Silva Neves Online Specialist Psychotherapy for Central London,
Mayfair W1

LGBTQ specific therapy . Rainbowflagmodern

Therapy dedicated to the LGBTQ community

Despite major step forwards in equality in recent years, people who identify as Lesbian, Gay, Bisexual and Transgender are still too often victims of homophobia, biphobia or transphobia, and they are greatly misunderstood.
For this reason, I offer therapy dedicated to the LGBT community:
  • Relationship Therapy (also known as Couple Therapy if there are two people in the relationship) and Intimate Partners Therapy (if there are more than two people in the relationship): sexual and relationship problems. For more information, Click here
  • Treatment for Compulsive Sexual Behaviours. Problematic porn use. Compulsive use of hook-up apps. For more information, Click here
  • Treatment for sexual abuse and PTSD (Post-Traumatic Stress Disorder). For more information, Click here

    I also offer LGBTQ- specific therapy:
  • Coming out
  • Chemsex
  • Survivors of homophobic attacks
  • Survivors of conversion therapy
  • Receiving a HIV diagnosis, living with HIV and having a relationship with different HIV status
  • Excessive use of the gym and exercise. pre-occupation with gaining muscles. Muscle Dysmorphic Disorder (MDD)
  • Body image issues
  • Exploration of diverse sexuality and relationships, including non-binary sexualities: open relationships, polyamory, polysexual. The exploration of kink sexuality in a non-pathologising approach.

LGBTQ specific therapy . Men in pride

Coming Out

Sometimes our sexuality and sexual desires can be complex, leaving us feeling confused about who we are. Accepting ourselves can be more difficult than it seems. Figuring out who we are and what to do can be a lonely process, especially when faced with pressure to conform to the ‘norms’ of society of what it ‘should’ be like to be a man or a woman, and what it ‘should’ be like to be sexual. There may be fear and anxiety thinking about the risk of humiliation or bullying by others, which can also be daunting and distressing when thinking about coming out.

Coming out also applies when we start to think about our gender. The process of questioning our gender is often misunderstood, leaving people feeling isolated and open to humiliation and bullying by others.

The process of coming out begins when we start to recognise our attitudes and feelings towards our own sexuality and gender. Comparing ourselves to the social and family ‘norms’ governing aspects of our lives, it may seem that our sexuality or gender is ‘abnormal’ or ‘deviant’, especially as our world is filled with heteronormative messages about what people believe to be ‘normal’ and ‘right’.

Psychotherapy will help you challenge these social conditionings and enable you to decide for yourself what is right for you. I provide a humanistic, non-judgmental, safe space for you to explore your sexuality, sexual feelings and gender identity in depth in order for you to make sense of it all. This process will enable you to make choices for what is best for you, including steps and strategies for coming out, and the considerations to keep safe.

LGBTQ specific therapy . Male violation

Survivors of Homophobic Attacks

Homosexuality has been decriminalised for 50 years now. Despite the advances of LGBTQ human rights like equal marriage, homophobia is still prevalent either in covert ways which can make people feel uncomfortable, or in overt ways: there has been 147% rise in homophobic attacks reported in the UK in 2016.

According to Galop’s Hate Crime report 2016:
  • 4 in 5 LGBT people had experienced hate crime.
  • A quarter had experienced a violent hate crime.
  • A third experienced online hate crime.
  • A tenth experienced sexual violence as part of a hate crime.

    Surviving a homophobic attack can leave people feeling distressed and scared for a long time. For some people, it can develop into PTS symptoms (Post-Traumatic Stress) or PTSD symptoms (Post-Traumatic Stress Disorder).
    PTS and PTSD symptoms are:
  • Re-experiencing the traumatic event in a range of sensory forms. This phenomenon is called a flashback. 
  • Avoiding reminders of the trauma by avoiding or numbing emotions. In some cases, we call it dissociation. 
  • Chronic hyperarousal of the nervous system. This is called disregulated arousal. 

    It is important to note that these symptoms are normal to experience immediately after traumatic event. If some of these symptoms persist one month after the traumatic event, a diagnosis of PTS can be formulated. 

