Research into multicultural competence in clinical supervision has expanded in the last two decades to pay closer attention to considerations of gender and sexual orientation diversity (Bidell, 2012; Walker & Hernandez, 2014). As supervision is an ideal space for mental health professionals to develop an understanding of how their identity influences their work and develop skills in supporting LGBTQ+ clients (O'Shaughnessy & Ladany, 2017), this thesis aimed to understand more about LGBTQ+ affirmative supervision. Part A presents a scoping review synthesising available literature on LGBTQ+ affirmative clinical supervision. Papers were mostly US based, from psychology professions and theoretical. Key practices found to be important in affirmative supervision were summarised using narrative synthesis: 1) Facilitating safe ‘self-of-the-therapist’ discussions, 2) Knowledge about LGBTQ+ issues, resources and guidelines, 3) Attention to power, privilege and oppression, 4) Considerations of intersectionality. Future research recommendations included empirical research with larger, more diverse populations and research into the clinical implications of affirmative supervision. Part B presents an empirical paper exploring affirmative and non- affirmative supervision from the perspective of LGBQ+ (Lesbian, Gay, Bisexual, Queer+) UK trainee clinical psychologists. Twenty-five participants took part in a story-completion task, writing about supervision scenarios. Reflexive thematic analysis (Braun & Clarke, 2019) was used to identify three key areas of importance in affirmative supervision: 1) Supervisor’s LGBQ+ Awareness, 2) The (In)visibility of Sexual Orientation within Intersectionality 3) Positioning and Reflexivity in the Supervisory Dyad. Affirmative practices impacted clinical discussions during supervision in two ways, facilitating: a) Relational Safety and b) An Appreciation for Individual Difference. The findings supported existing literature which suggests that a supervisor’s attention to affirmative practice can support in scaffolding clinical discussions (Satterly & Dyson, 2008) and in creating safety (Hagler, 2020). Future research is needed into how supervisory dyads navigate non- affirmative scenarios and how practices impact subsequent training experiences.