Lesbian, gay, bisexual, and queer individuals are utilizing the services of couple and family therapists and many other mental health professionals at increasing rates. Some of the clinical issues include seeking help with processing sexual and/or gender identity; coming out; improving intimate relationships and family dynamics; alleviating symptoms of depression, anxiety, and other mood disorders; and receiving affectional reorientation therapy. Oftentimes, religion is a significant motivator in an individual's decision to participate in the different types of affectional reorientation therapies. The primary aims of this article are (1) to highlight the connection to religious fundamentalism as a significant motivator for many individuals who receive affectional reorientation therapy; (2) to describe ethical considerations to consider while working clinically with lesbian, gay, bisexual, and queer clients; and (3) to summarize clinical implications and provide a person-centered, culturally-sensitive lesbian, gay, bisexual, and queer framework for couple and family therapists who work with clients struggling with their religious beliefs and affectional orientation.