SPECIALIST THERAPY ● LONDON & ONLINE
LGBTQ+ Affirming Therapy
in Fitzrovia, London, and online.
Finding a therapist you don't have to come out to (again) matters. Someone who already knows the landscape: the terminology, the complexity, the moments that are hard to name and harder still to explain to someone who hasn't lived near them.
I'm Matthew Frener, a UKCP Registered and BACP Senior Accredited integrative psychotherapist based in Fitzrovia, Central London. I use he/him pronouns, and working with LGBTQ+ clients is a central part of my practice. This is work that I'm genuinely invested in, personally and professionally.
If you've been let down by therapy before, or you're approaching it for the first time and wondering whether it's worth the risk, take a look through this page, and if something resonates, get in touch to explore how we might work together.
Last updated: May 2026
OVERVIEW
LGBTQ+ Affirming Therapy Sessions in Fitzrovia & Online
What is LGBTQ+ Affirming Therapy?
Affirming therapy is not the same as accepting therapy. Acceptance sets a low bar, it means a therapist won't pathologise your identity or make you feel unwelcome.
Affirming goes further.
It means working with who you are as a source of meaning, complexity and strength, rather than something to be managed, explained away, or quietly bracketed from the work.
In practice, this means bringing genuine knowledge of LGBTQ+ experience into the room, of minority stress, of the particular ways shame and identity can become entangled, of the cultural and community contexts that shape how we understand ourselves. It means not needing you to educate me before we can begin.
I work within a framework that encompasses what is increasingly referred to as GSRD (Gender, Sex and Relationship Diversity). This is a broader and more accurate lens than LGBTQ+ alone, one that holds the full range of human experience around gender identity, sexual orientation and relationship structure, including those that don't fit neatly into existing categories or labels. If you've ever felt that the available language doesn't quite describe you, that framing might feel like a relief.
What affirming therapy is not
A rainbow lanyard, a land acknowledgement on a website, or a therapist who means well but needs bringing up to speed. If you've encountered that version before, I understand the wariness. This is something different.
The Research is Clear
3 in 5
LGBTQ+ people in the UK experienced anxiety in the past year, and half experienced depression
Stonewall / Mind, 2025
Not Identity
These disparities are not caused by being LGBTQ+. They are caused by minority stress, the chronic strain of stigma, discrimination, and concealment
Meyer, 2003, foundational minority stress model
1.5 x more likely
LGBTQ+ people are one and a half times more likely to develop depression or an anxiety disorder than the wider population
Mental Health UK
9,600+
LGBTQ+ young people surveyed across the UK in 2024, over half had considered suicide in the past year, with trans and non-binary youth most affected
Trevor Project / University of Birmingham, 2024, * figures relate to ages 13–24
The mental health gap facing LGBTQ+ people is real, well-documented, and driven by external pressures, not by identity itself.
So is the evidence that the right therapy makes a meaningful difference.
Who I Work With
My LGBTQ+ clients are not a homogenous group, and this page isn't written as if they are. Some people arrive with a clear sense of who they are and what they're carrying. Others are still working that out. Both are equally welcome.
I work with gay and lesbian individuals, bisexual and pansexual people, trans and non-binary clients, and those who identify as queer or are somewhere in the process of questioning. I work with people who have a word for what they are and people who don't, and people who have decided the words don't particularly matter to them.
I work with people in monogamous, open, and polyamorous relationship structures and relationship anarchists, and with people navigating the specific dynamics that come with loving someone while one or both of you is still figuring out who you are.
If you're LGBTQ+ and also neurodivergent, or managing ADHD alongside everything else, you'll know that those two things don't sit in separate boxes. They shape each other in ways that a therapist needs to understand, not ask you to explain. The same is true if you're navigating addiction, compulsive behaviour, or chemsex, areas where LGBTQ+ experience brings its own specific pressures and contexts, and where the right therapeutic relationship makes an enormous difference.
I also work with LGBTQ+ people from racialised communities, and with clients who are navigating multiple, intersecting identities at once, where the question of who you are can't be answered by any single part of you.
