Assessment for diagnosis and physical treatments

Assessments, including assessments for diagnosis, hormones and surgeries

Please note that you will be seeing 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.

Initial assessment with Professor Richards (90 minutes) . . . . . . . . . . . . . .£300.00
General follow-up assessments (45 minutes) . . . . . . . . . . . . . . . . . .£150.00

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

Failed Appointments . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 100% of appointment cost (Not attended, or cancelled with less than 7 days notice)

If you would like assessment for physical treatments it would be really useful if you could include the following information  when you email me:

1 What name do you prefer to be known by (for example, when we meet you)? Have you made a legal name change (for example, via

2 How old are you?

3 Are you with other gender services, private or NHS?

4 Are you living, day to day, as you’d like to live, gender-wise? If not, what needs to change?

5 What do you do during the day (work, study, social activity)?

6 Are those close to you (family, friends, partners) aware of your gender circumstances? Do they support your plans?

7 Have you had any treatment for physical or mental health conditions?

8 What’s your objective in approaching Dr Richards– what would you like from us?