GenderGP

Last updated

GenderGP
Formation2015;9 years ago (2015)
FoundersHelen Webberley and Mike Webberley
Location
OwnerGenderGP PTE Ltd. [1]
CEO
Unknown
Nick Imrie [2] (formerly)
Helen Webberley [3] (formerly)

GenderGP is an online gender clinic founded in 2015 by English physicians Helen Webberley and Mike Webberley. It is based in Singapore but provides services worldwide. It has been the subject of controversy within the United Kingdom as a result of regulatory actions taken against its founders.

Contents

Founding and history

GenderGP was founded in 2015 by English physicians Helen Webberley and Mike Webberley as a private telemedicine service for gender-affirming care to transgender and gender-diverse patients following the concern of excessive waiting lists for an initial NHS assessment. [4] [5] The clinic provides worldwide access to gender-affirming healthcare [6] as well as counselling services for patients and family members. [5] Within the United Kingdom, the clinic is the only private provider of health care for transgender youth, where it is seen by some as the only available option due to lengthy waiting lists and uncertainty following the announced closure of the Tavistock clinic. [7] As a result of controversy surrounding the clinic's founders, ownership was transferred to Harland International of Hong Kong in 2019. [5] GenderGP is registered in Singapore as of December 2022. [5]

Alongside Susie Green, the former CEO of Mermaids, GenderGP launched a charitable fund in February 2023 to provide gender-affirming health care to young trans people through the clinic's services. [6] [7] Twitch streamer and gamer F1NN5TER donated $50,000 to the fund in May 2023. [8] Green said that the donation would likely provide support for 24 people, with each individual receiving a year of free care. [7]

The Telegraph published two investigative articles critical of GenderGP in February 2021. [9] [10] The first article reported that the clinic was willing to prescribe testosterone to an undercover reporter posing as a 15-year-old trans boy, without needing parental consent. [9] The second article stated that two undercover reporters posing as the parents of a 12-year-old trans girl might be able to get a prescription for puberty blockers, following the reporters having two appointments with a counsellor and one with a doctor. [10] Although the child was not present, the report also stated that the 12-year old would need to have a few appointments with a counsellor. [10] Responding to the investigations, GenderGP said that its doctors had "the ultimate authority on all treatments", and that the clinic follows a "stage not age" approach, referring to stage of puberty, [11] when providing health care to trans youth. [10] [9]

In February 2024, The Telegraph reported that the clinical commissioning group for south-east London had issued a safety alert advising doctors not to prescribe puberty blockers or gender-affirming hormone therapy on the advice of GenderGP, as the clinic does "not provide physiological or psychological support" to its patients. [12]

In May 2024, the High Court stated that there are "serious concerns as to the safety of patients accessing cross-hormone treatment from" Gender GP and that "any other court faced with a case involving Gender GP [should] proceed with extreme caution before exercising any power to approve or endorse treatment that that clinic may prescribe". The statement in the ruling was based on evidence from Dr Jacqueline Hewitt, consultant paediatric endocrinologist, who said there was no physical examination of the patient, no skeletal bone age x-ray and bone densitometry investigation, a single 'extremely poor quality' psychological assessment with an unregistered counsellor, and "no record of counselling regarding the known risks of hormone treatment for gender dysphoria". [13] [14] [15] Dr. Hewitt also stated that Gender GP had followed a "highly abnormal and frankly negligent approach" by prescribing an immediate "top-end dosage to a testosterone-naïve child" such that "the level of testosterone in the blood was 'dangerously high' and that, apart from the potential for adverse long-term consequences of such a level, J was 'presently at risk of sudden death due to thromboembolic disease".

Suspension of founders

In May 2017, Helen, a general practitioner, was issued an interim suspension order by the General Medical Council (GMC), following complaints made about her clinical approach by clinicians at the Gender Identity Development Service. [16] On appeal, the Medical Practitioners Tribunal Service (MPTS) found in 2022 that while Helen failed to provide adequate follow-up care to two patients, she was competent to provide treatment to trans youth and adults. [17] [18] The tribunal also found that her fitness to practice was impaired, saying she had failed to provide adequate advise to a 11-year-old patient about the risks to fertility arising from treatment. It suspended her from practice for a period of two months. [19] [20]

The tribunal findings were later overturned by the High Court, with Justice Robert Jay describing the tribunal's thinking as "confused, clearly wrong in places," and that it "omitted reference to important evidence." [21] [22] The ruling found that the allegation in the charge of failing to provide advice on the effects of fertility to the 11-year-old patient was unclear, as it did not state whether there was no discussion at all, or whether there was a discussion but it was not directly with the patient. It also found that the tribunal had erred by omitting reference to an email from Helen's administrative assistant to the patient's mother. [21] [22] Although Jay had concerns about some aspects of Helen's practice in relation to the patient, including that she should have discussed the risks to fertility directly with the patient, he said that "it is far from clear to me that what did take place should be strongly criticised." [21] [22] As a result of the appeal, Helen was allowed to resume work as a doctor in the United Kingdom. [22]

