Helen Webberley

[Signalbox]

Looks like Helem Webberley's substantive case has finally been listed for 26th July 2021

www.mpts-uk.org/hearings-and-decisions/medical-practitioners-tribunals/dr-helen-webberley-jul-21

she may have felt entitled to identify as a member despite not being one.

I feel very sorry for Armando Iannucci when nowadays the satire writes itself.

Helen Webberley Tribunal Tweets
Looking at the full allegation sheet; Reminder that HW has admitted to allegations 10a; she signed a witness statement stating she had been a member of the RCGP. She has also admitted allegations 28a and b and 29; she carried on her GenderGP services without being registered.
RCGP is Royal College of General Practitioners.

twitter.com/tribunaltweets/status/1420297543825731584

I feel very sorry for Armando Iannucci when nowadays the satire writes itself.

I've long suspected we've actually slipped into some kind of a parallel universe where the laws of the universe were written by Armando Iannucci together with Charlie Brooker and - I strongly suspect - Glinner, given the level of absurdism we're living through right now.

The only explanation that makes any kind of logical sense, I reckon.

@merrymouse

I don't know much about membership of this professional body, but one of the functions of a professional body is to deal with complaints against members, and chuck people out when they don't comply with standards. It's not just about passing an exam.

It is the regulator that deals with fitness to practice / protection of the public and regulation of healthcare professions. So for doctors it's the GMC for dentists it's the GDC, for nurses it's the NMC, for pharmacists it's the GPhC and for other healthcare professions it's the HCPC. Registration with your regulator is mandatory. They are the ones who sanction you if you don't comply with standards.

Completely separately a doctor could also join the BMA or a nurse could join the RCN or a dentist could join the BDA which are like a trade unions/professional body for doctors. They are there to advocate for doctors and offer support and guidance. The RCGP falls into this category. So it's not an issue that she's not a member, just if she's lied about it on her CV obviously that's bad.

twitter.com/tribunaltweets/status/1420336838405931010

Helen Webberley and the Gender GP online business have actively promoted demand for 'bridging prescriptions' for a number of years.

'Bridging Hormones'
by GenderGP | Aug 28, 2020
(extract)
In 2016, there was excitement as the healthcare magazine ‘GP Online’ proudly announced that ‘GPs should consider prescribing ‘bridging’ hormone treatment to transgender patients attempting to self-medicate while they await specialised gender identity treatment, GMC guidance recommends.’
With waiting times for specialist appointments increasing rather than decreasing, this was incredibly positive news for trans people." (continues)
A harm reduction approach is advocated by the Royal College of Psychiatrist’s current guidelines and it would be in line with our guidance if judged it to be of overall benefit to your patient. We have highlighted the most relevant parts of guidance, for you to consider when making this judgement, in the related guidance section of this page.

But you should only consider issuing a bridging prescription in cases where all the following criteria are met:
the patient is already self-prescribing or seems highly likely to self-
prescribe from an unregulated source (over the internet or otherwise on the black market)

the bridging prescription is intended to mitigate a risk of self-harm or suicide, and

the doctor has sought the advice of an experienced gender specialist and prescribes the lowest acceptable dose in the circumstances.*
An experienced gender specialist is someone who will have evidence of relevant training and at least two years’ experience working in a specialised gender dysphoria practice such as an NHS GIC." (continues)

We need to stand together and raise the expectation that GPs put some time aside to read guidance for Primary Care doctors. There is ample information available, such as the excellent Guidelines from the University of San Francisco and California.
We need to raise our expectations: GPs should not be able to refuse to provide basic hormone therapy to patients who are fit and healthy, without concurrent health problems that could raise cause for concern, without very good reason. Trans people need to know their rights and they need to push for the care they are entitled to.
By refusing to follow the guidelines, which are so clearly set out by the GMC, GPs are either stating that they are unwilling to accept that their patient is trans, or that they cannot do so without a specialist clinic validating that person’s gender. (continues)

archive.fo/IveXl
www.gendergp.com/bridging-hormones/

It is worth considering the potential impact of advising vulnerable/distressed children and adults of the neccessary requirements: likely or actual purchase of black market hormones and need to demonstrate risk of self harm/suicide.
It would also be important to establish if GPs have been persuaded to accept the doctors Webberley/Gender GP in the role of "an experienced gender specialist"
My understanding is that GenderGP has promoted a "shared care" model.