    When the symptoms of PTS are chronic, they can lead to psychological disturbances such as: 
  • Acute anxiety and panic attacks.
  • Sleep disturbances.
  • Loss of appetite.
  • Sexual dysfunctions.
  • Difficulties with concentration.
  • Difficulties with relationships.
  • Self-hatred towards sexuality, wishing to be heterosexual.

    PTSD is a specific psychological condition. It manifests with the same symptoms as PTS but it is more severe causing a high level of daily dysfunction. 

    Both PTS and PTSD can be treated with specific psychological trauma therapy. For more information on trauma therapy and EMDR Click here .

    If you have survived a homophobic attack and feeling distressed by it, do not suffer in silence. There is specialist treatment that can help you heal.

LGBTQ specific therapy . Love capsule


What is Chemsex?
It is the behaviour of intentional sex under the influence of psychoactive drugs, mostly among men who have sex with men (MSM).
The drugs used are predominantly mephedrone (GHB) or butyrolactone (GBL) and crystalised methamphetamine. These drugs are often used to facilitate sexual activities lasting several hours and, sometimes, days with multiple sexual partners.

What are the drugs used?
Mephedrone and crystal meth are physiological stimulants increasing the heart rate and blood pressure, triggering euphoria and sexual arousal. GHB and GBL are powerful psychological disinhibitor and also a mild anaesthetic.
These drugs thus increase sexual pleasure with less inhibitions. They sustain arousal and chemically induce a feeling of instant rapport with sexual partners.

Chemsex: an epidemic
Chemsex behaviours is prevalent in the gay scene in London and other major cities around the world.
Most Chemsex behaviours happen in private sex parties, in someone’s home, behind closed doors. These sex parties are also called ‘chill out’ parties. It is so prevalent amongst gay men and MSM that health professionals call it an epidemic affecting the gay scene. It is a hidden epidemic that causes significant harm to the individuals engaging in Chemsex and the wider gay community. A majority of people engaging in Chemsex do not have sex without drugs (or sober sex) for a long period of time. The more people engage in Chemsex, the harder it is to have sober sex.

Chemsex is the illusion of the antidote to living in a heteronormative world: an instant, deep connection with people, free of judgements and no rejections.

The survey conducted by David Stuart and Johannes Weymann reveals that:
Chemsex episodes of between 12 to 48 hours are the norm:
  • 12% reported one partner per episode
  • 32% reported 2 or 3 partners per episode
  • 45% reported between 4 and 10 partners per episode
  • 11% reported 10 or more partner per episode

    HIV+ve patients not on medications:
  • 64% reported zero condom use for intercourse
  • 10% reported using condoms for intercourse less than 50% of the time

    HIV+ve patients on medications:
  • 25% reported zero condom use for intercourse
  • 51% reported using condoms for intercourse less than 50% of the time

    HIV –ve patients:
  • 10% reported zero condom use for intercourse
  • 40% reported using condoms for intercourse less than 50% of the time

    These statistics show that the likelihood of contracting HIV when engaging in Chemsex is very high. When one feels the illusion of being free of shame, and having an instant deep connection to multiple sexual partners, it is much harder to engage the rational brain about the reality and the consequence of sexual behaviours. In fact, thinking about reality is not desirable because it would spoil the euphoria state that feels so good at the time.

    The Chemsex Study published in March 2014 looked at the relationship between Chemsex and sex, relationships and intimacy. It supports the psychological evidence that Chemsex is not only a drug problem.
  • It is a sexual problem, sometimes covering other sexual problems such as erectile dysfunctions.
  • It is a relational problem.
  • It is an intimacy problem.
  • It is a self-esteem and self-worth problem, including body image.
  • It is an internalised homophobia problem.
  • It is governed by deep-seated shame and deep-seated core beliefs about the self.

    Chemsex has many negative consequences. After Chemsex behaviours, when the drugs wear off, there is a crash into reality. When it happens, the negative core beliefs come back with a vengeance, usually more acute than before. People often feel intensely ashamed, angry with themselves, disgusting, depressed, anxious, ill, etc.
    What seemed to be the ‘magic pill’ to the underlying shame actually makes it worse.