As a result of his wife's suspension in 2017, Mike, then a retired consultant gastroenterologist, took over care of the clinic's patients. [23] [24] In May 2019 the GMC issued an interim suspension order against Mike, stating that the care he provided "fell below the standards expected". [25] A subsequent MPTS hearing found Mike had acted outside the limits of his expertise when providing treatment to seven transgender patients of GenderGP. [24] Although the tribunal noted that he had not been subject to any previous disciplinary findings, it concluded that his conduct was incompatible with registration as a doctor, and struck his name from the medical register. [24]

Helen Webberley's licence to practice was revoked by the General Medical Council on 19 July 2024 after failing to comply with her legal obligation to revalidate her licence every five years. [26]

Related Research Articles

Gender dysphoria (GD) is the distress a person experiences due to a mismatch between their gender identity—their personal sense of their own gender—and their sex assigned at birth. The term replaced the previous diagnostic label of gender identity disorder (GID) in 2013 with the release of the diagnostic manual DSM-5. The condition was renamed to remove the stigma associated with the term disorder. The International Classification of Diseases uses the term gender incongruence instead of gender dysphoria, defined as a marked and persistent mismatch between gender identity and assigned gender, regardless of distress or impairment.

The World Professional Association for Transgender Health (WPATH), formerly the Harry Benjamin International Gender Dysphoria Association (HBIGDA), is a professional organization devoted to the understanding and treatment of gender identity and gender dysphoria, and creating standardized treatment for transgender and gender variant people. WPATH was founded in 1979 and named HBIGDA in honor of Harry Benjamin during a period where there was no clinical consensus on how and when to provide gender-affirming care.

The Standards of Care for the Health of Transgender and Gender Diverse People (SOC) is an international clinical protocol by the World Professional Association for Transgender Health (WPATH) outlining the recommended assessment and treatment for transgender and gender-diverse individuals across the lifespan including social, hormonal, or surgical transition. It often influences clinicians' decisions regarding patients' treatment. While other standards, protocols, and guidelines exist – especially outside the United States – the WPATH SOC is the most widespread protocol used by professionals working with transgender or gender-variant people.

Pediatric endocrinology is a medical subspecialty dealing with disorders of the endocrine glands, such as variations of physical growth and sexual development in childhood, diabetes and many more.

<span class="mw-page-title-main">Triptorelin</span> GnRH-agonist

Triptorelin, sold under the brand name Decapeptyl among others, is a medication that acts as an agonist analog of gonadotropin-releasing hormone, repressing expression of luteinizing hormone (LH) and follicle-stimulating hormone (FSH).

Gender dysphoria in children (GD), also known as gender incongruence of childhood, is a formal diagnosis for distress caused by incongruence between assigned sex and gender identity in some pre-pubescent transgender and gender diverse children.

<span class="mw-page-title-main">Histrelin</span> Chemical compound

Histrelin acetate, sold under the brand name Supprelin among others, is a nonapeptide analogue of gonadotropin-releasing hormone (GnRH) with added potency. When present in the bloodstream, it acts on particular cells of the pituitary gland called gonadotropes. Histrelin stimulates these cells to release luteinizing hormone and follicle-stimulating hormone. Thus it is considered a gonadotropin-releasing hormone agonist or GnRH agonist.

Norman P. Spack is an American pediatric endocrinologist at Boston Children's Hospital, where he co-founded the hospital's Gender Management Service (GeMS) clinic in February 2007. It was America's first clinic to treat transgender children, modeled after a similar Dutch system. He is an internationally known specialist in treatment for intersex and transgender youth, and is one of the first doctors in the United States to advocate prescribing hormone replacement therapy to minors. Spack, who is Jewish, has been an advocate for transgender resources and support groups for the Jewish community.

<span class="mw-page-title-main">Transgender youth</span> Children and adolescents who are transgender

Transgender youth are children or adolescents who do not identify with the sex they were assigned at birth. Because transgender youth are usually dependent on their parents for care, shelter, financial support, and other needs, they face different challenges compared to adults. According to the World Professional Association for Transgender Health, the American Psychological Association, and the American Academy of Pediatrics, appropriate care for transgender youth may include supportive mental health care, social transition, and/or puberty blockers, which delay puberty and the development of secondary sex characteristics to allow children more time to explore their gender identity.