33feethighandrising good observation and I'm with you. However, surely there would be more humour if that were the case? (also, yes, that would be an amazing collaboration and it should be commissioned immediately!)

I'm looking forward to hearing what Baroness Nicholson does from her webinars and the information she has gathered from them. In my head she's like Obi Wan Kenobe and our only hope. I hope that the evidence of HW's hearing, and all the others, contribute to the public enquiry that the Baroness is angling for.

It would also be important to establish if GPs have been persuaded to accept the doctors Webberley/Gender GP in the role of "an experienced gender specialist"

I'm sure I read here a long time ago that HW had only done an online training course in gender issues.

She's never worked in a gender clinic and I've only ever seen one accredited course for HCPs, and that's not solely for medics www.rcplondon.ac.uk/education-practice/courses/gender-identity-healthcare-credentials-gih

The expert clinicians in clinics seem to be a mix of psychiatrists, psychologists, sexual health practitioners and endocrinologists. There isn't a clear career pathway or NICE guidelines or Cochrane Reviews.

Smacks of "early days" for a specialism, doesn't it?

'Why are trans teenagers resorting to ‘DIY trans pills’ from ‘cowboy chemists’?'
by Helen Webberley | Apr 22, 2018

(extract)
"The medical profession has long accepted that some people need medical assistance to help them prevent the long term negative effects on their mental well-being which can be caused by their naturally produced sex hormones, and to replace these with the opposite hormone to induce characteristics that match their gender identity.

When the gender identity of a person is clear, providing access to this treatment can be lifesaving, because as we know, many transgender people are murdered or commit suicide, and the delays in accessing the medical help they need is a contributing factor.

The concept of self-medicating was not one that I encountered before I started my work with transgender patients. People with diabetes or high blood pressure, angina or epilepsy would not look to the Internet or local gym to source their medication. They would go to their GP and they would get the help they needed. If the condition in question was outside the knowledge and skills of their GP, then they would be referred to a hospital consultant. The NHS constitution states that you should start to receive specialist treatment within 18 weeks, but it is well known that the waiting times for accessing help for gender variance is far in excess of this.

So is it any wonder that children and adults are self-medicating? Obtaining medication that should be prescribed and monitored by a trained medic, from any source that they can so that they can prevent the mental anguish of knowing they have the wrong hormones, and replace them with the right hormones. Desperate people are buying them from unregulated drug stores. Being prescribed by online pharmacies after bending the truth on the medical history form. Borrowing their sister’s oral contraceptives. Obtaining body building injections on the black market." (continues)

The GMC has clear guidance for doctors to help their patients who have resorted to self-medication, so that they can prescribe bridging prescriptions to help keep their patients safe. In reality, though, many people who come to me for help and advice have found their doctor reluctant to offer help of this kind.

The chatrooms and forums that discuss the medication regimes and monitoring are in many cases well-informed and correct. But each person’s needs are individual and should be managed on a case by case basis. As with all medication: one size does not fit all.

Forums offer first hand experience and advice for those who are desperate. They offer information and treatment plans that people should be getting from their GP, but they are not. They help to inform and educate which is invaluable for people who feel they are entirely alone. But they are not written by medical experts and should not be treated as a guide on circumventing essential medical input.

There is clearly a desperate need for further education and acceptance around the subject of transgender children, with greater access to support for all the family. That any child feels desperate enough to embark on physically transitioning without parental support is deeply concerning and something that needs to be addressed as a priority.

