Michael Biggs, Department of Sociology, University of Oxford
Health Talk and the University of Oxford’s Nuffield Department of Primary Care are providing advertising for private healthcare provider, GenderGP, a private company in Singapore run by Dr Helen Webberley and Dr Michael Webberley. The pair have a long record of infractions including a criminal conviction for running an unlicensed clinic and suspensions by the General Medical Council after one of their transgender patients committed suicide. Dr Michael Webberley has just been struck off the Medical Register for dishonesty and ‘numerous serious breaches of … fundamental tenets of the medical profession’.
In February this year, Health Talk created a new website on the ‘Experiences of parents and carers of young trans and gender diverse people’. Its credibility is enhanced by logos of the University of Oxford and of the Nuffield Department of Primary Care, along with the National Institute for Health Research which contributed £700,000 to the research. The chief investigator was Dr Melissa Stepney at Oxford’s Nuffield Department of Primary Care. (More information on this study was unearthed by Lily Maynard.)
The website recommends three private providers:
‘Young people who used private healthcare spoke positively about it. Private healthcare providers that serve England and Wales, for example, GenderCare, GenderGP and London Transgender Clinic (LTC), were mentioned. They said each service provided their own form of assessment by qualified healthcare professionals to help trans and gender diverse people access healthcare.’
The London Transgender Clinic is the trading name of a company registered in the UK with Companies House and the Care Quality Commission. GenderCare is a network of registered medical practitioners, such as Dr Stuart Lorimer who leveraged his employment at the NHS Charing Cross Gender Identity Clinic to develop a lucrative private practice. GenderGP, by contrast, is not located in the United Kingdom. It used to belong to Harland International Ltd, a company registered in Hong Kong and owned by Roton Executors Ltd in Belize. In 31 December 2021 it became a private company registered in Singapore and owned by Dr Helen Webberley.
Health Talk does not normally promote profit-making enterprises. On its other websites—covering a wide range of medical conditions from arthritis to testicular cancer—the phrases ‘private healthcare provider’ and ‘private provider’ are found only once. A webpage on breastfeeding notes in passing that some women obtain information from ‘private providers (independent midwives, obstetrics/gynaecology and lactation consultants, breast pump manufacturers)’, but it does not recommend any particular companies.
Glowing praise for GenderGP
The Health Talk website does not simply mention GenderGP as a private provider, it promotes the company by featuring testimonials from two 17-year-old informants.
One is from Jessica:
‘Gender GP has been a big resource also. Throughout this process of going through getting hormones with them, they’ve always been there to give advice and support and be very definitive about things and like this is what you need to look out for. These are like this is the changes you are gonna have in your body. Do you consent to all this. They’ve been very clear in language and stuff about that and that’s how to do it. I fully understood the ramifications what I was doing when I was obtaining hormones and be like yeah, awesome.’
The other is from Jacob. The testimony deserves to be quoted in full to convey the repeated emphasis on this company’s competitive pricing (especially when the costs of tests and drugs can passed on to the NHS):
‘The specific place I went to was GenderGP and they have been great. They’ve been brilliant. I did some looking online at different private places. And I was shocked that nearly all of the places were huge amounts of money to go to have a single session was £900 at one place. And they, and I saw that as very visibly they are profiting off trans people. But the specific place I went to GenderGP were very supportive, I think very reasonably priced. They even offered financial help for people who were on low income and I believe, you know, they genuinely wanted to look out. They have free advice 24/7. You know, you can ask any question and you send them an email. They’ll respond. They’ll tell you they have advice on their website. And they were genuinely out to support people not profit off them. So, they were very helpful, very understanding. You know, I first contacted them I didn’t think my mum was going to support me with private. And my friend said that she would actually help me get some money together and pay, she would actually contribute and help me, cause she saw just how much it meant to me.