    Other negative consequences include:
  • More sexual problems: The Chemsex Study (2014) reports: ‘Many participants described how drugs could significantly increase sexual desire or libido, but at the same time diminish sexual performance. Erectile dysfunction under the influence of crystal meth and mephedrone was very widely reported, as was retarded ejaculation.’
  • Difficulties maintaining a job, sometimes leading to losing a job.
  • Difficulties maintaining relationships and friendships.
  • Feeling more and more alienated from the rest of society, including the gay community, unless it is within the Chemsex users.
  • Feeling depressed and living in despair.
  • And, of course, the ultimate negative consequence is death. Chemsex does a lot of harm to the body as well as psychologically. Taking an overdose and passing out is common. Many young gay men in their early 30’s with no medical problems died as a direct result of Chemsex. In fact, often, people come to me for help when they know a friend who died of Chemsex. It is the wake up call that gives them the courage to face their problem and seek professional help.

    What does therapy addressing Chemsex look like?
  • First, we have to address what is urgent: addressing the present behaviours to minimise the risk of harm.
  • Addressing behaviours to seek a more balance in life: how to self-care and nurture ourselves. How to recognise when we are not feeling good about ourselves.
  • Addressing intimacy issues. Recognising intimacy. Learning to feel vulnerable and intimate without resorting to drugs.
  • Addressing relationship issues. Finding the map to navigate relationships and connections.
  • Addressing sexual issues. Re-connecting with the natural arousal template and getting to know ourselves sexually.
  • Addressing self-esteem and self-worth. Learning to heal the shame and internalised homophobia. Identifying the negative core beliefs and change them to more reality-based, positive core beliefs.
  • Re-connecting with your daily needs and making the healthy choices to meet those needs.

    The therapeutic process is challenging but it is the best gift of love to give to yourself. It is a place where you can start to make long-lasting changes and reconnect to your true self. The investment in therapy is so much less costly than drugs and its negative consequences.

    If you are not sure about therapy, or if you can't afford the private fees, please do not stay without support! Access 56 Dean Street Clinic in Soho. It is a free NHS service and it is the world’s leading clinic in Chemsex support. For more information about 56 Dean Street, Click here

LGBTQ specific therapy . Lesbian couple old


The equal rights of LGBT people have improved significantly over the last few years. However, the LGBT community has a long history of trauma.

Today, unfortunately, homophobia still exists. And it is still violent.

The history: the trauma of homophobia
'Homosexuality' was a criminal offence until 1967 and a mental health disorder until 1990. Many LGBTQ people fought for equal rights, marching in the streets whilst stones were thrown at them throughout the 70’s and 80’s. The AIDS crisis in the 80s added another layer of large scale trauma in the gay community. Today, although the UK is one of the wonderful leading countries in LGBTQ equal rights, where Queer people can get married and live without fear of being arrested, homophobia, biphobia and transphobia is still very much alive.

The Stonewall report (2017) highlights:

  • One in five LGBT people (21 per cent) have experienced a hate crime or incident due to their sexual orientation and/or gender identity in the last 12 months.
  • Two in five trans people (41 per cent) have experienced a hate crime or incident because of their gender identity in the last 12 months
  • Four in five LGBT people (81 per cent) who experienced a hate crime or incident didn't report it to the police.
  • Three in ten LGBT people (29 per cent) avoid certain streets because they do not feel safe there as an LGBT person.
  • More than a third of LGBT people (36 per cent) say they don’t feel comfortable walking down the street while holding their partner's hand. This increases to three in five gay men (58 per cent).
  • One in six LGBT people (17 per cent) who visited a café, restaurant, bar or nightclub in the last 12 months have been discriminated against based on their sexual orientation and/or gender identity.

    Internalised homo-negativity
    There is another side to the trauma of homophobia. It is insidious and toxic. When one is feeling rejected because of who they naturally are, a deep psychological phenomenon happens: shame.

    Most Queer people have a sense of being different from others, usually as far back as they can remember, in early childhood. Of course, then, the young person cannot put words like ‘gay’ or ‘sexuality’ or ‘homophobia’ into those uncomfortable feelings. So, instead, they have to make sense of those feelings the best they can. Often, the young queer person translates those feelings into simple phrases such as: ‘There is something wrong with me’. Or ‘I am bad’. Or ‘I am wrong’. Or ‘I am not good enough’. These simple phrases feel so true at the time that they become embedded in the psyche, they become core beliefs, and the young queer person grows up until adulthood retaining those core beliefs. By adulthood, those core beliefs are so deep-seated that they are even unconscious. However, being unconscious does not mean dormant. In fact, it is the opposite. Those unconscious core beliefs are dynamic, and they often pull the strings and run the show. It means that an intelligent fully grown queer person can make decisions based on core beliefs rather than on the reality is that in front of them.