I do not support self-medication, I urge people to seek advice and prescriptions and monitoring from a doctor. If your GP lacks the knowledge and skills to help you then they should make it part of their continuing professional development to increase their understanding in this area of medicine, or refer you to someone who can help. If you have waited longer than 18 weeks from referral to treatment as set out in the NHS constitution, then you should complain and ask that the NHS take all reasonable steps to offer a range of suitable alternative providers if this is not possible. " (continues)
archive.fo/IhsKq
www.gendergp.com/why-are-trans-teenagers-resorting-to-diy-trans-pills-from-cowboy-chemists/

**bolding is as per article
emedded link signposts to GMC guidance for bridging prescriptions www.gmc-uk.org/ethical-guidance/ethical-hub/trans-healthcare#mental-health-and-bridging-prescriptions with the criteria used by GPs to determine whether such a prescription is appropriate.
My memory (unconfirmed) is that when the article was first published the link was to a previous source although the criteria listed was the same.

This article was in response to Sanchez Manning's investigation for Mail on Sunday,

'Cowboy chemists are selling 'DIY trans' pills to teenagers as more and more are 'risking their lives' by taking black market drugs
Boys under the age of 16 can obtain prescription-only oestrogen on the internet
The drugs can hinder hair growth, reduce muscle mass and cause incontinence
Some of the effects of the drugs can be irreversible according to experts
Our investigation showed how easy it is to buy the life-changing drugs online'
21 April 2018
www.dailymail.co.uk/news/article-5642617/Cowboy-chemists-selling-DIY-trans-pills-teenagers-online.html

Thanks Signalbox. It looks as I'm thinking of a different kind of professional membership (e.g. some accountancy bodies, some trade associations) where membership is a stamp of meeting particular standards, but where there is no actual need for a licence to practice.

@vivariumvivariumsvivaria

It would also be important to establish if GPs have been persuaded to accept the doctors Webberley/Gender GP in the role of "an experienced gender specialist"

I'm sure I read here a long time ago that HW had only done an online training course in gender issues.

She's never worked in a gender clinic and I've only ever seen one accredited course for HCPs, and that's not solely for medics www.rcplondon.ac.uk/education-practice/courses/gender-identity-healthcare-credentials-gih

The expert clinicians in clinics seem to be a mix of psychiatrists, psychologists, sexual health practitioners and endocrinologists. There isn't a clear career pathway or NICE guidelines or Cochrane Reviews.

Smacks of "early days" for a specialism, doesn't it?

Helen Webberley appears to be convinced (and may have convinced her customers and their GPs) that she fulfils the definition:

An experienced gender specialist is someone who will have evidence of relevant training and at least two years’ experience working in a specialised gender dysphoria practice such as an NHS GIC.

Webberley Has often written rapid responses i the online BMJ pushing for GPs to prescribe to people awaiting assessment for gender dysphoria.
www.bmj.com/content/368/bmj.m215/rapid-responses is an example of such a response from her. Note she doesn't say that she is currently suspended by the GMC.

And she doesn't think she has any competing interests !!!!

I can't help thinking that in a parallel universe where MN was less responsible and there were fewer doctors specialising in infertility, this case would be about 'Fertility GP' and Webberley would be claiming to be a fertility expert on the basis of having flogged Clomid to thousands of MNers.

All these claims of being an expert don't tie up with the business plan which seems to be about selling anything to anyone.

Again, I keep thinking about that post on the thread on Clomid which had clearly been found using a search function, and which ignored all concerns about on-line prescriptions of Clomid.

From BMJ link above there are a number of likely indications of Helen Webberley's defence as well as a couple of points which may well be used as evidence against her:

24 January 2020
Helen Webberley
Doctor
GenderGP
www.GenderGP.com
@MyWebDoctorUK

Re: The struggle for GPs to get the right care for patients with gender dysphoria

Dear Editor,

Once again we read about the difficulties faced by doctors who are asked to provide care for their trans patients. Yes, gender dysphoria can be a ‘difficult terrain for primary care doctors’, but it is also a difficult terrain for trans patients.