And I explained to them, you know, I’m currently no income or shall be low income soon I’ve got a friend will help me scrape together some money and some savings. But I really don’t have much. And they were like, “Okay, we’ll see what we can do. We can sort it out.” And then later I was like, “Oh wait I’ve convinced my mum and she said that she can help with this.” They were, they’ve been very affordable and they offer a shared care plan with the GP which means that if I can get my GP to agree to doing the blood test or getting my GP to agree to prescribing the testosterone, it means that I get it on the NHS and not have to pay for it. So the costs I’ve had to pay, you have £195 one time start up fee. That’s just your starting up one time. And then it’s £30 every 28 days for membership. That’s just that you’re a patient. Other and then everything costs some but it’s not ridiculous. I saw this one place that was like, “Okay, it costs £240 for a half an hour session.” GenderGP it was £60 for an hour booking of an assessment, which was very affordable and understandable, you can pick which person you want to be with or you can select that you want them to pick for you if you don’t have a preference for who you wanna talk to. And and then when it gets to testosterone or whatever hormone it’s, you know, £20 plus depending on what dosage you’re getting, what you’re getting, where you’re buying it from and it’s £20 plus a month.
Hormone blockers are a lot, which I understand some male to female people do need to have hormone blockers, at least to start with and they are about £100 a month. They are expensive, but that’s just the product itself is expensive. GenderGP aren’t just deciding that that’s a lot of money that’s just it is an expensive product to get hold of. But generally there, they’re quite cheap. If you can get your GP, you can go to your GP and explain and they agree to shared care then you don’t have to pay for it at all for that. They, they want to have, you had to have a blood test before you go which I had mine on Monday. And they do five like tests from the blood sample. But you only have to have that done once. They can either send you a kit privately, which just costs a bit of money or if you can get your GP to do it, which most GPs will do the blood test for you. That’s free as well. And then you just pay for what services you want. You want a voice therapy session, it costs a bit of money. If you don’t, you don’t have to pay. So all we’ve ended up doing is paying the start up fee and will have to pay the membership fee. That’s it. That’s all we’ve had to pay and the assessment. That’s it.
And I’m gonna be and it’s taken where it’s taken me two years to be told that I’m gonna be moved to another list with GIDS for GenderGP I’ve only been talking to them for about two months and I’m about to start testosterone and it’s been ridiculously quick. So much more useful. They’ve been so open and talking. You know, I can ask them any question, they’ll respond. You can look on their website. They’re really really helpful. And it’s been so much better. This is how I hoped the NHS would work or at least you know, it might have been a bit slower, but this is how I thought it was gonna work from the NHS. No, but the private has been incredible. And I, you know, very very grateful that I’ve been able to go through on all of this, because it means that I’ll be starting testosterone now, pretty much, so.’
To recruit informants for the research, the University of Oxford’s researcher, Dr Sam Martin (at that time identifying as ‘they/them’, but now as ‘she/her’), enlisted GenderGP, amongst others—including Mermaids and its chief executive, Susie Green, who featured on GenderGP’s podcast. It would be interesting to know whether Jacob or Jessica were recruited via the company—and if they received any discounts from GenderGP in return for singing its praises.
How typical were Jacob’s and Jessica’s positive experiences with the company? There is absolutely no information on the Health Talk website, even though the Oxford researchers spent hundreds of thousands of pounds interviewing trans-identifying adolescents and their parents. For a more representative range of experiences, it is simple—and requires no funding from the National Institutes of Health Research—to search for the word ‘GenderGP’ on the transgenderUK reddit. The views of patients are very mixed: some are positive, some are negative. There is also discussion of a ‘trans politician’ who resigned from employment with GenderGP (in January), accusing the company of exploiting its contractors, paying them only £9 per hour.
Children and their parents who rely on Health Talk for information will not learn that it is located overseas to avoid oversight by British regulators, and is operated for the benefit of Dr Helen Webberley and Dr Michael Webberley.
