LGBTQ+ therapy in New York that lets you stop translating yourself
Affirming LGBTQ+ therapy and psychiatric care in New York for queer, lesbian, gay, bisexual, pansexual, asexual and questioning people, and for the families, partners and friends who love them.
Queer lives are full of creativity, chosen family and hard-won joy, and they can also carry the weight of rejection, hiding and everyday stress. I offer a space where you do not have to explain your identity before you can talk about what is really on your mind. Our work is led by you, combining psychotherapy, somatic practice, mindfulness and medication support when it helps.
“Being queer is not what makes life hard. Living in a world that was not built with you in mind is, and that is something therapy can help you carry differently.”
We start from the understanding that your identity is a source of meaning, not a symptom to be managed.
What makes LGBTQ+ therapy genuinely affirming
Affirming therapy goes beyond tolerance. It means working with someone who understands queer life through years of clinical experience, and who will never treat your identity as the problem.
Most LGBTQ+ people have spent part of their lives scanning rooms for safety: deciding whether to mention a partner, adjusting their voice or clothes, weighing up whether to come out to a new colleague. That constant monitoring can become so familiar that you hardly notice it, yet it quietly shapes your nervous system, your relationships and your sense of self. Therapy is one place where that monitoring can finally rest.
Before specialising in psychiatry, I worked as an LGBTQIA+ primary care provider and HIV specialist. I have sat with people at every stage of coming out, through illness and recovery, through family estrangement and reconciliation. My further study in gender theory, feminist philosophy and visual art informs how I understand identity, desire and belonging, and why I see them as rich subjects for exploration rather than issues to resolve.
In practice, this means you can speak freely about sex, relationships, community, religion, family and culture. You will not be asked to justify your identity, explain queer terminology or educate me. Instead we can spend our time on what you came for, whether that is anxiety, heartbreak, a career crossroads or the slow work of healing old wounds.
Shame, rejection and the long shadow of the closet
Many queer people carry shame that was absorbed long before they had words for who they were. Even after coming out, it can surface as perfectionism, people-pleasing, difficulty with intimacy or a harsh inner critic. Psychoanalytic and relational therapy help us trace where these patterns began, while somatic work helps the body let go of the tension of having once needed to hide.
Families, partners and allies
I also work with parents, partners, siblings and friends of LGBTQ+ people. Perhaps someone close to you has come out and you want to support them well, or you are working through feelings you do not want to place on them. Our sessions offer a private place to learn, reflect and grow, always grounded in respect for the queer person in your life.
You might be looking for queer-affirming support
People reach out for many reasons, and some of them have little to do with sexuality or gender at all. What they share is a wish for a therapist who understands their world. These are some of the experiences that bring LGBTQ+ people and their loved ones to my practice.
- Coming out, at any age
- Shame or internalised homophobia
- Family rejection or distance
- Relationship and dating challenges
- Anxiety in unsafe environments
- Burnout from code-switching
- Faith and sexuality in tension
- Grief for lost community
- Supporting a queer loved one
- Exploring sexuality or orientation
Tailored care that is led by you
No two queer lives are the same, so no two treatment plans are either. I draw on several modalities, all offered within one ongoing relationship, and we adjust the mix as you learn what helps.
Exploratory psychotherapy
Through psychoanalytic, feminist and relational conversation, we look at how your history, family and culture have shaped the way you love, work and see yourself, and where you would like to loosen old patterns.
Somatic practice
Years of vigilance can settle in the body as tight shoulders, shallow breathing or a sense of not quite being present. Gentle somatic exploration helps you notice and release some of that holding, at a pace you choose.
Mindfulness
Mindfulness can help you meet difficult thoughts and feelings with more spaciousness, especially in moments of rejection or stress. We adapt practices to suit you, rather than following a one-size-fits-all script.
Medication support
If anxiety, depression or other symptoms are affecting your life, I can assess and prescribe as a board-certified psychiatric nurse practitioner. Every change is gradual, collaborative and monitored, and you remain in charge of decisions.
Chosen family and community
Connection is protective. We think about the relationships that sustain you, how to strengthen them, and how to rebuild community after loss, moves or estrangement, so you are not carrying everything alone.