Sally Howard has carefully balanced the plight of patients stuck on long waiting lists to see specialists, with the difficulties presented by the lack of education available for doctors. She mentions that gender identity and gender dysphoria are not part of the GP curriculum, but startlingly, they are not part of any Royal College curriculum. If we examine the core competencies of the current GMC approved curricula for all of the specialties, in particular the curricula for the core competencies of General Practice, Paediatrics, Paediatric Endocrinology, Child and Adolescent Psychiatry, then the needs and care of transgender patients only exist in the GP curriculum.

There is no specific GMC speciality or sub-speciality for doctors providing treatment to transgender patients. In the section of their website on education, the GMC states: ‘We set the standards for providers of medical education and training, and we regularly check to make sure those standards are met. Here you'll find the standards, guidance and curricula we publish along with supporting materials.’ www.gmc-uk.org/education

How can standards be set, if the core competencies of a doctor’s knowledge do not include care for this patient group?

In the current absence of UK educational materials, doctors have a duty to seek out international guidance to help their patients. There are excellent published guidelines for GPs which have been written to ‘equip primary care providers and health systems with the tools and knowledge to meet the health care needs of their transgender and gender nonconforming patients.’ How is it still so acceptable for doctors not to undertake personal learning to address their lack of knowledge?
transcare.ucsf.edu/guidelines/introduction

Sally Howard quotes The Royal College of GPs advising their GPs to not feel ‘expected to fill gaps in commissioned gender identity specialists and clinics.’ However, this leaves their patients unsupported and them open to litigation battles. Is this really the best advice for their members?

Articles such as this continue to reinforce the narrative that this is a ‘difficult’ and ‘complex’ issue that needs specialist training. Few publications that write about the difficulty faced by doctors in their lack of knowledge and skills, actually pin down what the patients are asking their doctor to provide.

In her letter to the BMA back in 2016 regarding their response to the GMC Guidance for doctors treating transgender patients, Susan Goldsmith, acting Chief Executive for the GMC, wrote, ‘While GMP [Good Medical Practice] states “you must recognise and work within the limits of your competence”, this principle cannot be a bar to doctors taking on new responsibilities or treating unfamiliar conditions.’ She went on to say that ‘…we don’t believe that providing care for patients with gender dysphoria is a highly specialised treatment area requiring specific expertise.’
gendergp.com/wp-content/uploads/2018/02/Susan_Goldsmith_to_Chaan...

Patients need belief, support and medication. They are not asking to be ‘diagnosed’; they are asking to be believed when they explain how their gender feels different to the one they were assigned at birth. They are not asking for medications that are addictive, dangerous or that require extensive monitoring. They are asking for medications in common use in every day practice. Medicines such as estradiol, testosterone and GnRH agonists. Commonly used medications when treating menopause, androgen insufficiency and prostate cancer. They are not asking for deep psychotherapy, they are asking for support to help them navigate their lives.

And who is better placed to provide this than their GP?

Competing interests: No competing interests"

background re current witness Professor Gary Butler:

(extract)
"Professor Gary Butler is a consultant in paediatric and adolescent medicine and endocrinology at University College Hospital London and holds an Honorary Personal Chair in Clinical Paediatrics at the UCL Great Ormond Street Institute of Child Health.

He was given the European Society for Paediatric Endocrinology Outstanding Clinician Award in 2020 as a result of his clinical expertise and significant national and international developments in the clinical practice of paediatric endocrinology. This is the highest award for a clinical doctor in this field." (continues)

Subsequently he directed the paediatric endocrine centre for Wales based in Cardiff. He conducted research on visual neurophysiology in adolescent diabetes. He was then appointed to lead paediatric endocrinology in the North East of England in Leeds. There he additionally developed a strong interest in undergraduate and postgraduate education. As a result of which he became foundation professor of paediatrics in Reading University.

