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.”

Will take a listen, the last podcast serious on Tavistock was annoying because it used a lot of fluffy language the "Tavi" and went to excessive lengths to being neutral (at the expense of journalism).

There's a reason why this medication is under gatekeeping, and private businesses are more likely than not to see people who were refused treatment under the NHS.

I have some sympathy for the freedom of patients to make their own decisions if they aren't trying to do anything insane.

I don't think the goal is always safety and minimising risks. I don't think doctors should be strictly following guidelines. And quite possibly there should be more use of off label medications.

But I'm still uncomfortable about doctors experimenting on children for profit.

Thank you for sharing this OP, I’ve only just seen the thread. Am about halfway through the podcast (and contemplating banging my head against the wall).

HW has just made the ludicrous claim that teenagers and young people don’t change their minds about their identity. Is she lying or deluded? That tiresome Knox on Twitter has changed her identity numerous times in the past few years (straight woman> lesbian > non-binary> transman) and she’s middle aged. Safe to assume that teenagers can and do change their minds about all sorts of things, including their identity.

And yes, as PPs (and Curtis) have said, Webberly clearly gets such a kick out of making her patients ’happy’. Medicine is about finding the most effective and safest treatments- these might make the patient happy and they might not. Sometimes patients won’t like what their Dr has to offer. I used to take Diazepam on flights because it helps the panic. Apparently most GPs won’t prescribe it for this purpose any more. This is because they have decided that it’s not the best way to treat the problem, and the risks may be too high. I’m not very happy about this, but my happiness is neither here nor there when it comes to clinical evidence and risk assessment. I trust that they know what they’re talking about and that there are safer ways for me to manage my anxiety around flying.

HW seems like someone with a God(dess) complex.

I trust that they know what they’re talking about and that there are safer ways for me to manage my anxiety around flying.

As far as I know, it's still perfectly within guidelines to use Diazepam for that purpose. If someone were having regular panic attacks, then it's against UK guidelines I think.

Doctors in the past got a load of people addicted without proper warning. If they now don't want to use them at all, it's actually a case, imo, you can argue that patients are getting screwed over twice.

Anyway, doctors are going to have different opinions over this issue. So many may agree that we have gone a little too far against using them.

I doubt your kind of use would even be controversial with psychiatrists.

The "evidence based" guidelines aren't always going to be correct, and maybe more importantly, the level of risk that is acceptable isn't even a medical question.

I think there are a number of reasons why some Drs won’t now prescribe Diazepam for flying- not just risk of addiction, which is obviously low if someone is only prescribed 2-4 tablets once a year or so to get them through a flight (though actually, the first time I was prescribed it for flying, the GP gave me 28 of them and I was only going to France and back 😂 He later got struck off for unrelated dodgy behaviour).

Some of the articles I’ve read have discussed the fact that the drug obviously causes people to be subdued and lethargic meaning they may be more difficult to manage if there is an emergency on the flight. Plus people taking it are likely to sleep or sit still for long periods, increasing the risk of DVT. And for some people, Diazepam has the opposite effect and can make them agitated/aggressive, none of which anyone wants on a flight.

The point is really that I don’t expect to just get what I want out of Drs when there may be good reasons for them not to give it to me. And because I have now flown without it (because I was given the impression there was no point asking for it as GPs won’t give it), I had to find other ways to manage and was glad to find that I could. It wasn’t a barrel of laughs but I coped.

OK it seems to be a policy of some GP practices not to prescribe. I think they are mechanically applying a contraindication.

Maybe you don't want to generally treat phobia with benzos, because of the risks of long term use, or it's not seen as that effective. But to apply that to flying a couple of times a year... as contraindications go, that's on the weak side.

Personally I don't want doctors to just mechanically follow a rule from somewhere.

I am just starting to get into podcasts and the gender GP one is the latest. I listen in my car so am only 10/15 minutes in.

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.

I picked up on that too, it explains a lot. The other point was where she talked of her first patient and them not being 'capable' of leaving Wales to go to London, but giving cross-sex hormones is all fine and dandy.