Online Transgender Clinic Doctor Appears Before Tribunal Over Patient Care

Ian Leonard

July 27, 2021

MANCHESTER—A doctor who ran an unlicensed online gender identity clinic (GIC) which offered treatments to children as young as 12 has appeared at a medical tribunal accused of failing to provide good clinical care to three patients.

Dr Helen Webberley/Credit: Ian Leonard/GenderGP

Dr Helen Webberley, who founded online clinic GenderGP, with her husband Dr Michael Webberley, is also accused of inappropriately prescribing to two other patients.

The 52-year-old, who is currently barred from practising, appeared today via videolink at a Medical Practitioners Service (MPTS) fitness-to-practise hearing in Manchester. She faces a total of 29 charges, most of which she denies, relating to the period March 2016 - November 2016, which include her failure to provide good clinical care to three child patients who received hormone treatment.

 

Patients A, B, and C

Dr Webberley is accused of failing to obtain adequate medical histories, failing to arrange adequate examinations, including physical examinations and psychological assessments to confirm a diagnosis of gender dysphoria before prescribing testosterone treatment to two patients - known only as Patient A and B - and failing to follow professional guidelines.

Patient A is said to have been given testosterone when it was "not appropriate for use" in children of their age while a third patient - Patient C - was prescribed testosterone and GnRHA - or puberty blockers - when Dr Webberley lacked the "adequate training, qualifications or experience in the field of paediatric endocrinology" and failed to discuss the risks of treatment

She also faces two charges of failing to assess Patient A and Patient C’s capacity to consent to treatment and a charge of failing to obtain informed consent for treatment from Patient B.

With all three patients, Dr Webberley is accused of failing to adhere to guidelines set out by the World Professional Association for Transgender Health (WPATH) and the Endocrine Society.

As such, she "knew or ought to have known" she was acting outside the limits of her competence as a GP with a special interest in gender dysphoria.

Patients D and E

Other allegations concern two other patients - Patient D and Patient E - following a CQC inspection of Dr Matt Limited where Dr Webberley was the safeguarding lead.

She’s charged with inappropriately prescribing medication and being unaware of and never seeing the safeguarding policy.

Dr Webberley also faces several charges in relation to her former role as CEO of Gender GP which states on its website that "all medical advice and prescriptions are provided by doctors working outside the UK".

Its operation method is allegedly "motivated by efforts to avoid the regulatory framework of the UK including the CQC (Care Quality Commission), HIW (Health Inspectorate Wales) and the GMC (General Medical Council).

Dr Webberley admitted charges relating to her conviction in October 2018 for illegally running an unregistered clinic - Online GP Services Ltd - while treating 1600 transgender patients and gender dysphoric children from her home in Wales. 

Mid Wales Magistrates court heard she gave hormones to children as young as 12 after the youngsters were denied treatment on the NHS.

A judge said there was a "clear refusal to follow the law" while regulator HIW said she posed a risk to patient safety.

Dr Webberley was later fined £12,000.

Consent and Capacity

Simon Jackson, QC for the GMC, said the case would touch on the issue of "consent and capacity" and whether experts believed Dr Webberley had provided the expected standards of care to patients.

He told the tribunal a paediatric endocrinologist would normally be consulted before hormonal treatment was prescribed to young transgender patients and while Dr Webberley saw herself as a specialist in this area it was "whether there were others who would regard her as having that necessary standard and expertise".

He continued: "Dr Webberley’s approach was more to seek to prescribe without an endocrinologist’s input and having made the diagnosis then seeking to transfer the shared care in terms of monitoring, blood samples and other testing to be done by the patient’s GP."

But he told the tribunal that Dr Webberley would suggest there was no training for doctors in this area and a "dearth of guidance" in place.

Dr Webberley also admits providing inaccurate information to an interim orders tribunal in May 2017 that she was a member of the Royal College of General Practitioners (RCGP).

But she denies that she "repeatedly frustrated" a 2017 review by the Aneurin Bevan University Health Board into her online practices.

Dr Webberley and her husband, who was suspended in May 2019, moved online GenderGP to Malaga in Spain in May 2019.

But it’s now owned by Hong-Kong based Harland International Ltd and she works only in a non-medical advocacy role.

The hearing is continuing.

High Court

The treatment of young transgender patients, which also includes the use of puberty blockers, has proved controversial.

The Tavistock and Portman NHS trust, which runs NHS England’s only gender identity development service for children, is challenging a landmark High Court ruling last year that children under the age of 16 considering gender reassignment are unlikely to be mature enough to give informed consent to be prescribed puberty-blocking drugs.

The case was brought by Keira Bell, a 24-year-old woman who began taking puberty blockers when she was 16 before detransitioning, and the mother of teenage autistic girl.

As a result of the decision, the Tavistock suspended new referrals for puberty blockers and cross-sex hormones for the under-16s.

But lawyers for the trust told the Court of Appeal in June that the ruling meant that children with gender dysphoria were "treated differently from others in their age group seeking medical treatment".

A decision on the trust’s appeal has yet to be made.

In a separate High Court case in March, a judge ruled that parents of transgender children can consent to treatment with puberty blockers on their child’s behalf without a court's approval.

Ian Leonard is a freelance journalist experienced in covering MPTS hearings.

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