en English

This episode of the GenderGP podcast features a Live Q&A with Dr Helen Webberley and Lead therapist Marianne Oakes. Together the pair discuss what the Tavistock and Portman NHS Trust ruling means for trans youth, how this will impact GenderGP service users, what is being done to help the community and how you can support young trans people.

This is also available as a video.

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We prescribe puberty blockers to young people – if that’s what they need

 

The GenderGP Podcast

The Tavistock Ruling

 

Hello, this is Dr Helen Webberley. Welcome to our GenderGP Podcast, where we will be discussing some of the issues affecting the trans and non-binary community in the world today, together with my co-host Marianne Oakes, a trans woman herself, and our head of therapy.

 

Dr Helen Webberley:
Hello to anybody or everybody that can see us and hear us. My name is Dr Helen Webberley. I am the founder of gender GP. I am a medical doctor although I’m not here in a medical capacity. And I am a passionate advocate for the improvement of the rights for transgender people’s access to health care. I’m here with Marianne Oakes who is the head of therapy at GenderGP. Anyone who listens to our podcast will know that Marianne and I often talk about issues related to the transgender community. We’re here today with slightly heavy hearts because of the ruling made by the judge in the case that was brought against the Tavistock and Portman NHS Trust. The Tavistock and Portman NHS Trust provides a whole host of services of medical services. And one small part of that is the gender identity service that we know serves young people in the UK, which is good. So the case brought against the, we’ll call it the Tavistock. So by the Tavistock, we mean the NHS service for young people within gender dysphoria. So a case was brought against the Tavistock by two people. One was an ex-patient of the Tavistock somebody who had presented as transmasculine and had gone through medical treatment and surgical treatment in the form of top surgery but now wishes to re-identify as female. And the other, the other claimant in the case was Mrs A who is a parent of a transgender youngster. And the youngster, as well as exhibiting symptoms and signs of gender identity disorder, also has been given a diagnosis of being on the autistic spectrum disorder. And Mrs A was worried that her child would be referred to GIDS and may have treatment. So those were the two claimants in the case. The court was asked to review the practice by GIDS of prescribing puberty blockers to patients under the age of 18. So the courts were very clear that this was not about discussing the medical merits of puberty blockers, whether they work, whether they are effective, whether they should or shouldn’t be used in this condition, because the court recognized that is an arena where a medical discussion would be needed rather than a legal discussion. So the courts were, therefore, felt that they were being asked to determine whether informed consent in the legal sense can be given by such children and young people. So basically the question is can young people under the age of 18 give consent to have a treatment such as puberty blockers for gender dysphoria, and the case that was being put against the Tavistock was really saying that puberty blockers are experimental. We don’t know the long-term effects of them. We don’t know whether that differs by different age group. For example, if you’re prescribing to a 10-year-old, does that differ to be prescribing to a 16-year-old? And so that was, that was the case. And, and how could really someone so young be able to make a decision on that treatment? So again, it wasn’t talking about whether someone so young can identify as a different gender. It wasn’t challenging the existence of gender dysphoria. It was really talking about the under eighteens and are they able to give that medical consent in their own right? And for a variety of reasons during the case the judge decided that given the evidence in front of him on that day, and I think that, you know, when I read it, I was so angry, I was so cross, I was so disappointed at, you know, the effect that this is going to have on young people in this country. And someone corrected me on Twitter actually and said, well, look, you know, the judge had to decide on what he was given that day. And that’s what judges do. Judges don’t go on what went on last week or what is going to happen next week. They go on what was presented to them on the day or the days of the hearing. And of course, what is presented to them is presented to them by the two sides. So you have the claimant who is Quincy Bell and Mrs A, and then you have the defendant which is the Tavistock and Portman. And then, of course, you’ve got other parties who are there to give evidence. And there was a doctor, a pediatric endocrinologist from Leeds, a hospital there who runs the Leeds endocrine department. Professor Butler was there who runs the London endocrine department. Polly Carmichael, who runs GIDS, the psychology service at GIDS. Of note, the commissioners, NHS commissioners, were a very interested party in this case. And they weren’t there, and they didn’t provide any representation. So not only did they not turn up if you like, they didn’t provide any, any barristers or assistants to act for them, which again is, it leaves the Tavistock in a very bare position. And again, unfortunately, as with anyone listening will know organizations such as Transgender Trent had quite a big part to play in the proceedings. And where was the backup from, from our side, if you like, why weren’t very important organizations such as GenderGP, such as Mermaids Charity, other voluntary organizations who have a lot of evidence and data for this case, where were they and why weren’t they there? And basically, the failings of the evidence provided by the Tavistock and the lack of support has meant that the judge was able to determine that the treatment was experimental and that it was highly unlikely that young people would be able to consent to that treatment. And that’s what he determined by the evidence in front of them, which was, which was very sad. Marianne, I don’t know what your thoughts are on the on, on the impact that this might have on young people in the UK.

