Gender GP: Inside the world of private trans healthcare

[Signalbox]

podcasts.apple.com/gb/podcast/the-slow-newscast/id1487320403?i=1000617431129

Just giving this podcast (which includes an interview with Helen Webberley) a thread of its own because it is frankly astounding and well worth a listen…

“Last year journalist Polly Curtis spent months trying to understand what went wrong at the Tavistock’s Gender Identity Development Service for young people. You can hear her Tortoise podcast series: Inside the Tavistock here. In the reporting of that series one thing kept coming up: some young people who couldn’t - for whatever reason - access the Tavistock - the only NHS service in England for young people with gender dysphoria, were going down the private healthcare route. So what happens if a young person follows that path? This is the story of Gender GP and its founder, Helen Webberley, an entrepreneurial doctor from south Wales.”

Bumping this for tonight

What’s happening tonight? 👀

Thanks for the link

Sorry, I missed this! Hang on....

https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5hY2FzdC5jb20vcHVibGljL3Nob3dzL3RoZS10YXZpc3RvY2staW5zaWRlLXRoZS1nZW5kZXItY2xpbmlj?ep=14

Hope that works!

Oh sorry, got the wrong thread!

There's a programme about the Tavistock on ITV at 1025 tonight
https://www.radiotimes.com/programme/b-q94sbc/the-clinic/

Thanks QuickWash :)

Oh well looks interesting anyway :)

Just listened to this. I hesitated because by the end of the Tortoise Tavistock podcast series I was so annoyed by Polly Curtis and her endless handwringing about how very nuanced it all was and failure to ask some very very obvious questions. Like 'Stef, isn't it a bit of a coincidence that you and your online gaming friend discovered you were trans at exactly the same time?' And 'How do you reconcile your belief at the time that you needed puberty blockers and hormones immediately, and you couldn't cope with having to wait, with your subsequent realisation that you are non-binary and not a trans girl after all"

(And then the whole thing just looked completely stupid reading Hannah Barnes book afterwards, because they'd missed the real story. )

But this was gobsmacking. Even Polly comes down off her 'it's all very nuanced' cloud somewhat. And almost everything Dr Webberley says is unbelievably shocking.
A masculine presenting girl is 'the most boy thing I'd ever seen' and therefore needed drugs to avert suicide, which was otherwise inevitable.
Flat denial that any patient has ever changed their mind, or that hormone treatment has ever not turned out well.
Getting a massive high from being people's saviour (for ££££).
'a doctor peddling in business' - and the string of weird side hustles. (Do doctors normally have time for side hustles?) I mean, I think she probably meant 'dabbling in business', and 'peddling' was a real Freudian slip. Quite the mental image.

Helen Webberley tweeted the following this morning on the new NHS service specification for children's gender care

I am self-taught in trans healthcare. I treated an 11 year old with blockers and a 12 year old with testosterone. This was fully scrutinised by a Medical Practitioners Tribunal and they determined this was good and necessary care.

So why is the NHS saying that we should not let kids socially transition, prevent them from accessing blockers at the start of puberty, certainly no hormones until they are adults?

Denying trans youth the healthcare that they need causes immense harm and the people responsible for this must be called out. Trans youth deserve the best healthcare possible. And yes, that includes blockers, hormones and surgery.

And let’s not forget - early access to blockers and hormones prevents the need for: Top Surgery, Facial Feminisation Surgery, Breast Augmentation and Suicide.

https://twitter.com/HelenWebberley

I am self-taught in trans healthcare. I treated an 11 year old with blockers and a 12 year old with testosterone. This was fully scrutinised by a Medical Practitioners Tribunal and they determined this was good and necessary care.

I'd love to know what part of the determination HW is referring to when she says this. It's not a direct quote (I've checked) which means she must be paraphrasing. If the determination actually said that you'd think she'd link it or quote it or screen shot the relevant paragraph.

