This article explores mental health risk factors and cultural considerations of Arab Americans who are LGBTQ+ (lesbian, gay, bisexual, transgender, queer, or belonging to other nonheterosexual and/or non-cisgender identities), including the influence of intersecting identities, religion and spirituality, familial influences, sexuality and sexual behavior, and attitudes toward mental health counseling. LGBTQ+ affirmative counseling recommendations are presented with a focus on developing cultural competence via awareness, knowledge, skills, and action. Implications for counselor training and future research conclude this article.

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