What We Might Explore Together
The experiences below are among the most common reasons LGBTQ+ people come to work with me, but this is not an exhaustive list, and your experience doesn't need to fit neatly into any of them. If something is bringing you to therapy and you don't see it named here, please do get in touch. What matters is not whether your situation matches a category, but whether we can work together, and the best way to find that out is to have a conversation.
Minority Stress
Minority stress is the term researchers use for something many LGBTQ+ people know intimately but may never have named: the chronic, cumulative toll of navigating a world that wasn't built with you in mind. The hypervigilance. The low-level exhaustion of constantly assessing whether a space is safe, whether a person can be trusted, whether it's worth saying something or easier to let it go. It accumulates quietly, over years, and often shows up in therapy as anxiety, depression, or a vague but persistent sense that something is wrong, without an obvious cause. There is a cause. And it can be worked with.
Shame and Internalised Homophobia or Transphobia
Shame is one of the most common things LGBTQ+ people bring to therapy, and one of the most difficult to name, partly because it often doesn't feel like shame. It feels like a quiet certainty that you are too much, not enough, fundamentally difficult to love. Internalised homophobia and transphobia are the specific forms this takes when the messages the world sends about who you are have been absorbed so deeply they feel like your own thoughts. Therapy can help you find the difference between what is true about you and what you were taught to believe.
Coming Out
Coming out is not a single event. It is something most LGBTQ+ people do repeatedly, across a lifetime: to new people, in new contexts, in new relationships with themselves. Some people arrive in therapy mid-way through the process, somewhere between relief and complication. Others come having never said any of it out loud. Some are coming out later in life, having built a whole life that is now quietly shifting around them. Wherever you are in that process, that's where we start.
Family: rejection, estrangement and not being fully known
For many LGBTQ+ people, the family of origin is not a place of safety or unconditional acceptance. Some have experienced outright rejection. Others live in a more ambiguous in-between, tolerated but not fully embraced, loved but not quite seen. The grief of not being fully known by the people who were supposed to know you best is real and significant, and it shapes how you move through the world and how you relate to other people. It deserves space.
Gender Identity and Dysphoria
Gender identity can be one of the most profound and disorienting things to navigate, particularly in a culture that has strong opinions about it and limited patience for complexity. Whether you are exploring your gender for the first time, living with dysphoria, considering or in the process of transition, or simply trying to understand what gender means to you, therapy can provide a space to do that without pressure, agenda or a predetermined destination.
Relationships and Intimacy
LGBTQ+ relationships carry all the complexity of any human relationship, and sometimes more. Attachment wounds, patterns that repeat, the particular dynamics that come with same-sex relationships or queer partnerships, navigating open relationships or non-monogamy, loving someone while one or both of you is still becoming who you are. Many LGBTQ+ people grew up without visible models for the kind of relationship they wanted, and that absence can leave its own mark.
Sex and Desire
Shame around sex and desire is extraordinarily common among LGBTQ+ people, often rooted in years of being told, implicitly or explicitly, that your desires are wrong, dangerous or something to be hidden. Sexual compulsivity, difficulties with intimacy, navigating desire in the context of identity, chemsex and its emotional aftermath, these are areas where the right therapeutic relationship, and a therapist who already understands the landscape, makes an enormous difference.
Kink and BDSM
Therapy can offer a space to explore what kink and BDSM dynamics mean to you, how they intersect with your broader sense of self, and how to navigate the relationships and communications they might involve. Whether you are new to this part of your identity or have lived it for years, the work here is about understanding yourself more fully, not about judgement, and not about change.
Anxiety and Depression
Anxiety and depression are among the most common reasons LGBTQ+ people seek therapy, and they are significantly more prevalent in this community than in the general population. But they rarely exist in isolation. They are almost always tangled up with identity, with minority stress, with the specific history of how a person has learned to exist in the world. Treating the anxiety without understanding that context is treating the symptom. The work here goes deeper.
Grief and Loss
LGBTQ+ grief is often unacknowledged and unmourned. The loss of the life you imagined before you knew who you were. The estrangement from family. The friends and community members lost to the AIDS crisis, a grief that an entire generation of gay and bisexual men has carried largely without ceremony. The loss, for some trans people, of relationships or careers that didn't survive transition. These are real losses. They deserve to be named as such.
