Bringing Mental Health Resources for the LGBTQ+ Community to Eastern Kentucky

Open Doors Counseling is building "an LGBTQ specialty center" for a region where the need for affirming therapists is high and availability is low.

Yesterday, we chatted with Tasha Sams, co-founder of Pikeville’s soon-to-launch LGBTQ+ arts and entertainment space, HOME. During our conversation, Sams mentioned another up-and-coming leader nearby doing groundbreaking work, and it just so happened I had spoken with him earlier in the week. (Eastern Kentucky is, if nothing else, a small world.)

Robert “Kyle” May is a therapist and founder of Open Doors Counseling Center, an LGBTQ-focused practice with offices in both Lexington and Prestonsburg. (The Prestonsburg office—which is currently open one-day-per-week with expanded hours to come—is the first of its kind in the area.) A Pikeville native, May is committed to providing mental health support and resources to the queer community in Eastern Kentucky, drawing much of his motivation from his own childhood.

“I wanted to become a therapist because when I was growing up, I identified as gay but didn't have really anyone to talk to. My family wasn't supportive. They're very religious, so I knew I couldn't talk to them. And they also didn't really believe in mental healthcare, so they never sought out any type of therapy for us,” May explains. “But when I was figuring out what I wanted to do with my career, I decided I wanted to be a therapist so I could be that person for other people. I wanted to provide a voice in our community to help advocate for others who still haven't found their own voice.”

Below, we discuss the current state of mental health for the LGBTQ+ community in Eastern Kentucky, as well as how the region can build a stronger, more inclusive future that values mental health for all.

During our conversation, some topics may be triggering for individuals around issues of suicidal ideation, homophobia and religious trauma.

Sarah Baird: Tell me a little bit about the process of launching Open Doors.
Kyle May: I moved from Prestonsburg to Lexington in 2019, and jumped around a little bit with my jobs at first. I moved with the hopes I would walk into agencies that were a lot more affirming for LGBTQ people, but that's not what I experienced.

It was a mixture of good and bad experiences. I told them all in my interviews I wanted to specialize with the LGBTQ population, and I'd get in there, and then they wouldn't even talk about it again. There was one agency that wanted to stay neutral on the subject instead of being affirming or against it. I remember talking to a youth who was coming out at the time, and [the agency] was reluctant for me to even talk to the youth about their identity because they were afraid that the caregivers would be too conservative and stop bringing them to counseling. I guess they didn't want the word to get out that they took a stance on it.

I moved on and found a better agency that was really affirming. It was really great, but by that time, I was like, “You know what? I just need to start my own practice, I guess.” I opened up and started seeing clients in June 2020.

SB: What has the response been like at your Prestonsburg office?
KM: I’m in the Prestonsburg office every Friday, and as soon as I announced that I was going to open up [there] this February, that first Friday I had scheduled was completely full. Every Friday ever since has been full, taking into account some cancelations. At one point, it was going to be like a month-and-a-half before anyone could even get on the schedule for the Prestonsburg office.

I've had to start a waiting list where new people aren't able to make appointments right now until I work through some of the other clients. I have people driving from hours away to come to my office. I started recently with a family who's driving from West Liberty, and they said it takes them and hour-and-a-half to get there.

(via Open Doors Counseling Center’s Facebook)

SB: There seems to be so much need for LBGTQ+ affirming therapists in the area. Do you plan on expanding?

KM: I want to keep growing as big as the agency needs to be. I hope to be able to offer a variety of services tailored to the LGBTQ community. I want it to be like an LGBTQ specialty center where they can come and get a good chunk of resources.

I've been searching for someone for the Prestonsburg office for quite some time, and I keep running into a lot of obstacles to where there's different reasons why people end up not being able to work for me. Honestly, I think one of the biggest reasons—that they don't really share—is because of the stigma and the fact that I'm so focused on the LGBTQ subject. They’re worried that they could experience some backlash if they are affiliated with me: it could be family, friends, maybe church or some social backlash. It could be possible issues for the future, career-wise, even.

But there are also a lot of allies, and the need is definitely there. I've been seeing people who identify with polyamorous relationships, swingers, other different types of interests. I just saw [a person] today who was like, “I'm poly and I’ve never told a therapist that,” because they didn't feel safe enough to navigate that with other therapists in the area.

SB: Have a lot of your clients had negative therapy experiences in the past?
KM: I have a lot of clients who say, “I have not been able to share this whole part of myself in therapy ever before.”

Many of them have had such different experiences with counseling and come to me because there was something lacking in treatment. And most of it has to do with just not being able to be authentic. I've worked with kids where it's made a big difference in their lives just to have someone to be able to talk with openly about their identity, and their families are able to come in and support them in treatment.

I had one [client] in particular I can think of that stands out quite well. They were seeing a therapist at the local community mental health center and had religious trauma. But the therapist kind of ignored that and was like, "Well, I'll pray for you," and encouraged them to seek religion as a form of therapy. So, that didn't go well, for sure. That happens a lot, especially in the more conservative areas where therapists will push or excitedly mention religious stuff. And in the LGBTQ community, most of us have had some sort of religious trauma that gives us an aversion to that.

SB: If you had someone like yourself—an LGBTQ+ affirming therapist—when you were younger, what would that have meant to you?

KM: Oh, it would have been great. I went through my entire adolescence and even into adulthood feeling very lonely and isolated and depressed. I battled suicidal ideation throughout the years and a lot of severe anxiety—fear of people finding out about my identity—and never had anyone to talk to until college. I didn't even have gay friends or know of any other LGBTQ people in high school, and the ones I did know were ridiculed and bullied. So, I was definitely not wanting to come out. But I think if I had someone back then, I would have been able to talk about it, work through it and understand that it's not a bad thing.