Puberty blockers are medicines used to postpone puberty in children. The most commonly used puberty blockers are gonadotropin-releasing hormone (GnRH) agonists, which suppress the natural production of sex hormones, such as androgens and estrogens. Puberty blockers are used to delay puberty in children with precocious puberty. They are also used to delay the development of unwanted secondary sex characteristics in transgender children, so as to allow transgender youth more time to explore their gender identity. The same drugs are also used in fertility medicine and to treat some hormone-sensitive cancers in adults.

Gender-affirming hormone therapy (GAHT), also called hormone replacement therapy (HRT) or transgender hormone therapy, is a form of hormone therapy in which sex hormones and other hormonal medications are administered to transgender or gender nonconforming individuals for the purpose of more closely aligning their secondary sexual characteristics with their gender identity. This form of hormone therapy is given as one of two types, based on whether the goal of treatment is masculinization or feminization:

The real-life experience (RLE), sometimes called the real-life test (RLT), is a period of time or process in which transgender individuals live full-time in their identified gender role in order to be eligible to receive gender-affirming treatment. The purpose of the RLE has been to confirm that a given transgender person could function successfully as a member of said gender in society, as well as to confirm that they are sure they want to live as said gender for the rest of their life. A documented RLE was previously a requirement of many physicians before prescribing gender-affirming hormone therapy, and a requirement of most surgeons before performing gender-affirming surgery.

Transgender health care includes the prevention, diagnosis and treatment of physical and mental health conditions for transgender individuals. A major component of transgender health care is gender-affirming care, the medical aspect of gender transition. Questions implicated in transgender health care include gender variance, sex reassignment therapy, health risks, and access to healthcare for trans people in different countries around the world. Gender affirming health care can include psychological, medical, physical, and social behavioral care. The purpose of gender affirming care is to help a transgender individual conform to their desired gender identity.

Transgender rights in Australia have legal protection under federal and state/territory laws, but the requirements for gender recognition vary depending on the jurisdiction. For example, birth certificates, recognised details certificates, and driver licences are regulated by the states and territories, while Medicare and passports are matters for the Commonwealth.

<span class="mw-page-title-main">Transgender rights in the United Kingdom</span>

Transgender rights in the United Kingdom have varied significantly over time.

The Gender Identity Development Service (GIDS) was a nationally operated health clinic in the United Kingdom that specialised in working with children with gender identity issues, including gender dysphoria. The service closed on 28 March 2024 after serious concerns were repeatedly raised over a number of years by several independent NHS whistleblowers.

<i>Bell v Tavistock</i> 2021 UK case regarding puberty blockers

Bell v Tavistock was a case before the Court of Appeal on the question of whether puberty blockers could be prescribed to under-16s with gender dysphoria. The Court of Appeal said that "it was for clinicians rather than the court to decide on competence" to consent to receive puberty blockers.

<span class="mw-page-title-main">Arkansas House Bill 1570 (2021)</span> 2021 Arkansas state law

Arkansas House Bill 1570, also known as the Save Adolescents From Experimentation (SAFE) Act or Act 626, is a 2021 law in the state of Arkansas that bans gender-affirming medical procedures for transgender people under 18, including puberty blockers, hormone therapy, and sex reassignment surgery. The law also bans the use of public funds for and prohibits insurance from covering gender transition procedures, while doctors who provide treatment in violation of the ban can be sued for damages or professionally sanctioned. The measure makes Arkansas the first U.S. state to make gender-affirming medical care illegal.

Laura Edwards-Leeper is an American psychologist and founder of the first pediatric gender clinic of the United States. She also served as head of the Child and Adolescent Committee for the World Professional Association for Transgender Health.

<span class="mw-page-title-main">Cass Review</span> Review of gender identity services in England

The Independent Review of Gender Identity Services for Children and Young People was commissioned in 2020 by NHS England and NHS Improvement and led by Hilary Cass, a retired consultant paediatrician and the former president of the Royal College of Paediatrics and Child Health. It dealt with gender services for children and young people, including those with gender dysphoria and those identifying as transgender in England.