Trauma
Trauma takes many forms in LGBTQ+ experience, hate crime, conversion therapy, medical trauma for trans clients navigating healthcare systems that have not always treated them with dignity, childhood experiences of rejection or abuse rooted in identity, the cumulative trauma of years of concealment. I am trained in somatic and body-based approaches to trauma, which recognise that what the mind has survived is also held in the body, and that healing often needs to involve both.
Addiction and Chemsex
Substance use and addiction are disproportionately present in LGBTQ+ communities, shaped by minority stress, social contexts and the particular role that substances can play in navigating intimacy, belonging and pain. Chemsex, the use of specific drugs in sexual contexts, particularly among gay and bisexual men, brings its own clinical complexity, including around consent, compulsivity and the emotions that substance use can both enable and suppress. This is an area I have specific experience in, and approach without judgement.
Body Image and Eating
Body image difficulties are widespread across LGBTQ+ communities, though they show up differently in different groups. Gay and bisexual men navigate specific and intense appearance-related pressures, muscularity ideals, ageing, visibility within community spaces. Trans and non-binary clients may experience profound disconnection from their bodies. Queer women navigate their own relationship with bodies and desire in a culture that has conflicting things to say about both. I hold a specialist qualification in eating disorders through the National Centre for Eating Disorders, and this is an area I work with both experience and care.
Aging as an LGBTQ+ Person
Older LGBTQ+ people face specific challenges that are rarely spoken about: isolation, the loss of community, navigating care and healthcare settings that may not be affirming, and the particular grief of those who lived through the AIDS crisis and carry its losses still. Ageing in a community that can be youth-focused brings its own complicated feelings. If you are an older LGBTQ+ person and have found that most therapy spaces feel like they were designed for someone younger, you are welcome here.
Loneliness and Isolation
Loneliness is one of the quieter crises in LGBTQ+ experience. It can affect people who are not yet out, people who are geographically distant from community, older LGBTQ+ people whose peers have died or drifted, and people who are out and connected but still feel fundamentally unseen. It is not always visible from the outside. And it is not something you simply have to live with.
Neurodivergence and ADHD
Many clients arrive having masked both their neurodivergence and their identity for years simultaneously, with enormous cost to their sense of self and their energy. If you are navigating ADHD, autism or another neurodivergent experience alongside your LGBTQ+ identity, that intersection deserves specific attention.
Workplace and Professional Life
Being LGBTQ+ at work brings its own set of calculations, whether to come out, to whom, in what context, with what risk. The exhaustion of code-switching. The particular difficulty of navigating homophobia or transphobia in a professional setting where the power dynamics make it hard to respond. For some clients, the workplace is where their identity feels most constrained, and that has a cost that extends well beyond office hours.
Developmental Lag
When people come out in adulthood, they may find themselves going through something that looks like adolescence, the experimentation, the intensity of new feelings, the need to try things on and see what fits, at a point in their lives when their peers went through all of that twenty years ago. This can be disorienting, even embarrassing. It can create friction in existing relationships and feel at odds with the adult life that has been built around it. Developmental lag is a well-recognised phenomenon in LGBTQ+ experience and nothing about it is unusual or wrong. Therapy can offer a space to move through it with some understanding of what is actually happening, and why.
Religion and Faith
For LGBTQ+ people raised in religious households, or who continue to hold faith themselves, the relationship between identity and belief can feel like an impossible conflict. The sense of being excluded from something that was once a source of meaning and community. The guilt, the grief, the theological questions that don't have simple answers. This is a territory that requires a therapist who can hold complexity without pushing you towards a particular resolution, and that is precisely what I aim to offer.
Dealing with the Aftermath of Conversion Therapy
Conversion therapy, any attempt to change, suppress or redirect someone's sexual orientation or gender identity, causes serious and lasting psychological harm. If you have experienced it, whether through a religious setting, a well-meaning family member, or a mental health professional who should have known better, the effects can be complex and far-reaching: damage to self-trust, difficulty knowing what you actually feel or want, a complicated relationship with faith or family, and a deep wariness of therapeutic relationships in particular. Working with the aftermath of conversion therapy requires care, patience and a therapist who understands precisely what was done and why it was wrong. This is an area I take seriously and approach with both knowledge and sensitivity.
