LGBTQIA+ affirming therapy, Philadelphia
Therapy where you arrive whole.
Rowhouse is my small queer-run practice in Fishtown. I work with people of all genders, partners and relationship structures, in person and by telehealth across Pennsylvania and New Jersey.
My commitments
Four promises I keep.
You never have to justify who you are.
Your identity is the starting point, not the subject of debate. I will not ask you to prove, explain or defend it.
Your chosen name is used everywhere I control.
Portal, emails, invoices and sessions. Where a legal name is unavoidable, I tell you exactly where and why.
You set the pace.
What we talk about, how fast and how deep is your call. You can pause, change direction or stop anytime.
I keep learning.
I invest in ongoing training and consultation, and I welcome correction when I get something wrong.
About me
Hi, I'm Elliot.
I opened Rowhouse in 2019 in a second floor studio on Frankford Avenue, with a lot of plants and a simple idea: queer and trans people deserve care from a therapist who already understands the basics, so sessions can be about your life rather than educating your therapist.
I draw on relational, attachment based and narrative therapy, and I pay attention to the real conditions of your life, including family, money, work, housing, faith and the news cycle.
Dr. Elliot Marsh, PsyD (he/they)Licensed psychologist and founder
Services
Care for the whole of you.
01
LGBTQIA+ affirming therapy
Individual therapy for anxiety, depression, grief, burnout and everything else, with clinicians who understand queer and trans life from the inside.
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02
Gender-affirming therapy
Space to explore, question and live your gender on your own terms, with or without medical transition.
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03
Letters for gender-affirming care
Support letters for hormone therapy and surgery, aligned with WPATH Standards of Care, Version 8, written collaboratively and quickly.
Read more04
Queer couples and relationship therapy
Therapy for partners of all genders and every relationship structure, including polyamorous and ethically non-monogamous relationships.
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Coming out and identity exploration
A steady place to figure out who you are and who, when and how to tell, at whatever pace feels right.
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Letters for gender-affirming care
Letters, made simple.
Support letters for hormone therapy and surgery, aligned with the WPATH Standards of Care, Version 8. A collaborative conversation about your goals, never a test to pass.
Hormone therapy letter
For providers or insurers that ask for a letter before starting estrogen, testosterone or blockers.
Surgery letter
For top surgery, bottom surgery, facial surgery and other gender-affirming procedures.
How it works
Book a letter consult
Tell me what your surgeon or provider needs. I will confirm requirements and timing before you pay anything.
Talk it through
One or two relaxed sessions about your goals, your support system and planning for recovery.
Receive your letter
I write it, review it with you, and send it directly to you or your provider.
Letters are sent within 5 business days of your final session. Already a Rowhouse client? Your therapist can usually write your letter within your regular sessions.
Who I work with
People of all genders and loves.
Gender identity
Exploring, questioning and living your gender.
Coming out
At any age, to anyone, or not at all.
Queer and trans couples
Partners of all genders.
Polyamory and ENM
Every relationship structure, without judgment.
Family rejection
Grief, boundaries and chosen family.
Religious trauma
Untangling faith, shame and belonging.
Anxiety and depression
Including minority stress.
Young adults
Ages 18 to 30 building an adult life.
Neurodivergent clients
Autistic and ADHD friendly sessions.
Asexual and aromantic people
Your experience is real and complete.
Getting started
How I begin.
Starting therapy should be the easy part. Here is what to expect.
- 01
A free 15 minute call
We talk briefly about what brings you in and whether I am the right fit. Ask me anything.
- 02
Your first session
A relaxed 50 minutes to get to know you. You lead, I listen, and nothing is required of you.
- 03
Find your rhythm
Together we decide how often to meet and what you want from the work. You can adjust anytime.
Fees
Clear, honest pricing.
| Individual therapy, 50 minutes | $160 |
|---|---|
| Couples and relationship therapy, 75 minutes | $210 |
| Letter for hormone therapy, 1 session plus letter | $225 |
| Letter for surgery, 2 sessions plus letter | $375 |
| Free consultation call, 15 minutes | Free |
I want therapy to be possible, so I keep my fees transparent and hold sliding scale spots every month.
In network
- Independence Blue Cross
- Aetna
Other plans
For other plans, I provide superbills you can submit for out of network reimbursement. Many PPO plans reimburse 50 to 80 percent.
Superbills provided for out of network reimbursement.
Full fees and insuranceCommunity resources
You are not alone.
- The Trevor Project (opens in a new tab)
24/7 crisis support for LGBTQ+ young people by phone, text and chat.
- Trans Lifeline (opens in a new tab)
Peer support hotline run by and for trans people. Call (877) 565-8860.
- William Way LGBT Community Center (opens in a new tab)
Philadelphia's LGBTQ+ community center, with peer groups, archives and events.
Questions
Things people ask.
Do I need a letter to start hormones?
Often not. Many Philadelphia clinics, including Mazzoni Center, prescribe hormones through informed consent without a letter. If your provider or insurer does ask for one, I can usually complete it in a single session.
How many sessions does a surgery letter take?
Usually two sessions. The first is a conversation about your goals and support, the second covers recovery planning. I send the letter within five business days of your final session.
Do you work with polyamorous and ENM relationships?
Yes. I work with polyamorous and ethically non-monogamous relationships, including triads and polycules. I never treat non-monogamy as the problem to be solved.
Are you LGBTQIA+?
Yes, I am part of the community. I am happy to share more about myself during a consult if that matters to you.
Can I use my chosen name on intake forms and billing?
Yes. Your chosen name and pronouns are used everywhere I control, including my portal, emails and sessions. When insurance requires a legal name, I keep it to the claim itself and tell you exactly where it appears.
Do I have to be out to work with you?
Not at all. You do not have to be out to anyone, including yourself. I can also schedule telehealth at times and in ways that protect your privacy at home.
Ready when you are.
Book a free 15 minute consult. No forms beforehand, no pressure after.