On return to London in 2009, he established an adolescent endocrine service at UCLH with special focus on disorders of puberty with specialist clinics for gonadotropin (puberty hormone) deficiency, Klinefelter syndrome, and growth disorders. He is also the clinical lead for the UK adolescent Gender Identity Development Service, taking an international lead in the standards of care for transgender children and adolescents. He is acknowledged as an international expert in these areas and lectures in the UK and internationally. (continues)
www.uclh.nhs.uk/our-services/find-consultant/professor-gary-butler

The NHS GIDS service specification relied heavily on WPATH guidance:

April 2016
www.england.nhs.uk/wp-content/uploads/2017/04/gender-development-service-children-adolescents.pdf
archive.fo/sOOVW

December 2020
[[https://www.england.nhs.uk/publication/gender-identity-development-service-for-children-and-adolescent-service-specification/]

Apologies
December 2020
www.england.nhs.uk/publication/gender-identity-development-service-for-children-and-adolescent-service-specification/

Helen Webberley Tribunal Tweets

"IS refers to a paragraph which discusses; distress to adolescents in developing secondary sex characteristics; as a result- adolescents can become vulnerable to social stigma.

IS is asking is “gender assigned according to a baby’s genitalia?” “The baby is registered according to the appearance of their genitalia, yes.” GB

GB says the designation as male and female isn’t always congruent with gender identity.

IS now starting to discuss that there has been differences in opinion about the age in which doctors feel is appropriate to prescribe puberty blockers to children. References Bell and Tavistock case.

GB talks about lack of knowledge about prescribing cross-sex hormones to under 16 year olds, with Patient A. IS says there’s not enough knowledge in any age is there? GB disagrees and says there is more knowledge with over 16s."

Professor Gary Butler appears to be a believer in children having a "gender identity"

This idea and terminology orignates with John Money:
www.goodtherapy.org/famous-psychologists/john-money.html
uncommongroundmedia.com/sexist-science-transsexualism-part-i-benjamin-ihlenfeld-money-ehrhardt/

Tavistock GIDS website
Our Gender Identity Development Service
4 November 2018

As reported in the Observer today, the Trust is currently conducting an internal review into issues raised about the Gender Identity Development Service (GIDS).
(extract)
The GIDS was founded in 1989 and is one of the longest standing services for gender diverse children and young people in the world. Domenico Di Ceglie, who founded the service, wrote a set of therapeutic aims which we still abide by today. This includes the unconditional acceptance and respect for young people’s gender identity. We do not therefore take a view regarding the outcome of an individual’s gender identity development: rather, our focus is to provide a space for exploration of gender, to ameliorate any negative impacts on general development and to work with young people to think through all the options open to them. These principles remain central to the delivery of the service.

A comprehensive psychosocial assessment precedes any referral to the endocrine clinic for consideration of physical treatments. Whilst it is the case that most young people attending the service have a wish to pursue physical interventions, 59% of those attending under 15 chose not to pursue an endocrine clinic referral.

We recognise that there are strongly held views among patients and families and their representatives including those who wish for physical treatment to be offered earlier or by those who feel that physical treatments should not be offered to young people at all. The service has worked hard, and continues to do so, to maintain a balanced view in which we are fully aware of wider social, cultural, legal and political factors, but maintain a focus on an individual approach to care informed by the particular circumstances of each young person we see." (continues)
tavistockandportman.nhs.uk/about-us/news/stories/our-gender-identity-development-service/

relevant threads:

www.mumsnet.com/Talk/womens_rights/3987338-What-is-WPATH

www.mumsnet.com/Talk/womens_rights/3414279-Can-we-talk-about-WPATH

OP MaudTheInvincible wrote, Tue 13-Oct-20
"WPATH and the Tavi
(see screenshot)
After the recent court hearing of Keira Bell's case about the quality of the care she received from the Tavi, I think this is interesting
twitter.com/ZaneEmma/status/1315877083633995776?s=20 "

www.mumsnet.com/Talk/womens_rights/4049656-wpath-and-the-tavi

Hacsi Horvath
'AFFIRMATIVE QUACKERY: Harry Benjamin and WPATH'
Posted on June 2, 2020
"Q: Why does the “World Professional Organization for Transgender Health” (WPATH) insist that if kids or adults claim to be “trans,” they REALLY ARE “trans,” and that psychotherapy is pointless?