References

  1. ↑ "About Us". GenderGP. Archived from the original on 16 February 2024. Retrieved 3 March 2024.
  2. ↑ "GenderGP Appoints a new CEO". GenderGP. 30 October 2023. Archived from the original on 16 February 2024. Retrieved 3 March 2024.
  3. ↑ "Trans Youth – A Live Discussion on Affirmative Healthcare". GenderGP Transgender Services. Retrieved 29 March 2024.
  4. ↑ Rogers, Chloë; Webberley, Mike; Mateescu, Roxana; El Rakhawy, Yasmeen; Daly-Gourdialsing, Anaïs; Webberley, Helen (3 April 2021). "A retrospective study of positive and negative determinants of gamete storage in transgender and gender-diverse patients". International Journal of Transgender Health . 22 (1–2): 167–178. doi:10.1080/26895269.2020.1848693. PMC   8040686 . PMID   34961859.
  5. 1 2 3 4 Rigby, Jennifer; Respaut, Robin; Terhune, Chad (15 December 2022). "England's trans teens, lost in limbo, face mounting barriers to care". Reuters . Archived from the original on 26 November 2023. Retrieved 3 March 2024.
  6. 1 2 Baska, Maggie (9 February 2023). "Ex-Mermaids CEO and GenderGP launch vital trans youth healthcare project". PinkNews . Archived from the original on 3 March 2024. Retrieved 3 March 2024.
  7. 1 2 3 De Peña, Luis Xavier (19 June 2023). "UK Twitch streamer raises $50k for trans health care". Watermark Online. Archived from the original on 2 March 2024. Retrieved 8 March 2024.
  8. ↑ Ferlita, Gabriella (2 March 2024). "F1NN5TER comes out as gender-fluid and bisexual: 'I am just here to be me'". PinkNews . Archived from the original on 2 March 2024. Retrieved 3 March 2024.
  9. 1 2 3 Rushton, Katherine; Eastham, Janet; Newell, Claire; Barnes, Sophie (26 February 2021). "How children can order life-altering transgender drugs from their bedroom". The Telegraph . Archived from the original on 14 January 2024. Retrieved 9 March 2024.
  10. 1 2 3 4 "Exclusive: Online clinic willing to prescribe sex change drugs to children without asking them to talk to doctor". The Telegraph . 28 February 2021. Archived from the original on 7 February 2024. Retrieved 9 March 2024.
  11. ↑ "The Importance of STAGE not AGE". GenderGP. 20 September 2022. Archived from the original on 16 February 2024. Retrieved 9 March 2024.
  12. ↑ Dixon, Hayley (28 February 2024). "NHS issues urgent warning for discredited transgender clinic". The Telegraph . Archived from the original on 7 March 2024. Retrieved 9 March 2024.
  13. ↑ "J (Transgender: Puberty Blocker and Hormone Replacement Therapy), Re - Find Case Law - the National Archives".
  14. ↑ "Unregulated online clinic gave teen dangerous hormone dose". BBC News. 2 May 2024. Retrieved 2 May 2024.
  15. ↑ Bannerman, Jonathan Ames (2 May 2024). "Teen prescribed 'dangerously high' hormone dose by online clinic". The Times . ISSN   0140-0460. Archived from the original on 2 May 2024. Retrieved 3 August 2024.
  16. ↑ Welstead, Mary (2021). "England and Wales Treatment for Children Suffering from Gender Dysphoria: A Polarised Debate". In Brinig, Margaret (ed.). International Survey of Family Law 2021. Intersentia. pp. 174–175. doi:10.1017/9781839702020.010. ISBN   978-1-83970-202-0. Archived from the original on 9 March 2024. Retrieved 3 March 2024.
  17. ↑ Baska, Maggie (26 April 2022). "Medical tribunal rules on founder of online clinic for trans kids GenderGP". PinkNews . Archived from the original on 3 March 2024. Retrieved 3 March 2024.
  18. ↑ "GP's online transgender clinic follow-up care criticised". BBC News. 25 April 2022. Archived from the original on 3 March 2024. Retrieved 3 March 2024.
  19. ↑ Dyer, Clare (1 July 2022). "GP who ran a gender identity clinic online is suspended for two months". BMJ . 378: o1633. doi:10.1136/bmj.o1633. PMID   35777779.
  20. ↑ "Transgender children GP: Helen Webberley suspended for misconduct". BBC News. 30 June 2022. Archived from the original on 3 March 2024. Retrieved 3 March 2024.
  21. 1 2 3 Dyer, Clare (3 April 2023). "GP who ran gender identity clinic wins appeal against suspension". BMJ . 381: 773. doi:10.1136/bmj.p773. PMID   37011920.
  22. 1 2 3 4 "Transgender children GP: Helen Webberley wins suspension appeal". BBC News. 31 March 2023. Archived from the original on 3 March 2024. Retrieved 3 March 2024.
  23. ↑ Leonard, Ian. "GP Who Ran Unregistered Clinic for Transgender Children Suspended for 2 Months". Medscape . Archived from the original on 9 March 2024. Retrieved 3 March 2024.
  24. 1 2 3 Dyer, Clare (30 May 2022). "Retired consultant is struck off over treatment of young transgender patients". BMJ . 377: o1357. doi:10.1136/bmj.o1357. PMID   35636765.
  25. ↑ Parsons, Vic (28 May 2019). "GenderGP's trans patients face uncertain future as doctors suspended". PinkNews . Archived from the original on 3 March 2024. Retrieved 3 March 2024.
  26. ↑ Beal, James (19 July 2024). "Doctor who gives puberty blockers to trans children loses licence". The Times . Retrieved 19 July 2024.
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