Impact of the Political Climate
The public conversation around LGBTQ+ rights, and particularly around trans and non-binary people, has become increasingly hostile in recent years. For many clients, the daily news cycle is not an abstraction. It is a direct and ongoing assault on their sense of safety, legitimacy and belonging. The psychological impact of living through this, the hypervigilance, the anger, the grief, the exhaustion, is real and serious.
Parenting and Family Building
LGBTQ+ people navigating decisions about having children, through donor conception, adoption, surrogacy or co-parenting arrangements, face a set of questions and pressures that most parenting literature simply doesn't address. And LGBTQ+ parents raising children in a world that still sometimes treats their family as unusual carry that additional weight alongside everything else that parenting brings. This is an area where having a therapist who understands the specific landscape, rather than having to explain it, matters.
Bisexuality and Bi-erasure
Bisexual people make up the largest group within the LGBTQ+ community and are consistently among the least well served by mental health provision. Bi erasure, the experience of having your identity doubted, dismissed or rendered invisible, including by other LGBTQ+ people and by therapists who consider themselves affirming, is its own form of harm, and one that accumulates. If you have been told you are confused, going through a phase, or that your identity will resolve itself once you settle down with someone, you will know how corrosive that is. Bisexuality is not a stepping stone, not a temporary position, and not something that requires further explanation in this room.
Intersectionality
Identity is not experienced in separate compartments. If you are LGBTQ+ and also from a racialised community, or disabled, or working class, or navigating a faith background, or living with chronic illness, those things do not sit neatly alongside each other. They shape each other, compound each other, and produce experiences that cannot be understood by looking at any single part of who you are. Many LGBTQ+ people from multiply marginalised backgrounds find that mainstream LGBTQ+ spaces do not fully see them, and that mainstream mental health services understand even less. Therapy that holds the whole person, not just the part that is easiest to name, is what I aim to offer.
The Benefits of LGBTQ+ Affirming Therapy
Therapy is only as effective as the context it's delivered in.
For LGBTQ+ people, that context matters enormously as a clinical necessity. Research consistently shows that identity-affirming therapy produces significantly better outcomes than non-specialist treatment for LGBTQ+ clients, across depression, anxiety, substance use and overall wellbeing.
These are some of the specific ways that working with an affirming therapist makes a difference:
No explanation fatigue and no editing yourself
In affirming therapy, the groundwork is already done. Explanation fatigue (the exhausting, cumulative experience of having to educate every new professional you encounter about basic terminology, community context, or the significance of your lived experience) stops here. And it goes beyond not having to educate. No part of your experience needs to be left at the door either. Your identity, your relationships, your desires, your community, your grief, all of it is welcome material. Therapy works best when you don't have to perform a particular version of yourself to receive it.
Your identity is treated as a strength, not a problem
Affirming therapy doesn't treat being LGBTQ+ as the source of your difficulties. It understands that the difficulties you carry are largely shaped by external pressures (minority stress, discrimination, shame that was taught rather than earned) not by who you are. That distinction changes everything about how the work unfolds.
Minority stress is recognised and addressed directly
Rather than treating anxiety, depression or exhaustion as purely internal problems, affirming therapy understands them in context. The chronic stress of navigating a world that wasn't built for you is a real clinical factor, and one that can be worked with directly, rather than managed symptom by symptom. Research by Burger and Pachankis (2024) confirms that LGBTQ-affirmative therapy produces measurable improvements in depression, anxiety and substance use, with shame, hypervigilance and negative self-schemas identified as the key clinical targets.
Distinguishing what is yours from what was put there
One of the most significant benefits of affirming therapy is helping you untangle what is genuinely yours (your character, your values, your ways of being in the world) from what was installed by a culture that pathologised you. Many LGBTQ+ people have absorbed external messages so thoroughly that the two feel inseparable. Therapy can help you find the difference between what is true about you and what you were simply taught to believe.