The MPTS decision is here:
https://www.mpts-uk.org/-/media/mpts-rod-files/dr-helen-webberley-30-june-22_following-appeal.pdf

It's long (over 300 pages) so I've skimmed and I think this might be the relevant paragraph about prescribing testosterone to a 12-year-old girl:

284. The Tribunal relies on its analysis of Dr Webberley’s competencies as set out in the relevant preceding paragraphs of this determination. It rejects the allegation that Dr Webberley failed to provide good clinical care to Patient A by prescribing a hormone, testosterone, which was not appropriate for use in children of his age.

It doesn't exactly say this was 'good and necessary care', but the MPTS seem to have accepted that Webberley was competent and this treatment was appropriate.

237. Dr Webberley was at the material time a GP with a special interest in gender dysphoria and she was competent in the roles of mental health professional and hormone prescriber. Dr Webberley adopted a hub-and-spoke approach to her care for Patients A, B and C, referring them to specialists if and when required. She was competent to determine when such referrals were necessary. Dr Webberley was not bound to follow precisely the WPATHSOC7 or Endocrine Society Guidelines 2009 guidelines, although she did avail herself of the guidance therein. She was at liberty as an autonomous medical practitioner to look to alternative guidance and did so. Her reliance on the UCSF Guidelines was in accordance with a responsible body of expert medical opinion.

281. The Tribunal relies on its analysis of Dr Webberley’s competencies as set out in the relevant preceding paragraphs of this determination. The Tribunal finds that Dr Webberley, who had a special interest in gender dysphoria, was competent to recognise that the anxiety and depression which Patient A was evincing was a reaction to his profound and lifelong gender dysphoria coupled with the bleak prospect of being suspended by GIDS in a peripubertal state for some four and a half years while XXX and peers progressed through puberty. In consequence, Dr Webberley prescribed testosterone.

Thanks OldCrone. The tribunal definitely appear to have been fully convinced of HW’s expertise in this case. I still think to say the tribunal said the treatment was “good and necessary” is a push. What they’ve basically said is that they have accepted that she was competent to make the decision about treatment. I’m not convinced these things are the same. Also thankfully this will not set president (in terms of treatment) so another tribunal in the future could easily come to a different decision on very similar facts.

I think you are right, they aren’t the same. What Webberley did cannot be said to be misconduct because it was in line with a respectable body of medical opinion. That is not the same as saying that this treatment approach is “good and necessary”, as webberley claims.
the sands are shifting here of course, which is why webberly is bleating. I am not sure that this sort of hearing will play out in the same way in say 5 years time.

The tribunal definitely appear to have been fully convinced of HW’s expertise in this case. I still think to say the tribunal said the treatment was “good and necessary” is a push. What they’ve basically said is that they have accepted that she was competent to make the decision about treatment.

I've read some of the section about her treatment of Patient A (paragraphs 237-403), and I find it quite worrying that the MPTS were convinced that what she was doing was the right thing.

For example:
275. Essentially, both Dr Y and Dr P are saying the same thing. Dr Webberley’s case is that she did take into account synchronising pubertal development with Patient A’s peers. Had she not, the prospect of Patient A having to wait for four years before being prescribed gender-affirming hormones, while living alongside XXX and his peers whose puberty would continue to develop, could have had a detrimental impact on Patient A’s emotional and mental wellbeing. Indeed, the Tribunal finds that Dr Webberley’s treatment plan for Patient A was developed precisely to ameliorate the distress that would result from being held back developmentally while Patient A’s peers progressed through adolescence.

276. Based on the evidence, the Tribunal is satisfied that Dr Webberley assessed Patient A’s pubertal development to ensure synchronised pubertal development with his peers. It therefore finds paragraph 1(b)(i)(5) of the Allegation not proved.