Identity and self-expression
Whether you are questioning, newly out or long established in your identity, we can explore what authenticity looks like for you now, including the creative, sensual and joyful parts of queer life.
Queer-informed care versus generic therapy
Every therapist should be respectful, but understanding queer life deeply changes what therapy can reach.
General therapy
- You educate the therapist
- Identity treated as the issue
- Assumptions about family and partners
- Little awareness of minority stress
- Medication handled separately
Queer-affirming care with me
- Shared understanding from day one
- Focus on what you bring
- Chosen family recognised
- Context of stigma understood
- Therapy and prescribing together
Starting LGBTQ+ therapy in New York
Simple first steps, with you setting the pace throughout.
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1
Free consultation 15 minutes
A relaxed, confidential conversation to share what is on your mind, ask how I work with LGBTQ+ clients and decide whether we feel like a good fit. There is no pressure to book afterwards.
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2
First full session
We take time to understand your story, relationships, health and what you hope to change. You choose how much to share about identity, family and history. If medication is relevant, I begin assessing that carefully.
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3
Shaping your care
Together we decide on focus and approach, whether talk therapy, somatic practice, mindfulness, medication support or a blend. Your priorities guide the plan, and it stays flexible as things shift.
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4
Ongoing sessions
We meet regularly for 60 or 90 minutes. Many clients find that having a consistent, affirming space helps them feel steadier, more self-accepting and more connected to the people who matter.
Francesca Rome-Marie, PMHNP-BC
I bring together psychiatry, psychotherapy, somatic work and whole-body health, informed by years in primary care and further study in gender theory, feminist thought, culture and visual art.
I keep a deliberately small caseload so that every client receives consistent, unhurried and genuinely attentive care, held within one relationship rather than split across several providers.
Clear, upfront rates
I don't accept insurance. Modern Holistic Psychiatry is an out-of-network provider, so sessions are paid for directly. Depending on your plan, you may be able to claim reimbursement through your out-of-network benefits.
Find out how much your insurance may coverNeed urgent support? If you're in crisis or thinking about harming yourself, call or text 988 (Suicide & Crisis Lifeline) or call 911.
Therapy for LGBTQ+ People FAQs
Are you an LGBTQ+ affirming therapist in New York?
Yes. I provide LGBTQ+ affirming psychotherapy and psychiatric care across New York State. I bring years of experience as an LGBTQIA+ primary care provider and HIV specialist, along with further study in gender theory and feminist philosophy. Affirming means your identity is respected without question and never treated as the cause of your difficulties.
Do I need to talk about being queer in every session?
Not at all. Many LGBTQ+ clients come for help with anxiety, grief, burnout or relationships, and their identity is simply part of the background. You can bring it in whenever it feels relevant. The point is that you never have to hide it or edit your stories to feel safe.
Can you help me with coming out?
Yes. Coming out is not a single event but an ongoing series of choices about who to tell, when and how. We can explore your fears and hopes, think through practical and safety considerations, and process whatever reactions you receive. There is no right timeline, and choosing not to come out in some settings is also valid.
I am a parent of an LGBTQ+ child. Can I see you?
Yes. Parents and other family members are welcome. Many love their child deeply and still feel confused, worried or grief-stricken, and they need a private place to work through those feelings. Our sessions help you understand more, respond with care, and strengthen your relationship, always from an affirming perspective.
Can you help with shame or internalised homophobia?
Yes. Shame learned early often lingers long after we consciously accept ourselves. We work with it from several angles: understanding where it came from, noticing how it shows up in your body and relationships, and gradually building a more compassionate inner voice. This is slow, meaningful work, and it can change how you experience yourself and others.
Do you prescribe medication as well as offering therapy?
Yes. As a board-certified psychiatric nurse practitioner, I can assess, diagnose and prescribe, as well as adjust or taper existing medication. Having therapy and prescribing in one place means I understand the full context of your life, and any changes are made gradually, collaboratively and with careful monitoring.
A space where you simply belong
Book a free 15-minute consultation and talk with someone who understands queer life. There is nothing you need to prepare.