Your relationships and family history are understood in full
LGBTQ+ relationship histories don't always look like the models most therapeutic training is built around. Chosen family, non-monogamous structures, the particular dynamics of same-sex partnerships, the impact of family rejection on how you attach to people, affirming therapy holds all of this without requiring you to translate it into a heteronormative framework first.
Support through transition and life change
For trans and gender-nonconforming clients, affirming therapy offers something that general mental health provision rarely can: a therapist who already understands the landscape of social, legal and medical transition, the decisions, the timelines, the impact on relationships and identity, and the mental health weight of navigating systems that are not always equipped to respond well. You don't have to explain what you're going through before support can begin.
The therapeutic relationship itself becomes part of the healing
For many LGBTQ+ people, the experience of being fully known by another person, without editing, without managing their reaction, without waiting for the moment the warmth runs out, is genuinely new. That experience, repeated over time within a safe and consistent therapeutic relationship, can quietly begin to change how you relate to yourself and to others.
How LGBTQ+ Affirming Therapy differs from general Counselling and Psychotherapy
Most therapists will tell you they are inclusive. Fewer have the training, knowledge and lived proximity to LGBTQ+ experience to work with it in any depth. The difference matters, and it tends to show up not in the first session, but in the second, third and fourth, when the real work begins.
Knowledge of LGBTQ+ Experience
Traditional therapy: May require you to explain terminology, community context or the significance of your experience before the work can begin.
LGBTQ+ affirming therapy: Brings existing knowledge of LGBTQ+ communities, minority stress and GSRD frameworks. You don't need to educate your therapist first.
Identity
Traditional therapy: Treats sexual orientation and gender identity as background information, noted, then set aside.
LGBTQ+ affirming therapy: Treats identity as central and dynamic, something that shapes every aspect of a person's experience and deserves to be worked with, not around.
Minority Stress
Traditional therapy: May not recognise minority stress as a clinical framework, or understand how it accumulates and presents.
LGBTQ+ affirming therapy: Understands minority stress as a primary driver of LGBTQ+ mental health difficulties, and works with it directly, not just its symptoms.
Relationships & Family
Traditional therapy: Applies general models of family and relationships that may not account for queer family structures or non-normative relationship models.
LGBTQ+ affirming therapy: Works with the full range of relationship structures, same-sex partnerships, polyamory, chosen family and the specific dynamics of queer intimacy.
Coming Out
Traditional therapy: May treat coming out as a single event that has either happened or not.
LGBTQ+ affirming therapy: Understands coming out as a non-linear, lifelong process, and works with wherever a client is in that process, without a predetermined endpoint.
Shame
Traditional therapy: May address shame in general terms without understanding the specific, layered nature of internalised homophobia, biphobia or transphobia.
LGBTQ+ affirming therapy: Recognises internalised oppression as a distinct clinical presentation, with specific tools and frameworks for working with it at depth.
Gender Identity
Traditional therapy: May have limited knowledge of gender diversity, trans experience or non-binary identities, and may inadvertently apply cis-normative assumptions.
LGBTQ+ affirming therapy: Works within a GSRD framework that holds the full range of gender experience, without assumptions, agenda or a binary model of gender.
The Broader Context
Traditional therapy: May treat a client's difficulties as purely internal, without accounting for the external, structural pressures that shape LGBTQ+ mental health.
LGBTQ+ affirming therapy: Holds both the internal and the external, understanding that what a client carries is shaped by the world they live in, not just the life they have lived.
The question is not whether a non-specialist therapist can be helpful, many can. The question is whether you want to spend your therapy sessions doing the groundwork, or whether you want to start from a place of being already understood.
LGBTQ+ Affirming Therapist in Fitzrovia, London, Matthew Frener
Matthew Frener, MSc, Clin. Dip, UKCP Reg, BACP (Snr Accred), SNPCS (Accred)
Integrative Psychotherapist & DBT Therapist · he/him
I work with LGBTQ+ adults who are tired of explaining themselves, to other people, to previous therapists, and to themselves. People who are self-aware, who can often name their patterns, trace them back to where they began, and yet find the same dynamics returning. People who have spent years being legible to others at the cost of being known.