    Those core beliefs become triggered especially in situations when we feel vulnerable. We feel vulnerable when we go on a first date, when we have sex, when we try to connect to others, when we want to be liked, when we want to feel accepted. Those core beliefs are the great motor of one of the most distressing human feelings: shame.

    The LGBT population share a traumatic history, and still have to face both external and internal homophobia today, causing a range of difficulties:
  • Low self-esteem and self-worth
  • Body image problems
  • Difficulties starting or maintaining relationships
  • Sexual difficulties
  • Engaging in high risk sexual activities
  • Engaging in Chemsex
  • Compulsive sexual behaviours
  • Addictions to drugs or alcohol
  • Eating disorders
  • Compulsive exercise
  • Acute anxiety
  • Depression
  • Feeling suicidal

    Processing and resolving trauma can help with:
  • Coming out
  • Acceptance of sexuality
  • Healing from homophobic attacks
  • Having satisfying relationships
  • Having a satisfying sex life
  • Finding balance in life
  • Managing a HIV diagnosis
  • Healing sexual shame

    I employ a sexuality diversity affirmative approach.

LGBTQ specific therapy . Man in church

Survivors of conversion practices

Conversion 'therapy', also called 'reparative therapy' or 'gay cure' is an unethical and extremely harmful practice that assumes heterosexuality is the only 'natural' sexuality and being gay is 'wrong' and a 'lifestyle choice'. Most modern version of conversion therapy may be called under different names, including 'spiritual guidance' and it coerces people in believing that their same-sex attraction is a result of childhood trauma and the therapy can change them to heterosexuality so that they can marry an opposite-sex partner and have children as God intended.

All the major UK psychology and psychotherapy bodies have denounced the practice as unethical and harmful. They have signed a MoU on conversion therapy making it unethical to promote or offer conversion therapy. However, it is not yet illegal in the UK so conversion therapy is thriving underground, mostly in religious settings but also in some clinical settings. Some of the unethical practice can be subtle, offer of false sense empathy, weaponising the language of therapy and introducing pseudo-science. In fact, it shouldn't be called 'therapy', it should be called conversion abuse.

Most people don't speak up about being a survivor of conversion therapy because of shame, but it is estimated that a large number of LGBTQ people have been offered and have gone through conversion therapy.

The body of research unanimously shows that conversion therapy does not work and it causes great psychological harm including:
  • Depression
  • Suicidal thoughts or/and suicidal attempts
  • Self-harm
  • Eating disorders
  • Increase in shame
  • Feeling bad about themselves and their sexuality
  • Post-traumatic stress symptoms

    If you are a survivor of conversion therapy, don't suffer in silence. Help is available. I am an experienced psychosexual and relationship psychotherapist, trauma psychotherapist and I embrace gender, sex and relationship diversities (GSRD). I have experience in helping LGBTQ+ people heal from the trauma of conversion therapy.

LGBTQ specific therapy . Gaysex

Receiving a HIV diagnosis, living with HIV and having a relationship with different HIV status

Receiving HIV diagnosis and living with HIV.
Despite so much medical progress in treating HIV, the virus cannot yet be eradicated and the condition cannot yet be cured. However, receiving a HIV diagnosis is not a life sentence any longer. If diagnosed early and treated early, HIV is now a chronic condition that can be well-managed with medications to be taken for life.
Receiving the diagnosis of HIV Positive can be shocking and it is an abrupt life changing moment. Suddenly, the future that you had imagined for yourself may crumble leaving a void before you. It can be difficult to figure out your thoughts and feelings and what it all means for you. Sexual psychotherapy can help you explore all of those thoughts and feelings in a humanistic, non-judgmental and safe space in order for you to make sense of it all and enable you to make the necessary steps forward for the lifestyle changes needed, to keep you safe and to re-construct the vision of a new future for yourself.

