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

Awiltu "A 10-year-old gave consent to a medical therapy with potential life-altering consequences without discussing those consequences fully with the medical practitioner involved?
And that was OK because the mother received some of the necessary information from the medical practitioner and passed it on to the child?
"

Isn't that exactly what SG did with Jackie? So, if HW is saying she is competent because SG says she is, well

The other live tweeting account has a bit more detail. I think it's from here and goes on for quite a lot if tweets. But she is vague and confusing, and never says 'no I did not work beyond that date' in a forthright uncomplicated way, but illustrates it by saying the spreadsheet shows when she had patients.

Oh wow it's even more vague on that thread! I mean if I received a letter from my regulator saying that I was suspended from x date I would know the exact date that I stopped working. There would be no need to look at a spread sheet or not remembering the exact date. How can she not know. It's just not credible evidence.

This baffles me. My DS was diagnosed with a brain tumour back in 1995, when he was 8. DH and I had to sign consent forms for just about everything after being talked through the risks for everything. It was hard to hear and horrible. The initial surgery to drain the fluid from his brain, the full on surgery to remove the tumour, the weeks of radiotherapy and the years of growth hormone injections.

In later years, when he was legally an adult, DS had to sign consent forms for later related treatment. Thyroidectomy and radioactive isotope treatment. None without risks of course. But the risks were fully explained and he had to sign to confirm he consented to the treatment.

This all seems incredibly lax. I can't understand why Dr W, as a GP, wouldn't want to protect herself by doing this or why parents would sign their kids up for treatment without this. I guess some might not know that this should be a requirement.

It's mindboggling that the TRAs think she's nailing it? If a clinician in any other field revealed a a near complete lack of professional oversight, checks and balances, record-keeping and independent appraisal of their clinical practice, people would be absolutely outraged.

If I was a gender ideology adherent I'd be embarrassed that someone supposedly on my side had turned out to make it look so bad and the whole thing look so unevidenced and unprofessional.

I guess it's just more confirmation that TRAs are totally out of touch with reality, really....

Just been catching up on this, some of the quotes on Twitter are utterly mind boggling.

One summed it up as Dr saying the equivalent of “yeah, they came in, I gave them some hormones, I don’t know when, the main thing was I got paid”. That appears to be not far off the long and short of it.

And I agree it’s very odd how the TRAs think she’s doing well. Bizarre.

One summed it up as Dr saying the equivalent of “yeah, they came in, I gave them some hormones, I don’t know when, the main thing was I got paid”. That appears to be not far off the long and short of it. shock

This is painted as a trans rights issue now, but given that HW and her husband were trying to sell fertility drugs on mumsnet, ignoring concerns about unsupervised use of those drugs, it feels to me as though they would have sold anything. The lack of expertise and treatment options for patients with gender dysphoria just created a bigger marketplace.

BelindaBumcrack

It must be difficult to listen to all this made up crap flouting all the protocols, when you and your child have been in such a situation.

💐

@BelindaBumcrack

This baffles me. My DS was diagnosed with a brain tumour back in 1995, when he was 8. DH and I had to sign consent forms for just about everything after being talked through the risks for everything. It was hard to hear and horrible. The initial surgery to drain the fluid from his brain, the full on surgery to remove the tumour, the weeks of radiotherapy and the years of growth hormone injections.

In later years, when he was legally an adult, DS had to sign consent forms for later related treatment. Thyroidectomy and radioactive isotope treatment. None without risks of course. But the risks were fully explained and he had to sign to confirm he consented to the treatment.

This all seems incredibly lax. I can't understand why Dr W, as a GP, wouldn't want to protect herself by doing this or why parents would sign their kids up for treatment without this. I guess some might not know that this should be a requirement.

Thanks for sharing. How hard that must’ve been for you all 💐

@Manderleyagain

Part of webberly's defence of herself seems to be that it wasn't a life altering treatment, because pb are only a 'pause' and don't affect fertility in themselves. I know there's lots of evidence that that isn't a good way of looking at them, but it's possible the tribunal will agree with her on that.

It is weird how the TRA's think she's doing great - schooling the court on how to provide care.

The tribunal may agree with her, but I hope they have more sense. HW's own evidence indicates that she didn't prescribe puberty blockers as a neutral step - the aim of using them was to prevent feminisation for long enough for the child to be old enough to "choose" whether to take cross-sex hormones. Taking puberty blockers could be said to make it easier to opt for cross-sex hormones later on, because without normal pubertal changes it's just a case of initiating virilisation rather than also reversing feminisation. Therefore puberty blockers shift the balance of probability in favour of a subsequent decision to take cross-sex hormones (this is true hypothetically but also what the evidence from Keira Bell's case showed is happening in practice), and the potential consequences of taking this path need to be covered in order for consent to PBs to be fully informed.

@Manderleyagain
Part of webberly's defence of herself seems to be that it wasn't a life altering treatment, because pb are only a 'pause' and don't affect fertility in themselves. I know there's lots of evidence that that isn't a good way of looking at them, but it's possible the tribunal will agree with her on that

I believe the tribunal have been clear that they are not there to pass judgement on the actual treatment / issues around transgenderism, they are there to decide if she has followed accepted practices in a professional, safe manner.
I had a knee op last year, the surgeon spent time explaining the procedure in detail, including a sketch, plus the possible side effects of the surgery immediately after and in years to come. I had to sign my agreement that I understood what she was telling me. HW didn’t seem to think such an approach with toxic, life altering meds for children needed such rigour!