At the heart of how I work is the therapeutic relationship: a connection built on trust, genuine understanding, and mutual respect. I believe the self is formed in relationship, and that relationship is also where change becomes possible. Not through technique alone, but through what happens between us in the room. For many LGBTQ+ clients, a therapeutic relationship in which they are fully known, without editing, without managing the other person's reactions, is itself something new. That newness matters.
My approach is integrative, drawing on relational and attachment-based theory, psychodynamic thinking, DBT, CBT, IFS, and somatic approaches, shaped by clinical experience across residential treatment, outpatient services, and private practice. I don't apply a single model to every person. I work with what you bring, at your pace, attending to the whole of your experience: cognitive, emotional, somatic, relational.
I do not consider myself a therapist who is a neutral blank screen. I bring warmth, directness, a willingness to say difficult things carefully, and a genuine personal investment in this work. I use he/him pronouns. Working with LGBTQ+ clients is not a specialism I arrived at by accident, it is work I am drawn and committed to.
UKCP Registered · Registered Member MBACP (Senior Accred) · Senior Accredited Registrant SNCPS (Accred) · Addictions Professional AP
My Approach to Working with LGBTQ+ Clients
Relational and Attachment Focused
Many LGBTQ+ people arrive in therapy having learned that it is not safe to be known. The experience of concealment, rejection or conditional acceptance, whether from family, community or wider society, leaves its mark on how a person relates to others, how much they trust, and how close they allow people to get. My work is grounded in relational and attachment theory, which means that the therapeutic relationship itself is both container and central to the work. Building an experience of being genuinely known, without editing or consequence, can be transformative for people who have spent years doing the opposite.
Identity-Aware, GSRD-Informed and Intersectional
I work within a GSRD (Gender, Sex and Relationship Diversity) framework, which means I bring existing knowledge of the full range of human experience around gender identity, sexual orientation and relationship structure. I understand that identity is not experienced in separate compartments. If you are LGBTQ+ and also from a racialised community, neurodivergent, disabled, working class, or navigating a faith background, those things shape each other in ways that cannot be understood by looking at any single part of who you are. I aim to hold the whole person, not just the identity that is easiest to name, and to work with the specific intersection of experiences that has brought you here.
Parts work - IFS-informed
Internalised homophobia, biphobia and transphobia don't always feel like external messages that have been absorbed. They often feel like a voice, or several voices, that have become so familiar they seem like your own thoughts. Internal Family Systems-informed parts work offers a way of relating to those voices differently: understanding where they came from, what they were trying to protect, and how to find a different relationship with them. For LGBTQ+ clients carrying significant shame, this approach can be particularly powerful, it offers a way to work with the internal critic without being at war with yourself.
Trauma-Informed and Somatic
Trauma is disproportionately present in LGBTQ+ experience, in forms both acute and cumulative. Discrimination, hate crime, conversion therapy, medical trauma, childhood rejection, the slow accumulation of years of concealment. What the mind has survived is also held in the body, and healing often needs to involve both. I have trained with world-renowned trauma specialist Babette Rothschild, in Somatic Trauma Therapy.
Integrative and Person-Centred
No two LGBTQ+ clients are the same, and no single therapeutic model is adequate to the full range of what people bring. My integrative approach means I draw on whichever frameworks, tools and ways of working best serve the person in front of me, rather than fitting a client to a model. What remains consistent is the orientation: collaborative, curious, and genuinely invested in understanding your particular experience rather than a version of it that is easier to work with. You can arrive uncertain, contradictory, unresolved, or not yet sure what you are looking for. That is not a problem. It is where we start.
Dialectical Behaviour Therapy (DBT)
Minority stress is chronic. It doesn't arrive in discrete episodes, it accumulates, quietly and persistently, across years of navigating a world that wasn't built with you in mind. For many LGBTQ+ clients, the result is a level of emotional intensity or dysregulation that has never been adequately explained or addressed. DBT offers a set of evidence-based skills for managing overwhelming emotion, tolerating distress, and building a life that feels worth living, and I draw on it where emotional regulation is part of the picture, integrated into the broader relational work rather than delivered as a standalone programme.