I'd assumed that the tribunal members were medically trained, but it seems that only one of the three appointed to this tribunal was a medical doctor. But surely even a non-medically trained adult of reasonable intelligence knows that a girl cannot go through a male puberty. How could a girl have 'synchronised pubertal development' with her male peers? Do these people think that giving a girl testosterone actually changes her into a boy?

The way to prevent this girl from being 'held back developmentally' is to not give her puberty blockers and let her go through puberty naturally with all the other girls.

But as you say, the tribunal ruled on her competence to make these medical decisions, not the suitability of the actual decisions she made since two of the tribunal members are not medically trained themselves and the other one may have no expertise in this particular area. So they haven't commented on whether the treatment was 'good and necessary', since that was not the purpose of the tribunal.

4/4 And let’s not forget - early access to blockers and hormones prevents the need for: Top Surgery, Facial Feminisation Surgery, Breast Augmentation and Suicide.

The need for suicide? A doctor saying that suicide is necessary?

I think the trouble with this case is that HW’s expert witness was an extremist and the GMC expert, although more cautious, was still very much pro treatment. So there was no robust challenge to the idea that puberty blockers and hormones are a good thing. The starting point from both experts was that treatment with hormones is the correct treatment. As you say the committee members are not experts so the only thing they can go on is what the expert witnesses are saying. I think the GMC really missed an opportunity here which is frustrating since they had about 5 years to prepare.

I am not sure that this sort of hearing will play out in the same way in say 5 years time.

🤞

Just badly written - they mean
prevents [the need for Top Surgery, Facial Feminisation Surgery, Breast Augmentation] and Suicide.

She appears to make decisions by making up fantasy futures for her patients.

Health watchdog probes private gender clinic https://www.dailymail.co.uk/news/article-12254933/Now-health-watchdog-probes-private-gender-clinic-set-staff-scandal-hit-Tavistock-unit.html?ito=native_share_article-nativemenubutton

HW shows very clearly how far immense confidence can take you, even when you're making confident statements about entirely hypothetical things (such as this child definitely 'wouldn't have made it' ie would have killed themselves) or things which are clearly, provably untrue (such as 'noone has ever complained or regretted their treatment'), then jumping to the assertion that this treatment is lifesaving, necessary and has no downsides. People, understandably, prefer to hear clearly asserted, confident statements, not nuance and caveats about lack of evidence or inconvenient downsides. It's how hucksters have always thrived. I'm still surprised that the GMC Tribunal seem to have been vulnerable to this bias though.

I listened to the first of Polly Curtis’s podcasts about the Tavistock and found them so woolly and hand-wringing that I decided not to bother with the rest. However, I felt the Gender GP one might worth a go so heard it yesterday.

As pps say, even Polly Curtis had to come off the fence with this one, didn’t she? She was clearly gobsmacked by HW. It was very striking that HW readily admitted she’d been scouting around for ways to make money for some time with her various schemes that didn’t pay off. How lucky for her that a stray algorithm led to her initial attempts at what became the Gender GP website receiving hundreds or thousands of hits and sparking the realisation that this was the one to pursue.

Curtis’s rough calculation that just the registration fees alone might be capable of pulling in 300k a month was the point at which my eyebrows shot up into my hairline.

This is big, big business if so. Affirmation all the way? Well. Yes.

There is a YouTuber called Ezra butler who has used Gender GP. Ezra is F2M.
Ezra was prescribed T after one consultation in February and last week after only 6 months underwent top surgery!!

"I am self-taught in trans healthcare. I treated an 11 year old with blockers and a 12 year old with testosterone. This was fully scrutinised by a Medical Practitioners Tribunal and they determined this was good and necessary care."

I don't see how anyone could be "self taught" here, when the quality of evidence for the treatments is in question.

People have mentioned she is very likely misrepresenting the decision of the tribunal, but even ignoring that it's just meaningless anyway.

Even if this tribunal had an opinion on the underlying research, if they even looked at that question in any detail, their opinion on this isn't going to outweigh other assessments of the evidence.