Therapy for reproductive and sexual health advocates who hold so much
Therapy for reproductive and sexual health advocates in New York, and for anyone moving through fertility, pregnancy, postpartum, menopause or hormonal change. A grounded, affirming space where your own body and experience come first.
Whether you answer helplines, accompany people to clinics, provide care, organise for access or are living through a reproductive transition yourself, the weight of this work is real. I offer unhurried psychiatric and therapeutic care that makes room for burnout, secondary trauma, grief and change, combining psychotherapy, somatic support and, where it helps, medication in one steady relationship.
“You spend your days protecting other people's choices about their bodies. Therapy can be the one place where your own body, choices and limits are protected too.”
Advocacy asks for constant vigilance. Our sessions are designed to let some of that vigilance soften, at a pace that feels safe.
What reproductive and sexual health advocacy asks of you
Reproductive and sexual health work sits at the intersection of the deeply personal and the intensely political. That combination shapes the kind of support people in this field need.
People who work in reproductive and sexual health often carry stories that most of the world never hears. You may hold someone's fear in a clinic waiting room, take calls from people in crisis, navigate shifting laws, or face hostility simply for doing your job. Over time, the emotional residue builds up. Many advocates notice that they are tired in a way that sleep does not fix, or that their tenderness for others has started to feel thin.
This kind of exhaustion is not a personal failing. It is the predictable cost of sustained exposure to other people's distress, combined with a political climate that can make the work feel urgent and endless. Secondary trauma, compassion fatigue and moral injury are common in caring professions, and they deserve care rather than a quiet expectation that you will keep going regardless.
Therapy for reproductive health advocates offers a place to set that load down for a while. Together we look at what you have been carrying, how it has been landing in your body and relationships, and what would help you continue your work, or step back from it, in a way that feels sustainable and true to your values.
Support for people living through reproductive transitions
This page is also for anyone moving through the reproductive and hormonal changes of life: fertility struggles, pregnancy, loss, postpartum shifts, perimenopause and menopause, or hormonal changes linked to gender-affirming care. These transitions can unsettle mood, sleep, identity and relationships all at once. As a psychiatric nurse practitioner, I can assess how hormonal and life changes are affecting your mental health and discuss whether medication, supplements or other approaches might help alongside our therapeutic work.
Why my background matters here
Before focusing on psychiatry, I worked as an LGBTQIA+ primary care provider and HIV specialist, so sexual health, bodily autonomy and stigma are familiar ground rather than theory. My further study in gender theory and feminist thought shapes how I listen. I will not ask you to justify your work, your politics or your choices, and you will not need to educate me before we can begin.
Care that respects confidentiality and safety
Many people in this field worry about privacy, especially in the current climate. I keep a small caseload by design, and our work is confidential within the usual legal and ethical limits, which I explain clearly at the start. We can talk openly about any concerns you have around safety, documentation or visibility.
Signs you might benefit from dedicated support
There is no threshold you need to reach before asking for help. Some people come to me in crisis, others because they can sense their capacity slowly narrowing. If any of the following feel familiar, a conversation may be useful, whether you work in the field or are living through a reproductive change yourself.
- Exhaustion that rest does not touch
- Intrusive images from difficult calls
- Numbness or irritability at work
- Guilt when you take time off
- Grief after pregnancy loss
- Low mood after giving birth
- Mood shifts in perimenopause
- Anxiety during fertility treatment
- Feeling unsafe because of your work
- Losing connection with why you started
Integrated care for advocates and bodies in change
I bring psychiatry, psychotherapy and somatic work into one relationship, so you do not have to coordinate several providers or repeat your story. Each element is offered, never imposed, and we shape the balance around what you actually need.
Reflective psychotherapy
Space to speak about the stories you hold, the anger and grief that come with this work, and the meaning it has in your life. Drawing on psychoanalytic, feminist and relational traditions, we look beneath the surface rather than rushing to fix.
Nervous system support
Secondary trauma often lives in the body as tension, hypervigilance or shutdown. Gentle somatic exploration helps you notice these patterns and find ways to settle, so your system is not running on alarm long after the workday ends.
Psychiatric assessment
If depression, anxiety, sleep disruption or postpartum and perimenopausal mood changes are affecting your life, I can assess, diagnose and discuss medication. Any changes are gradual, collaborative and closely monitored, and you always have a say.
Holistic and lifestyle care
We look at sleep, nourishment, movement and recovery time. Vitamins, nutraceuticals or supplements may support mood and resilience, and I review them for safety and interactions with any medication. They complement medical care rather than replace it.
