This chapter explores the specific needs of LGBTQ+ individuals in therapy through the lens of Positive Psychotherapy (PPT after Peseschkian). It highlights the importance of cultural sensitivity, inclusivity, and identity-affirming care when working with LGBTQ+ clients. The chapter examines key concepts, including the distinctions between sex assigned at birth, gender identity, sexual orientation, and gender expression, and how these aspects intersect in therapy. A significant focus is placed on the use of labels, acknowledging both their empowering and restrictive potential. The chapter also delves into the psychological process of coming out, referencing Cass’s model, and discusses the impact of internalised homophobia on mental health. Using the PPT framework, the therapeutic process is outlined through five stages: observation and distancing, taking inventory, situational encouragement, verbalisation, and broadening of goals. Additionally, intersectionality is emphasised as a critical factor in understanding the varied experiences of LGBTQ+ individuals, particularly regarding discrimination and social exclusion. Through case studies, the chapter illustrates real-world applications of LGBTQ+-affirmative therapy, underscoring the necessity of therapist self-awareness, ethical considerations, and the need for a supportive and nonjudgmental therapeutic environment.