Doctor suspended over unregistered gender clinic says NHS gatekeeping is harming trans people

A doctor suspended for running an unregistered gender-affirming online trans healthcare clinic is appearing before tribunal to defend herself against accusations of negligence in her treatment of transgender patients.

During a 55-day tribunal that began on Monday (26 July), panel representatives of the GMC (General Medical Council) will address claims that Dr Helen Webberley breached NHS guidelines by prescribing hormone therapy to trans youth, as well as running the online health and wellbeing clinic GenderGP without the proper licence.

Founded in 2015, GenderGP is an online clinic born of Webberley’s long-standing commitment to patient-centred trans healthcare, which offers everything from hormone prescriptions to voice therapy. The service has long been a lifeline for trans communities, who often face healthcare discrimination or battle exhaustive waiting lists.

Currently, the length of waiting lists at NHS gender clinics is at an all-time high, with some stretching up to five years.

GenderGP provided vital support in the meantime, a fact acknowledged by the trans activists who created the #StandWithDrHelen hashtag and penned a comprehensive open letter, which details exactly how beneficial the service has been to many over the last six years.

An open letter to @gmcuk – to inform you we the transgender community #StandWithDrHelen

Who matters?

People.

We are the people. @GenderGP @MyWebDoctorUK #TransHealthcare @WiganNikki @mimmymum

26th July. Dr Helen Webberley, the GMC – an open letter https://t.co/3g7z9ocYMj

— www.stephsplace.uk (@PlaceSteph) July 26, 2021

Webberley launched the service while she was a practicing GP in Abergavenny, Wales. “I tried to register GenderGP, and initially HIW [Healthcare Inspectorate Wales] worked with me to register it while it continued to operate,” she explained to PinkNews.

When the GMC launched an investigation against Webberley in 2016, the registration was refused and HIW took Webberley to court, which ultimately resulted in a £12,000 fine issued in December 2018.

“That’s when I transferred ownership to Harland International, an LGBT+ organisation registered in Hong Kong,” she continued. “To close down [GenderGP] would have meant people would have come to harm.”

The main accusation levelled against Webberley is that she went against NHS guidelines by prescribing hormone therapy to trans youth, including a 12-year-old boy. NHS guidance states that 16 is the minimum age for hormone therapy, though in reality, extended wait times mean many will be much older.

In a lengthy blog-post published earlier this month, Webberley wrote: “Did that 12-year-old, who is now 17, suffer harm, or did he flourish as a result of intervention?

“What competencies should a doctor have to care for trans patients, are special qualifications available, or required? Is it obligatory to follow the NHS protocols for care in the UK?”

She added: “During the investigation, both sides have sought opinion from experts in the field, from the patients and doctors involved in the complaints made by the NHS gender consultants, and from the patients themselves.

“The reports and findings differ – a reflection of the continuing debate on the right way forward for the medical care of transgender patients. There is no doubt that this is a contentious area of healthcare, opinions are divided, emotions run high.”

In a separate BBC interview, Webberley also challenged the legitimacy of NHS guidance not to prescribe hormone therapy to transgender under-16s, arguing that the guidelines are “not set on any medical evidence or research.”

Of course the question will arise of ‘watchful waiting’, should we wait and see what happens during puberty or should we allow trans youth access to blockers and hormones? What can we do to make sure no more lives are lost? 4/10

— Dr Helen Webberley (@MyWebDoctorUK) July 9, 2021

The wider implications of the long-delayed tribunal

“I know that there are doctors who are waiting for this outcome,” continued Webberley in her statement to PinkNews. “There is currently fear amongst doctors when it comes to providing this care in the UK. They’ve seen what’s happened in the past to others who have helped trans patients outside the NHS, namely Dr Russell Reid and Dr Richard Curtis.”

Webberley fears that this demonisation of doctors stepping outside of NHS protocol is discouraging medical professionals from helping trans people being held back by bureaucracy and gatekeeping.

“When patients ask for help, the doctors have to say they’re unable to help without authorisation from specialist NHS clinics. Of course, that authorisation doesn’t come for many years due to such long waiting lists, and harm comes to patients while they wait.”

Webberley has faced a lengthy wait of her own in fighting her corner. In 2016, the GMC promised a decision on whether restrictions on her work within the NHS could be lifted within 18 months. These pushbacks have continued to block Webberley from working, making the long-awaited arrival of this tribunal hugely important to her.

“I think this 55-day hearing will be a terrible ordeal,” she said, explaining that her case would open up wider questions around whether GPs could “gain the experience and skills required to assess and manage medical transition”, as well as at what age young patients should be allowed to start gender-affirming hormones.

Amongst other things, the panel will look at the care I provided trans youth, and see whether a GP like myself can learn the skills and knowledge to provide this care. See whether gender-affirming medication is in the best interests of the patient. 5/10

— Dr Helen Webberley (@MyWebDoctorUK) July 9, 2021

It’s also been somewhat of a personal hell for Webberley, regularly targeted by transphobic accounts on Twitter. “It is well-known that GMC investigations are stressful, but nobody ever prepared me for how terrible it would be and the impact it would have on my work life, personal life, finances and wellbeing,” she wrote in the aforementioned blog post.

Still, Webberley remains hopeful that the tribunal will have a ripple effect across trans healthcare in the UK more widely.

“I hope the tribunal will see that we have to allow more doctors to provide this care,” she concluded. “We have to develop formal training and qualifications, and we have to keep trans patients safe.”