Some of the approaches I draw on
Relational Psychotherapy
Attachment-based therapy
GSRD-Informed Practice
Trauma-Informed Practice
Psychodynamic therapy
Developmental Neuroscience
Internal Family Systems (IFS)
Somatic & body based approaches
Mindfulness-based approaches
Humanistic and person-centred
Dialectical Behaviour Therapy (DBT)
Cognitive Behaviour Therapy (CBT)
PRACTICAL INFORMATION
Fees for LGBTQ+ Therapy in Fitzrovia, London, and Online
Sessional Fees
I offer individual therapy on a sliding scale of £100 to £120 per 50-minute session. Longer sessions are charged on a pro rata basis.
We can agree a fee at the outset of therapy based on your circumstances, or those of the person funding your sessions. This scale is intended to make therapy more accessible, with higher-fee sessions helping to support the availability of lower-fee and concessionary spaces.
Invoices are issued monthly in advance, usually on or around the 15th of each month, and are payable by bank transfer before the 1st of the upcoming month. Payment secures your regular weekly session time.
Concessions & Insurance
I keep a limited number of concessionary spaces for NHS workers and those on a low income. If this may apply to you, you are welcome to mention it in your enquiry form, and I will let you know whether I currently have any reduced-fee availability.
I currently accept AXA, Aviva, WPA, Cigna, and Vitality insurance. If you are with another provider, I can provide an invoice or receipt for possible reimbursement.
As policies vary, I recommend checking directly with your insurer in advance. If there is any difference between what your provider covers and my fee, you will be responsible for paying the shortfall.
HOW WE MEET
In person & online LGBTQ+ Affirming Therapy
In person - Fitzrovia, Central London
My practice is based at 12–12a Margaret Street in Fitzrovia, a short walk from Oxford Circus.
In-person sessions offer a dedicated, private, and grounded space that many clients find valuable.
Well served by multiple tube lines. See location details below.
Online - via secure video
Online therapy takes place via a secure, encrypted video platform and is available to clients throughout the UK and internationally. Many clients choose online therapy for greater accessibility and preference.
You will need a private space and a stable internet connection.
LOCATION
Fitzrovia, Central London
12-12a Margaret Street, London, W1W 8JQ
Conveniently located in the heart of Central London, Matthew Frener Therapy is easily accessible with multiple transport routes nearby. On-street parking is available.
Closest Tube Stations:
Oxford Circus
4 min walk
Bakerloo · Central · Victoria
Great Portland Street
11 min walk
Circle · Hammersmith & City · Metropolitan
Goodge Street
7 min walk
Northern
Bond Street
11 min walk
Central · Elizabeth Line · Jubilee
Tottenham Court Road
9 min walk
Central · Elizabeth Line · Northern
Piccadilly Circus
12 min walk
Bakerloo · Piccadilly
GETTING STARTED
What to expect
If you are interested in working together, here's what to expect during the process:
01
Complete the enquiry form
If you are interested in starting therapy, the first step is to complete my enquiry form. It is a more detailed form, designed to give me a fuller sense of what is bringing you to therapy, what support you are looking for, and whether I may be the right fit for your needs. This helps me respond thoughtfully and prioritise genuine enquiries. You will have the option to book a free introductory call (Step 02), or we can move straight to registration and agreement (Step 03)
I aim to respond within 48 hours. If you have not heard back from me within that time, please check your junk or spam folder in case my reply has landed there.
02
Introductory call
If you choose to book a free introductory call, we will arrange a time for a 15-30-minute call, either by phone or via Zoom, depending on your preference. This gives us a chance to discuss your enquiry form in more detail, talk about what is bringing you to therapy, and consider what you are hoping for from the work. I will also explain how I work and answer any questions you may have.
This call is not a therapy session, but a space for us to begin getting a sense of whether working together feels like the right fit. There is no fee for this call and no obligation to continue.
03
Registration, agreement and confirming your weekly slot
If we decide to work with one another, I will send you a New Client Registration Form and my Therapeutic Agreement to complete through my practice management software. These documents set out the practical and professional framework for our work together, including confidentiality, cancellations, and the terms of therapy.