A: It’s because WPATH slavishly follows the stupid whimsies of super-quack HARRY BENJAMIN, their great inspiration and patron saint. This thread will explain." (continues)
stoptransingkids.wordpress.com/2020/06/02/who-was-harry-benjamin/

I find it interesting that Webberleys defence today seems to be that GIDs were equally incompetent.

I find it interesting that Webberleys defence today seems to be that GIDs were equally incompetent.

It's not an unexpected defence. Helen Webberley may well claim to be abiding to WPATH guidelines and have support from some with status within the organisation.

It would be difficult for NHS and/or GMC to deny the extent of allegations of compromise to the service in light of Bell vs Tavistock findings and evidence from Sonia Appleby's Employment Tribunal.

relevant threads:
www.mumsnet.com/Talk/womens_rights/4256306-sonia-appleby-raising-questions-about-the-tavi-s-child-safeguarding

www.mumsnet.com/Talk/womens_rights/3961244-GIDS-being-sued-by-their-safeguarding-lead

Helen Webberley may well claim to be abiding to WPATH guidelines and have support from some with status within the organisation.

However, some of the case against her seems to relate to basic things like keeping proper patient records.

However, some of the case against her seems to relate to basic things like keeping proper patient records.

Which, as far as a I remember , GIDs didn't do either. I really hope this is well reported. Quite happy to see some sunlight around GIDs as well as Webberley,..

Though most of GIDS are not doctors and not regulated by the GMC.

relevant threads:
www.mumsnet.com/Talk/womens_rights/4276239-Keira-Bell-and-Mrs-A-vs-Tavistock-Court-of-Appeal-hearing-23-24-June-2021

www.mumsnet.com/Talk/womens_rights/4202823-Good-Law-project-have-succeeded

www.mumsnet.com/Talk/womens_rights/3943022-Newsnight-Tonight-Tavistock-Clinic-concerns

www.mumsnet.com/Talk/womens_rights/4275338-Tavistock-gender-clinic-converting-gay-children

www.mumsnet.com/Talk/womens_rights/3881347-Keira-Bell-from-Tavi-case-here-AMA

www.mumsnet.com/Talk/womens_rights/4104208-Tavistock-Blocker-Study-released-after-9-years

www.mumsnet.com/Talk/womens_rights/4135631-the-tavistock-whistleblower-has-done-a-podcast

www.mumsnet.com/Talk/womens_rights/3804872-Keira-Bell

www.mumsnet.com/Talk/womens_rights/4095067-Transgender-Trend-Statement-on-Judgment-in-Keira-Bell-Case

www.mumsnet.com/Talk/womens_rights/4099069-Observer-today-re-Keira-Bell

www.mumsnet.com/Talk/womens_rights/4095611-Susie-Green-and-Keira-Bell-on-Newsnight

www.mumsnet.com/Talk/womens_rights/4039438-Newsnight-has-done-a-follow-up-report-on-Tavistock-Clinic-finding-that-concerns-were-first-raised-in-2005

www.mumsnet.com/Talk/womens_rights/3509817-Times-16-2-1-9-Staff-at-trans-clinic-fear-damage-to-children

www.mumsnet.com/Talk/womens_rights/3515980-Times-article-Governor-quits-blinkered-Tavistock-clinic

www.mumsnet.com/Talk/womens_rights/3510367-Tavistock-article-in-the-DM