Boundaries and sustainability
Together we explore where your limits are, how to protect them in a culture of urgency, and what a sustainable relationship with advocacy could look like, whether that means changing your role, your pace or how you recover.
Grief and reproductive loss
Fertility struggles, miscarriage, termination and difficult births can bring grief that others overlook. I offer a place where every feeling about your reproductive story, including ambivalence and relief, is welcome and treated with care.
Beyond the employee assistance line
Workplace programmes and brief counselling have their place, but advocates often need something slower and more thorough.
Typical short-term support
- A handful of brief sessions
- Focus on coping strategies only
- Limited understanding of the field
- Medication handled elsewhere
- Little attention to the body
Working with me
- Longer, unhurried sessions
- Space for meaning, grief and values
- Familiarity with sexual health and stigma
- Therapy and prescribing in one place
- Somatic tools for secondary trauma
Starting therapy for advocates
Beginning is straightforward, and you decide the pace at every stage.
-
1
Free consultation 15 minutes
A short, no-obligation call to tell me a little about your work or situation and what you are hoping for. You can ask about my approach and get a sense of whether we are a good fit before committing to anything.
-
2
In-depth first session
We take time to understand your history, the demands of your role or transition, your physical health, sleep and support network. If medication or supplements may be relevant, I gather what I need to assess that thoughtfully.
-
3
A shared plan
Together we agree on focus and rhythm. That may be regular psychotherapy, somatic work, medication support or a combination. The plan reflects your priorities and is revisited as your circumstances and the wider climate change.
-
4
Ongoing sessions
We meet in 60 or 90-minute sessions, building steadiness over time. Many advocates find that having a dependable space outside the movement helps them return to their work with clearer limits and renewed care.
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 Reproductive & Sexual Health Advocates FAQs
What does therapy for reproductive health advocates in New York focus on?
It focuses on the particular strain of working in reproductive and sexual health: secondary trauma from hearing distressing stories, burnout from constant urgency, moral injury when systems fail people, and the personal toll of hostility or threats. We also explore what keeps you connected to the work. Sessions are shaped around your role, whether you are a clinician, doula, helpline volunteer, organiser, educator or researcher, and around how this work intersects with your own life.
Do I need to work in the field to see you about reproductive health?
No. I also support people living through fertility treatment, pregnancy, loss, postpartum change, perimenopause, menopause or hormonal shifts related to gender-affirming care. These transitions can affect mood, sleep, anxiety and identity in ways that are often minimised. You are welcome whether your connection to reproductive health is professional, personal or both.
Can you help with postpartum or perimenopausal mood changes?
Yes. As a board-certified psychiatric nurse practitioner, I can assess postpartum and perimenopausal depression and anxiety, consider how hormonal changes may be contributing, and talk through options including psychotherapy, somatic work, lifestyle changes and medication. If medication is appropriate, we start carefully and monitor closely. Where other medical input is needed, such as from your obstetric or gynaecological provider, I will say so clearly.
Will you share my political views or judge my work?
I approach this work from an affirming, feminist and trauma-informed perspective, and I respect bodily autonomy. You will not be asked to defend your choices or your advocacy. At the same time, therapy is your space, not mine, so my role is to help you explore your own thoughts and feelings, including any complicated or conflicting ones, without pushing an agenda.
How is my privacy protected?
Confidentiality is central to my practice. I keep a small caseload, and what you share is protected within the legal and ethical limits that apply to all health care, which I explain at our first meeting. If your work raises specific safety or visibility concerns, we can discuss how they are handled so you can speak as openly as you need to.
What if I am thinking about leaving advocacy altogether?
That is a valid and often painful question, and many people carry guilt about it. Therapy can help you separate exhaustion from genuine change of direction, explore what you would grieve or gain, and make a decision that respects both your values and your limits. Stepping back is not a betrayal of the cause, and staying is not the only way to remain committed.
What if the work has left me feeling hopeless or unsafe?
Please tell me, because it matters. Hopelessness is a common response to prolonged exposure to injustice and distress, and it can be worked with. If at any point you are thinking about ending your life or are in immediate danger, call or text 988 for the Suicide and Crisis Lifeline, or 911 in an emergency, and then reach out so we can support you.
Let someone hold space for you
Book a free 15-minute consultation to talk about your work, your body and what support would feel right. There is no pressure and no need to have it all figured out.