This study investigated the role of therapy practices and the therapy relationship on lesbian and gay clients' feelings about their current therapist. Participants were 76 lesbian and 40 gay male clients ranging in age from 19 to 69 years. The real relationship was found to predict an additional 8% of variance in clients' positive feelings about their therapist above and beyond months in therapy, therapy practices, and the working alliance. However, therapy practices did not add significance in predicting lesbian and gay clients' feelings about their therapist beyond the working alliance and the real relationship. Fifty-three of the participants responded to a question about their current experiences in therapy, and the data were analyzed using consensual qualitative research-modified (CQR-M; Spangler, Liu, & Hill, 2012). Thirty percent of clients indicated a preference for a lesbian or gay therapist, or gay-friendly therapist. Only 25% found that their therapist lacked knowledge about lesbian and gay issues, but 21% indicated that their therapist was dismissive of and/or viewed their sexual orientation as a problem. More than two-thirds of the participants indicated they had a positive therapy relationship with their therapist. Results highlight the important role that therapy practices and the therapy relationship play in lesbian and gay clients perceptions' of their therapist. The findings also provide support for heterosexual therapists' ability to develop a positive therapy relationship and be effective with lesbian and gay clients.