Noah Krell, Dani Fazio and Craig Cardamone share a couch at their new therapy studio on Exchange St. in Portland's Old Port. The three licensed social workers have seen a surge of new clients since opening Therapy for the People, a mental health center for LGBTQ-identified people, on Feb. 10. Credit: Nick Schroeder

PORTLAND, Maine — It wasn’t until 1987 that the American Psychiatric Association’s most commonly cited manual stopped referring to homosexuality as a mental disorder or “disturbance.” Many gay, lesbian, transgender and queer-identified people still routinely cite stigma or discrimination from accessing health services today.

But in Maine’s largest city, a new therapeutic center is bridging that gap. Since it opened less than two weeks ago with a goal of “prioritizing the mental health needs of the queer community,” the founders of Therapy For the People have been filling dozens of requests from prospective new clients, affirming the need for a designated LGBTQ-focused therapy practice.

There are 1,700 active licensed social workers in Cumberland County, and many are affirming of the LGBTQ community. But Therapy For the People flags its support front and center in its overall design and business model, recognizing the elevated need for health care among its community as well as their own profession’s checkered history.

“Queer people have higher rates of estrangement from family of origin, and they are not always given equal access to housing or employment.” said Dani Fazio, one of three licensed therapists who founded the space this month. “All of that impacts someone’s ability to have financial capital in their lives, and often it impacts access to health care.”

Since therapy is all about reducing stigma, the fact that clients don’t have to worry about their identity or sexuality being understood is a big draw.

“We’re seeing people appreciate that they don’t have the burden of having to educate their therapist” on these issues, Noah Krell said.

Krell and Fazio met while getting their masters degrees from the University of Southern Maine, studying trauma training. With Craig Cardamone, who moved to Portland from New York two years ago, the three offer a wide range of therapeutic practices for clients, with specific focuses for individuals, couples, family, grief counseling and those suffering with substance use disorders.

A 50-minute session with Cardamone, Fazio or Krell costs $120-125, typical for the region. They each accept MaineCare, in addition to private insurance and offer payment plans on a sliding scale for those who need it.

Cardamone said the group’s basic principle is about reducing oppression, which can require some creative financial flexibility to ensure people get what they need. Each said they set aside a certain number of hours per week to see clients in their community who can’t pay the full amount.

Access to health care is one of the most pressing national concerns in the country. In Cumberland County, there are several nonprofits and integrated health care providers available to the public that offer low-cost therapy for the uninsured or underinsured, or for people whose health care plans have high deductibles.

But those models also come with certain restraints, such as lengthy waitlists, and limits on the number of sessions. Clients are also often assigned a therapist, sometimes an intern, who may not be a good match and who might not understand the full spectrum of experience for LGBTQ people.

While therapy sessions won’t necessarily come as cheaply as they do with certain low-cost providers, Therapy for the People hope its model fills the specific needs of its community with accessibility in mind on a case-by-case basis.

“Body-positive, fat-positive, sex-positive, kink-positive, polyamory-allied, sex worker-allied — that’s what therapy for the people is,” Fazio said. “Come as you are.”

Cardamone, Fazio and Krell also treat Therapy for the People as a co-working space, a design that is often employed by technology companies. Other queer-friendly clinicians can rent space in the office’s Old Port location to see their own clients, or host group workshop or therapy sessions.

Strict confidentiality rules prohibit the team from sharing information about their clients, but the co-working model helps get young therapists on their feet, and fosters an environment of connection that they say is part of the healing process.

“It can feel really daunting opening up your private practice,” Cardamone said, adding that the profession can feel isolating for therapists as well. “We want to help other therapists start that up for themselves.”

“It’s not true of everybody,” Fazio said, ”but the queer community has been oppressed in so many ways,” noting the factors that have contributed to higher rates of substance use, depression and suicide among LGBTQ people than the rest of the population.

“When we don’t know how to manage our pain, we often self-medicate, and we don’t have to.”

Gia Drew, a program director with the LGBTQ advocacy organization EqualityMaine, said the the practice is an important step to helping people in the community feel validated and whole.

“While significant progress has been made in LGBTQ rights across society and here in Maine, individuals still face significant bias and discrimination within their families, their communities, the workplace and places of worship,” Drew said.

Maine passed a law last year that prohibits “conversion therapy.”

Fazio said she has clients in therapy now who were young people when homosexuality was considered a mental disorder by the diagnostic and statistical manual that therapists regularly use in their work.

“We’re still living with the scars of the system that we are voluntarily working in, but we’re working to untangle them.”