Having a partner of different HIV status.
You may have heard the rather horrid term: serodiscordant couples to describe a couple with different HIV status.
Thanks to the medical progress in HIV research, couples with different HIV status can now enjoy a sexual life that has few barriers. If the HIV Positive partner is on medication is his condition is well managed to the point of having an undetectable viral load, the virus is unlikely to be transmitted to the HIV Negative partner. However, there is still a lot of stigma around the HIV status.
Sexual Psychotherapy can help with:
Disclosing your HIV status to your new partner.
As a couple, you can explore together your sexuality, sexual desires and sexual practices so that you can make your own choices for a fulfilling sex life.
As a couple or an individual, you can explore your anxiety, doubts, blocks, thoughts and feelings regarding HIV in a safe and non-judgmental space.
As a couple, you can explore the relationship issues that you may have and find some ways to move forward into the relationship that you both want.

LGBTQ specific therapy . mangym

Excessive use of the gym and exercise. Pre-occupation with gaining muscles. Muscle Dysmorphic Disorder (MDD). Body Image.

Excessive use of the gym and exercise. Pre-occupation with gaining muscles. Muscle Dysmorphic Disorder (MDD).
Being pre-occupied with gaining muscles and going to the gym and exercise excessively is very common amongst gay men. Sometimes it develops into MDD (Muscle Dysmorphic Disorder).
Muscle Dysmorphic Disorder, sometimes called bigorexia, is a psychological condition that makes people obsessively believe they are too small and not muscular enough. If left untreated, this condition can have serious damaging consequences such as social isolation, risk of suicide, high likelihood of substance misuse and steroid abuse. The quality of life of people suffering from MDD is severely impacted by the obsessional need to train, and the inability to prioritise other important needs for wellbeing.
If you think you have an issue with this, do not wait until you suffer the damaging consequences. Psychotherapy can help with exploring all the thoughts and feelings you have about your body image and your exercise behaviours in a safe and non-judgmental space, so that you can make the choices that you want in order to lead a functional and fulfilling life that feels right for you.

Body Image
Gay men are bombarded with what the ideal body ‘should’ look like. Having a body that is ‘perfect’ has become the unattainable goal for many gay men in order to feel desirable and wanted.
This unattainable goal of body perfection deepens the pain of the already embedded homophobic message of ‘I’m not good enough’ which many gay men have internalised unconsciously by the very fact that they grew up in a heteronormative world.
Other factors can also affect how we see our body and escalate the struggle to accept ourselves as we are: disrupted childhood, violence in childhood, experiencing hate crime, bullying, being humiliated by others.
As a result, it is common for gay men to suffer from strong body image issues: focusing on the parts of their body that they do not like and being hyper-critical of those parts. Gay men can struggle to accept themselves as they are.
Sometimes, the body image problems lead to other psychological disturbances such as MDD (Muscle Dysmorphic Disorder), BDD (Body Dysmorphic Disorder) and eating disorders.
If you struggle with accepting your body, are pre-occupied by how you look, and notice that you start to be concerned with the amount of exercise you do or what you eat, do not wait until your life becomes unmanageable. Seek professional help now. Psychotherapy will help with exploring your thoughts and feelings you have about your body image, your exercise behaviours and your eating behaviours in a safe and non-judgmental space, so that you can make the choices that you want in order to lead a functional and fulfilling life that feels right for you.

LGBTQ specific therapy . Sexuality Diversity

Diverse Sexuality and Relationships

It can be difficult to find a meaning to our sexuality, sexual desires and how we want to form relationships.
There are many social and family ‘norms’ that preach how sexuality, sexual desires and sexual practice ‘should’ be like and what is ‘right’ or ‘normal’. If you feel you don’t fit in this narrow ‘norm’ which is often heteronormative, it can be a lonely and distressing place to be.
Sex and Relationship Therapy will help you challenge these social conditionings and enable you to decide for yourself what is right for you. I provide a humanistic, non-judgmental, safe space for you to explore your sexuality, sexual feelings, sexual desires, sexual practice preferences in depth in order for you to make sense of it all. This process will enable you to make choices for what is best for you. I am experienced in exploring all types of sexual desires and practice including Kink and BDSM. I am also experienced in working with all kinds of relationships including monogamy, open relationships, polyamory, etc.

LGBTQ specific therapy . Pink Therapy Accreditation 2021

©2022 Silva Neves — powered by WebHealer
Website Cookies  Privacy Policy  Administration