated by people who hear from clients about outcomes.
For Alberta practitioners, the list of Calgary counselling providers listed on LGBTQ and ALL is a useful bookmark. Listings show each practice's service lines (such as individual, couples, family, child, group and sex therapy). That way you can match the referral to the actual need rather than sending every client to the same place.
Beyond directories, build your own list from three sources:
colleagues whose work with LGBTQ+ clients you have seen first-hand
local community organizations that run referral programs
clients themselves, who will tell you who treated them well if you ask
Example: what a well-matched Calgary practice looks like
It helps to know what a well-matched referral destination looks like. Curio Counselling in Calgary is a multi-clinician practice with registered and provisional psychologists covering individual, couples, family and youth work. It offers in-person sessions in Calgary and virtual sessions across Alberta. A practice of that shape lets you refer with some precision (a couples specialist, a youth specialist) rather than hoping the generalist on the other end happens to fit.
The free consultation most such practices offer is also useful from the referring side. Your client can check fit before committing, which lowers the risk that the referral itself becomes another disappointing experience.
Referring out is not an admission of failure. Done well, it is one of the clearest demonstrations of competence a counsellor can offer.
Looking for support in Ontario?
If you live in Ontario and are looking for support, you can start with a free 15-minute consultation at Transformation Counselling. You can read about our LGBTQ2S+ counselling and gender identity counselling pages first, then book a time that suits you.
Last reviewed: October 2026
Sources
College of Alberta Psychologists. "Standards of Practice" (May 31, 2023), section 4, Competence. https://www.cap.ab.ca/Portals/0/adam/Content/PCibGBBnCE6ZY6pd7EKcqQ/Link/Standards%20of%20Practice%20(May%2031,%202023).pdf
Canadian Psychological Association. "Canadian Code of Ethics for Psychologists," Fourth Edition (2017). https://cpa.ca/docs/File/Ethics/CPA_Code_2017_4thEd.pdf
Centre for Addiction and Mental Health (CAMH). "CAMH Resources for 2SLGBTQIA+ People." https://www.camh.ca/en/camh-news-and-stories/queer-specific-resources-at-camh