The purpose of this thesis was to shed light upon the experiences of therapists and clients as they navigate discussions of gender and sexual identity in the therapy room. This was achieved in three stages: Section one presents a metasynthesis of qualitative research pertaining to the experiences of therapists and counsellors working with gender and sexually diverse clients; Section two explores the ‘coming out’ experiences of eight sexually diverse young people, who disclosed their sexual orientation in therapy; Finally, section three offers a critical appraisal of the research journey. It contains reflections pertinent to the author’s personal and professional development.