They will not learn that Dr Helen Webberley earned a criminal conviction in 2018 for running an unlicensed transgender clinic. According to the judge, ‘there seems to be a clear refusal to follow the law and that is a significant aggravating factor’. Her medical registration was suspended from May 2021 to February of this year. Her license to practice was then reinstated with severe restrictions: she must not, for example, ‘prescribe, administer or have primary responsibility for any drugs’. The Medical Practitioners Tribunal Service has just found her guilty of ‘serious misconduct’ for failing to follow up girls aged 12 and 17 for whom she prescribed testosterone; she was also faulted for prescribing puberty blockers to an 11-year-old girl without discussing the negative effects of the drug on fertility.
Readers of Health Talk will not learn that the same Tribunal recently (in May) found Dr Michael Webberley guilty of providing treatment that was ‘not clinically indicated’ and had been prescribed without adequate tests, examinations or assessments for 7 children and adolescents who identified as transgender. To take one example, he prescribed puberty blockers to a 9-year-old ‘tomboy’ after a 20-minute Skype consultation; he did not even ascertain whether she had started puberty (p. 216). He lacked ‘the necessary qualifications and training and experience in transgender medicine’ (p. 237). How can this be squared with Health Talk’s description of GenderGP as staffed by ‘qualified healthcare professionals’? Dr Mike Webberley also failed to provide good clinical care for a further 18 male patients suffering from hypogonadism, for his other business called Balance My Hormones. The Tribunal observed that he invariably prescribed the patients exactly what they wanted.
The most tragic transgender patient was Jayden Lowe (‘patient W’ in the Tribunal hearings). Lowe contacted GenderGP at the age of 17 (coincidentally the same age as Jacob and Jessica). Although Lowe had Asperger’s Syndrome and a long history of self-harm, Dr Michael Webberley did not bother to ask for any medical information from the patient’s general practitioner, mental health workers, or school nurse (p. 297). After one consultation over Skype, he prescribed testosterone—‘which was not clinically-indicated’— ‘without first establishing whether the risks of prescribing testosterone were lower than the risks to Patient W’s [Lowe’s] mental and physical health if not prescribed’ (pp. 234–35). Three months later, Lowe committed suicide. After the inquest, Lowe’s mother declared that she ‘had no idea the online service was unregulated’. Neither will anyone who consults the Health Talk website.
Profiting from Oxford’s research
The researcher who used GenderGP to enlist informants, Dr Sam Martin, previously tried to exploit this research to promote a consultancy business operated in concert with Jessica Lynn, who sat on the project’s steering committee. Their marketing pitch was adorned with logos of the University of Oxford and the NHS:
‘Kinsey Institute Global Ambassador and a world-renowned transgender advocate, Jessica Lynn and transhealthcare researcher at the University of Oxford, Dr Sam Martin, have developed a number of bespoke awareness, training and education packages to improve understanding about trans and gender diverse people and their multiple health and care needs. … TransFutures International Awareness, Training and Education is unique in the field because it uses detailed case studies from the healthtalk.org trans and gender diverse healthcare project based at the University of Oxford, funded by the National Institute for Health Research (NIHR). We draw from 95 in-depth interviews with GPs, health practitioners, trans and gender diverse people and their families about their experiences of healthcare services. We use these interviews formulate [sic] innovative strategies and suggestions for how to improve care.’
The text and logos disappeared from Lynn’s website following my complaint to the University of Oxford’s Registrar in June 2020.
What must happen now
Health Talk must immediately add a disclaimer to its promotional material for GenderGP, admitting that this online company avoids regulation in the UK. It must also disclose the conviction of Dr Helen Webberley in the Welsh court and the findings against Dr Michael Webberley, culminating in his removal from the Medical Register. Because the website is showcasing research conducted by the University of Oxford’s Nuffield Department of Primary Health Care, the Department and the University cannot evade responsibility. The researchers led by Dr Stepney must disclose how many of the informants who endorsed GenderGP were recruited via GenderGP—and whether the researchers had any financial or other connections with the Webberleys.
The Health Talk website does not provide any contact details, but the website is run by a charity called DIPEx. The Chair of Trustees is Professor Sean Hilton (firstname.lastname@example.org). The Chair of the Nuffield Department of Primary Care is Professor Richard Hobbs (email@example.com).