Private Practice

I am available for private practice consultations and psychotherapy.

I can assist with any of the practices and identities covered in my book including:

  • Trans
  • Intersex/DSD
  • Cisgender
  • Non-binary genders
  • BDSM/Kink
  • Asexuality
  • Bisexuality
  • Lesbian
  • Gay
  • Heterosexuality
  • Cross-dressing
  • Infantilism/ABDL
  • Furry
  • Fetish
  • Monogamy
  • Non-monogamies

I can also assist with common issues such as depression and anxiety, job difficulties, relationship difficulties, bereavement, personal losses and similar issues.

My fees (paid one week before the session) are as follows:

Assessments, including assessments for hormones and surgeries
Assessments are in person in Nottingham.

Initial assessment with Dr Richards (90 minutes) . . . . . . . . . . . . . .£200.00
General follow-up assessments (45 minutes) . . . . . . . . . . . . . . . . . .£130.00

Follow-up appointments are only available following an initial assessment.

Please note that you will be paying me for an assessment, not a recommendation. I can, of course, only make recommendations for hormones, surgeries etc., after assessment, and when clinically appropriate. In addition, surgeons, GPs, and others may take their own view as to whether they wish to act upon any recommendation. Some are very supportive of trans people, some sadly rather less so. While gender specialists are able to recommenced treatment, we are not able to force other clinicians to act. If that is the case we can, however, refer you to other more specialist clinicians who may be more open.

I am a doctor of psychology rather than medicine and so do not give immediate prescriptions. Instead I assess on psychological grounds and then refer to my endocrine colleagues (who are medical doctors which specialise in hormones); or surgical colleagues (who are medical doctors who specialise in surgery) as necessary.

I will usually need to see you for an overall assessment appointment to get to know you, and then one or more follow-up appointments to talk about any specific physical treatments you request. I will work as quickly as possible within the bounds of safe, effective clinical practice. While I try to be flexible, please do not book appointments with surgeons, endocrinologists, etc., which cannot be moved before seeing me. This is because for clinical safety reasons I cannot work only to your diary, but must work to the appropriate clinical outcome.

Physical treatments without transition
I generally make a recommendation for hormones or surgeries only once a person has formalised their transition into whatever gender suits them – whether binary or non-binary/genderqueer. This means making a legal change of name and identity documents; telling important people; and starting to live in your preferred gender role.

I am happy to see people who have not done these things to assess and give advice as I understand that those steps can be daunting, but I am unlikely to recommend physical treatments at that stage.

Genital Surgery
I will usually only refer for genital surgery when a person has made a formal change of gender role for at least a year; and when they have had at least six months of testosterone if they are trans masculine; or at least six months of androgen suppression if they are trans feminine.

Please do email me for clarification if you do not wish to take hormones; and/or if your gender and/or surgical requirements fall outside of this.

If I have not seen you previously, I would need to undertake a standard first assessment appointment and then the surgical assessment on another occasion.

Psychotherapy will usually consist of a single 50 minute session for us both to determine if we can work together well. If we feel that we can, then an agreement to undertake ten 50 minute sessions together before a review of progress would be expected.

Psychotherapy (in person in Nottingham) . . . . . . . . . . . . . . . . . . £90
Psychotherapy (via Skype) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .£65

Failed Appointments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100% of appointment cost (Not attended, or cancelled with less than 24 hours notice)

These fees cover appointment costs only. If any further services are required  then these may incur additional cost.

Written reports:
A comprehensive written report is included in the assessment fee. This can be addressed to the referrer and/or the individual themselves.

I can also undertake GRC reports for people I have seen personally.

Under 21s and Carer referrals
Unfortunately I do not see people under the age of 21 unless you are in work or at university, or other similar full-time occupation. I do not accept referrals from carers in my private practice. I do accept professional referrals.

Professional Witness work
I will not generally act as a Professional Witness unless summonsed to do so. I do act as an Expert Witness, but, of course that is a separate matter and I cannot have met the client beforehand.

Payment methods:
Payment can be by cash if meeting in person or PayPal.

I do not deal directly with medical insurance companies and will expect medically insured clients to obtain reimbursement themselves from their insurance company.

My accrediting bodies are the BACP and the HCPC.

Unfortunately my rooms require stairs to access them. If you cannot use stairs, or have other access needs, do contact me and I will see if alternative arrangements can be made.

I am afraid there is no facility for people to wait for people having their appointment. Please make alternate arrangements if you arrive with someone who will not be in the session with you.

Private Practice Contact
Please note I will not receive contact regarding my private practice through my NHS clinics. This is because I am not contracted to work privately when I am at work within the NHS; and the administrative staff are accordingly not allowed by the NHS Trusts  I work at to pass on any  information to me, including the fact that you have called.

Instead, please e-mail me.

For more information please contact me at:

You may also like to visit the website of some of my highly skilled colleagues at GenderCare