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The private GP who has administered cross-sex hormones to twelve-year-olds, Dr Helen Webberley, was recently featured on Channel 4 News in an item which included an interview with her at the ‘online transgender medical clinic’ which she runs from her home in south Wales.

The doctor, who communicates with her patients via Skype, gave an account of her online business which raised serious questions about the regulation of such services for children and the qualifications of the doctors who do the prescribing. There are two issues here: what qualifies a GP to set up shop as a gender specialist and, within that specialist area, to work with children?

Professionals in the field themselves are worried and have voiced concerns to the General Medical Council, pointing out that Dr Webberley’s methods might increase the risk of hormones being inappropriately prescribed, to which the GMC responded that “the complaint did not meet their threshold for investigation.” It’s hard to imagine what exactly would meet the GMC’s threshold for investigation if not the risk of sterilising a healthy child.

It’s clear that Dr Webberley has set up a lucrative business, providing services for two and a half thousand people over the past eighteen months, catering mainly to adult males who wish to transition. In an article on the website Dr Webberley states that it’s “mostly people who are born male who feel they should be female” and the case studies shown on the site are exclusively male late transitioners. The testimonials are also overwhelmingly from males although it seems that none were available for the programme, which featured instead the unrepresentative example of a 30 year-old female.

To provide a service dedicated mainly to selling hormones to adult males is of course a very different thing to medically diagnosing and treating vulnerable and troubled children and adolescents. On being asked whether she was “perfectly confident” that she was qualified enough to administer cross-sex hormones to minors, this was Dr Webberley’s answer:

“To be qualified enough to administer the treatment I have to have made a good enough assessment of my patient, both a medical – er, physical – assessment and a psychological assessment and yes, on both occasions I have absolutely no reservations at all that it was the right thing to do.”

This quick correction of the word ‘medical’ we can assume is because transgender lobbyists do not want ‘trans’ to be seen as a medical disorder, but a natural and innate human variation akin to homosexuality. In her answer, Dr Webberley conspicuously fails to provide evidence of the professional qualifications which give her the authority to make these physical and psychological assessments of children. The following statement reveals that she doesn’t believe in a set of rules anyway, and listening to the words of children alone is enough to give her all the information she needs to make a professional diagnosis:

“My overwhelming belief is that each child, each adult, each person should have their care individualised and not by a set of rules. If you could meet that child and hear that child’s story from birth to twelve you would understand why for that child it was completely right to prescribe hormones.”

This reads as a very naive position for a doctor to take. Paediatric professionals know that personal preconceptions need to be put aside when listening to a child’s words, but Dr Webberley shows no awareness of the dangers of the projection of preconceived ideas and assumptions onto a child. Her specialist qualification is in sexual health, not paediatrics, so we can assume that she will not have had extensive experience in listening to children. Nor, it seems, has her team of councellors, therapists, life coaches and hypnotherapists; there is nothing here to suggest experience in working specifically with children and adolescents.

Without this expertise, Dr Webberley’s clear belief in the innate gender identity from birth narrative – one which is reinforced continually by her adult clients – means that children’s words will only be heard as validation of what she already believes. In this case, what is a physical assessment other than a means to determine whether a child’s body is healthy enough to take synthetic hormones? And what is the purpose of a “psychological assessment” other than to check that the child’s story confirms Dr Webberley’s fixed preconceived assumptions?

Here is a doctor who has set up an online business which is no different to that of a cosmetic surgeon with the job of providing the no-questions-asked body modifications demanded by their adult clients. Even in the area of aesthetic cosmetic surgery for adults there are rigorous checks and balances and the NHS provides advice on its website to protect patients from rogue surgeons.

So when it comes to life-changing and irreversible sex-change procedures for children, what are the regulatory bodies and GP qualifications parents need to check for? For a private GP to be qualified to work with children in such a highly specialised area, a parent would have the right to expect some extensive training: a placement at a gender clinic for children and adolescents for example, working alongside experienced clinicians; a recognised and approved medical qualification; training in child and adolescent developmental psychopathology; membership of a specialist professional body perhaps.

Well, no. The only evidence of any relevant training Dr Webberley has undergone is a certificate on her website from the Royal College of General Practitioners stating that in 2015 she completed “Gender Variance,” a course hosted on the RCGP Online Learning Environment.

A one-hour online course.

Further investigation reveals that this course is designed by the Gender Identity Research and Education Society (GIRES), not a medical or scientific organisation but a campaign group for transgender rights. They state on their website:

“GIRES upholds the right of all those who do not fit the typical boy/girl, man/woman tick boxes, including people who intend to change gender role completely”

Of course, they are not supporting children to change “gender role” at all, but to medically alter their biological sex characteristics; changing gender role involves no puberty suppression, hormones, breast-binding or surgery. GIRES does not support those children who do not fit the typical boy/girl tick boxes, they do the opposite by advocating sex-change in order that these children DO fit the boxes.  How is it that an organisation which makes such a fundamental and crucial error is given authority to train NHS doctors in the treatment of children?

In collaboration with Mermaids, GIRES has been campaigning since 2000 for the NHS “to make puberty suspending medication available to gender nonconforming young people.” They promote social transition of pre-pubertal children and advocate lowering the age at which cross-sex hormones may be administered. As a stakeholder in the NHS Gender Identity Development Service For Children and Adolescents consultation (which we responded to here) they proposed many changes to the NHS document, which were typically met with the response ‘No Action Required’ or a request for further evidence. So the NHS is fully aware of the agenda of this pressure group, has rejected their demands to relax the protocols in the treatment of children and adolescents, and yet promotes their E-Learning module to GP’s. Why the shock that a private GP sees fit to prescribe cross-sex hormones to twelve year-olds if the only ‘training’ she has received has come from GIRES?

The GIRES agenda is reflected in Dr Webberley’s videos and blogs on her website; ‘gender variance’ clearly means only one thing to her: these kids are trans and need medicalising for life. Not only that, but enabling them is an act of kindness:

“It’s a very safe, very kind, very caring and safe place where people can discuss their gender variance and get the treatment that they need. My biggest passion by far is in the next decade or two really make a difference for all those people who are crying out for timely care and not receiving it on the NHS and not receiving it from their basic family doctor and not receiving it from specialist services …um, and hiding in the closet.”

Dr Webberley exhibits all the characteristics of a social justice warrior in her view of herself as kind and caring; a crusading pioneer in transgender rights (“we’re going to shout, march and wave placards” she enthuses in her newspaper interview on the website). Her choice of the phrase “hiding in the closet” is revealing of her conflation of ‘transgender’ with ‘gay’ – to her, these kids are ‘coming out’ as trans and her job is simply to provide them with the means. Her fellow professionals, the gender clinicians who have expressed concerns about her treatment of children, she refers to as “the trans mafia.”

The issue is not that one rogue doctor is prescribing synthetic hormones to children four years younger then the minimum age stipulated by the NHS, unacceptable as that is. The real scandal here is that not only can a doctor set themselves up as a gender specialist, qualified to work with children and adolescents, on the basis of a one-hour online course, but that this ‘professional training’ is provided by the very pressure group whose demands for a fast-track treatment pathway for children the NHS has REJECTED.

The GMC’s dismissal of concerns suggests that Dr Webberley’s form of social justice therapy is viewed as an acceptable alternative to the professional standards of care expected in every other area of healthcare. When the result is invasive medical treatment which has such irreversible and life-long effects on children, with no sound evidence base to support its effectiveness, the cavalier attitude of both the NHS and the GMC represents nothing less than a failure in their duty of care towards our most vulnerable young people.