Since the declassification of homosexuality as a mental illness in 1973, psychology has transformed the way it approaches sexual orientation and gender identity issues in scientific research and clinical practice. The paradigmatic shift from psychopathology to identity has corresponded with the introduction of “LGBT-affirmative therapy,” which suggests that therapists should affirm clients’ sexual orientations rather than reinforce sexual minorities’ experiences of stigma and marginalization. And though the academic literature on LGBT-affirmative therapy is proliferating, there remains little consensus on what exactly this means conceptually and what it looks like in practice. This interdisciplinary research explores psychology’s ongoing project of both producing what constitutes LGBT issues and the practices used to treat them therapeutically. Based on analysis of over 2,000 minutes of recently produced psychotherapy training videos, I will explore what these films suggest an LGBT-affirmative psychotherapist looks like: what does she know, what does she (not) do, and how is her approach any different from therapy-as-usual? In the complex space where science, culture, beliefs, and attitudes about sexual orientation, gender, and other dimensions of identity collide, what is the new psychotherapy of sexual orientation?