I will ask you to select a sessional fee on my sliding scale that best reflects your, or the bill payer's, household income. Then, once the registration form and therapeutic agreement have been completed, I will issue the invoice for your first set of sessions, and your regular weekly slot is confirmed once payment has been received.
04
Initial assessment sessions
The first few sessions are a space for us to begin building a fuller understanding of what is bringing you to therapy. We may explore your current difficulties, the broader context of your life, earlier experiences that may still be shaping you, and what you are hoping for from therapy, whether clearly formed or not yet fully known. This can help us co-create a path forward.
I see assessment as more than a process of gathering background information. It is also the beginning of the therapeutic relationship. As we talk, I will be listening not only to the content of what you bring, but also to how you experience yourself, how you relate, what feels difficult to say, and what may already be unfolding between us. Often, these early sessions begin to reveal something important about the patterns and relational ways of being that therapy can help make sense of over time.
It is also completely normal to feel apprehensive, uncertain, or nervous during the first few sessions. After all, you may be sharing deeply personal parts of your life with someone you do not yet know well. Even having read my website or spoken with me in an introductory call, I am still, at this stage, a stranger. Part of the early work is allowing enough time and space for trust to begin to develop at a pace that feels manageable for you.
Just as importantly, these sessions allow you to get a sense of me, and of whether this feels like a space in which you can begin to do meaningful work. The assessment is not separate from therapy, but the beginning of it.
05
Ongoing weekly sessions
We meet at the same time each week for 50 minutes, creating a regular and dependable space for the work to unfold. Weekly sessions provide the consistency therapy needs for trust to grow and for the work to deepen over time. I do not usually offer sessions less frequently than this, as longer gaps can affect the continuity and containment of the process. Where appropriate, and where availability allows, twice-weekly sessions may be offered during more challenging periods when additional support is needed.
My approach is non-directive, which means I do not follow a fixed agenda or work through a set programme. Instead, we attend to what feels most important, difficult, or alive for you. At times this may be something immediate in your present life. At others, it may be a recurring pattern, a relationship, a feeling, or something harder to name that begins to emerge between sessions or within the therapy itself.
Non-directive does not mean distant or passive. I will be actively engaged in thinking with you, helping us make sense of what you bring, what may remain outside awareness, and how past and present can become linked in meaningful ways. You do not need to arrive with things neatly worked out. Therapy can hold confusion, ambivalence, uncertainty, and change.
06
Review and endings
We will regularly check in on how the work is feeling for you. These reviews are usually informal rather than structured, and may sound like: How has this been for you? What has felt useful? What has not? I want to understand how you are experiencing me, the therapy, and the process we are in together. Your sense of what is helping, what is not, and what you may need more or less of matters. Therapy is collaborative, and I cannot meaningfully adjust how I am working if I do not know how it is landing for you, so I encourage this kind of honesty throughout our work. Using your voice in this way can be an important part of the therapy itself.
I work in an open-ended way, which means there is no fixed number of sessions. Therapy continues for as long as it feels meaningful, needed, and useful. This allows the work to unfold at depth and at a pace that respects the complexity of your experience, rather than forcing it into an arbitrary timeframe.
At the same time, I always encourage clients to plan their ending where possible, rather than bringing therapy to a sudden stop. A great deal often becomes visible in how someone approaches endings, including how they relate to separation, completion, loss, and change. Because of this, endings are part of the therapeutic process in their own right.
Planning an ending gives us space to reflect on what has been helpful, what has felt less helpful, what you are taking with you, and what may still need thought or support. Where needed, we can also consider what structures or resources may help you feel supported once therapy comes to an end.
Frequently asked questions
FURTHER READING
From the journal
READY TO TAKE THE NEXT STEP?
Finding the right therapist takes courage, particularly if you have been let down before, or if you have spent years wondering whether therapy could ever really account for the fullness of who you are.
If anything on this page has resonated, I would welcome the chance to connect. The first step is a conversation, no commitment, no pressure, and no need to have everything figured out before you get in touch.