Formation | 2015 |
---|---|
Founders | Helen Webberley and Mike Webberley |
Location | |
Owner | GenderGP 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.
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 [update] . [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".
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]
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.
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.
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 children who experience significant discontent due to a mismatch between their assigned sex and gender identity. The diagnostic label gender identity disorder in children (GIDC) was used by the Diagnostic and Statistical Manual of Mental Disorders (DSM) until it was renamed gender dysphoria in children in 2013 with the release of the DSM-5. The diagnosis was renamed to remove the stigma associated with the term disorder.
Histrelin acetate, sold under the brand names Vantas and Supprelin LA 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.
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 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 to treat other conditions, such as precocious puberty in young children and some hormone-sensitive cancers in adults.
Transgender hormone therapy, also called hormone replacement therapy (HRT) or gender-affirming hormone therapy (GAHT), 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 the United Kingdom have varied significantly over time, with transgender Britons facing many issues not experienced by non-trans individuals. These include various laws and public attitudes in regards to identity documents, as well as anti-discrimination measures used by or pertaining to transgender people, in the areas of employment, education, housing and social services, amongst others.
Detransition is the cessation or reversal of a transgender identification or of gender transition, temporarily or permanently, through social, legal, and/or medical means. The term is distinct from the concept of 'regret', and the decision may be based on a shift in gender identity, or other reasons, such as health concerns, social or economic pressure, discrimination, stigma, political beliefs, or religious beliefs.
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.
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.
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.
Genspect is an international group founded in June 2021 by psychotherapist Stella O'Malley that has been described as gender-critical. Genspect opposes gender-affirming care, as well as social and medical transition for transgender people. Genspect opposes allowing transgender people under 25 years old to transition, and opposes laws that would ban conversion therapy on the basis of gender identity. Genspect also endorses the unproven concept of rapid-onset gender dysphoria (ROGD), which proposes a subclass of gender dysphoria caused by peer influence and social contagion. ROGD has been rejected by major medical organisations due to its lack of evidence and likelihood to cause harm by stigmatizing gender-affirming care.
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.
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.
Alice Litman was a transgender woman from Brighton, England, a notably LGBT-friendly city. She took her own life in May 2022, aged 20, after spending 1,023 days waiting for her first appointment with the Gender Identity Development Service (GIDS). Her case received criticism due to the duration of her wait to receive gender-affirming care and insufficient mental healthcare. Litman's death led to an inquest and a prevention of future deaths report.