The tribunal will have to weigh up the experts evidence (both sides) and decide whether or not they think that PB's are a harmless pause of puberty. We've yet to hear from Webberley's experts so it'll interesting to hear what they say. I wonder if all her experts will be American.

Leaving aside fertility, if long term use of the drugs described as ‘puberty blockers’ isn’t advised for conditions like endometriosis because of side effects, how can they be advised for potentially long term use as a puberty blocker?

I know that they have been used to delay precocious puberty for a while, but that is also controversial because of the long term side effects. It also has a defined end point.

Perhaps HW could argue that more information has come to light since the events dealt with in the tribunal, but it doesn’t seem as though her opinions have changed.

Do GPs usually prescribe these drugs? It seems that for other uses (endometriosis, precocious puberty, prostrate cancer, IVF) it would be prescribed by specialists.

I believe the tribunal have been clear that they are not there to pass judgement on the actual treatment / issues around transgenderism, they are there to decide if she has followed accepted practices in a professional, safe manner.

Yes that's true, none of the heads of charge relate specifically to whether or not puberty blockers are a safe treatment. Just whether or not HW followed protocols, took MHs, carried out physical exams etc.

I'm really out of the loop on this tribunal ...

Has Helen Webberley actually been prescribing hormones (not just puberty blockers) to children? That's quite extreme.

Incidentally, what is the rationale for hormones only being prescribed to adults and blockers to kids at the Tavistock? Is this because blockers are supposed to be reversible/ a pause whereas hormones are obviously permanent?

Also, would a GP generally prescribe an indirect course of treatment (so not anti depressants) to prevent suicidal feelings, or would they refer to a mental health specialist?

Obviously GPS can prescribe anti-depressants, but the assessment that somebody should receive specialist

Sorry - please ignore that last paragraph.

But how do you separate the treatment itself from practice? PB are used off licence, they are controvesial, have life long impacts, and it is questionable whether they actually help. Surely as a professional you mustn't prescribe things beyond you capability, and you should be on top of the evidence surrounding treatments especially where you are prescribing a controversial treatment off licence? And how can anyone give informed consent if you are not informed in the first place? Even just referring to them as a pause undermines informed consent if that is not what they do.

@InvisibleDragon

I'm really out of the loop on this tribunal ...

Has Helen Webberley actually been prescribing hormones (not just puberty blockers) to children? That's quite extreme.

Incidentally, what is the rationale for hormones only being prescribed to adults and blockers to kids at the Tavistock? Is this because blockers are supposed to be reversible/ a pause whereas hormones are obviously permanent?

She prescribed testosterone for Patient's A, B and C and some of the heads of charge are related to her not carrying out certain things prior to prescribing.

So for Pt A charge 1b is that...

Following an initial consultation with Pt A on 22nd March 2016, you failed to provide good clinical care in that you did not:
arrange for Pt A to be examined prior to prescribing testosterone treatment, including:
a physical examination to determine: blood pressure; weight development; final height assessment; bone health; an assessment to ensure a synchonised pubertal development with peers; a psychological assessment to confirm a diagnosis of gender dysphoria.

Thank you Signalbox - I had been trying to follow all the tweets but it just got so confusing I forgot all the details

@Tibtom

But how do you separate the treatment itself from practice? PB are used off licence, they are controvesial, have life long impacts, and it is questionable whether they actually help. Surely as a professional you mustn't prescribe things beyond you capability, and you should be on top of the evidence surrounding treatments especially where you are prescribing a controversial treatment off licence? And how can anyone give informed consent if you are not informed in the first place? Even just referring to them as a pause undermines informed consent if that is not what they do.

There are 3 heads of charge 2b, 4b and 6b that allege she has worked outside of her competence. They can do this without making an assessment of the treatment itself.

In treating Pt A/B/C as set out at paragraph X above you: knew or ought to have known you were acting outwit the limits of your competence as a GP with a special interest in gender dysphoria.

Yes that's true, none of the heads of charge relate specifically to whether or not puberty blockers are a safe treatment. Just whether or not HW followed protocols, took MHs, carried out physical exams etc.

But the question of how risky the treatment is is relevant to whether the consent process was safe - or HW is making it relevant - because if it's only a temporary treatment with no long term implications for the patient, there are no long term implications for the child to consent to, and requires less from the clinicians in terms if going through risks etc.

Something HW said (in the tweets) made me think thats was her thinking. She was downplaying the likelihood of lost fertility because pb in themselves don't cause lost fertility. It may be no defence, but that's been the general tra argument.

Sorry there's been a fair bit of discussion since I started typing my post, some already answered.

How can you even begin to address the question of consent without considering the treatment?

That's true manderleyagain but whatever it is HW says about the risks and benefits of puberty blockers is not all that relevant because she is not the expert in this case. The panel will have heard from experts from both sides. The experts are unlikely to completely agree but neither of them will be saying that PBs are an unsafe treatment if prescribed in the right way. So the question becomes whether or not she prescribed appropriately within her competence and whether or not she carried out proper assessments.

Has Helen Webberley actually been prescribing hormones (not just puberty blockers) to children? That's quite extreme.

She prescribed testosterone to a 12-year-old girl. I'm not sure if this is one of the patients giving evidence for the tribunal.

This gives some details about her activities.

<a class="break-all" href="https://web.archive.org/web/20210227052118/www.telegraph.co.uk/news/2021/02/26/children-can-order-life-altering-transgender-drugs-bedroom/" rel="nofollow" target="_blank">web.archive.org/web/20210227052118/www.telegraph.co.uk/news/2021/02/26/children-can-order-life-altering-transgender-drugs-bedroom/