Marianne Oakes:
Well, firstly, thank you for explaining that too, because I wasn’t quite kind of fully aware of what had gone on and I’m sure there’s a lot of people listening might have done, but I think the impact is just going to be devastation. I felt devastated, and you know, I’m way beyond puberty blockers. But I was devastated not just for the children and the families that are going through the service and the ones that have waited for so long. I was devastated because personally, I think there’s, there’s an agenda beyond puberty blockers and the Tavistock and that it will, you know, this is about, is any child under the age of 18 able to get consent? You know, it will come down to things like voting, driving a car, you know, choosing their exams, you know. It’s just the implications that this is a thin end of a really big wedge if we’re not careful. But personally, I was really shocked that it was even being presided over by judges. When actually to me, it was a medical issue. How did they turn it into a judicial issue? So yeah, the devastation for the families that have been waiting for so long, I’m not even sure. Maybe you can help here. What’s going to happen to the children that are already on blockers? Does that end now? What are the ramifications of that, really?

Dr Helen Webberley:
Well, what’s happened is that the judge has said that it is unlikely that the young people are going to be able to get, to get this consent. He has not said that it is unlawful to prescribe blockers. He hasn’t said that nobody could, nobody is allowed to prescribe blockers. He simply said that he finds it; he found that the information given to him was that it was an experimental treatment. And he, and he said that he finds it unlikely that people will be able to consent. However, what’s happened is the Tavistock has now declared that they are basically stopping treatment. So nobody’s been going to be referred on from GIDS onto endocrinology to receive prescriptions because of course, we are in a bizarre situation in this country where you have to go through psychology for assessment and cage-rattling as I’ve had it put to me. And that consent process, in order to get to endocrinology, so the Tavistock has said that they will not be referring anyone to endocrinology. And of course, there is no other way to get to endocrinology. GPs aren’t allowed to directly refer them. They have to refer them in the UK to the Tavistock. So the Tavistock, I’ve taken this, this bold, and I feel the early and perhaps very damaging and unnecessary decision to blanket stop. And of course, it’s turned the whole world into a panic in the UK. You know, I’ve seen people on Twitter saying, but my child was just about to get to the endocrine clinic next week and now they can’t. I’ve seen people say, well, I’ve just been told that I can go to my appointment, but I, I’m not going to be able to get any medical treatment. And of course, when you’re dealing with a young person at home, and you’ve got to be the one that’s going to have to give them that news, that that is really sad. We’ve had lots of, lots of questions, Marianne about gender GP and whether gender GP, doctors will be continuing to prescribe puberty blockers. And I have taken a statement from the doctors and the medical team that is providing care to young people at the moment, and that they are very clear that the consent process by which GenderGP undertakes is robust and that they will be continuing to prescribe blockers for people who are on blockers. And they will be continuing to prescribe new blockers for anybody who is able to give consent to that treatment. So that’s a very, very clear message that I have been asked to give from the medical team that is currently running GenderGP. And I think Marianne, that’s going to give, that’s going to give some reassurance, but actually, this reassurance should be coming from the NHS.

Marianne Oakes:
Without question. And to be fair, why should it be left to just one single organization to be brave enough to continue offering this treatment? I think as you said, it’s not illegal to prescribe this drug. I mean, on what do we even mean by able to give consent? I’m not actually even sure that there is a litmus test that says you can or you can’t, you know, if saying you can’t give consent well, how can you, how can you prove that? How could you prove somebody isn’t able to give it? So it just feels like a black hole but really pleased that we are able to continue and that the doctors at GenderGP are committed to serving our patients despite all of this. Can I just ask one other question as well? Sorry, just to expand on that. I also want to ask a question, make a point. I don’t know, but this drug, there is plenty of evidence, and there is actually this idea that this is the only experiment that’s happening right now is what’s going to happen to these children that I’ve just had a rug pulled completely from under them. That is the experiment. If you wanted to say, right, we’ll do research into what would happen over 30 years. If we remove this medication, that’s one thing to pull the rug is experimental. Nobody knows now.

Dr Helen Webberley:
Well, the trouble is if you have a look at the determination, what happened was, and if you look at the international guidelines that are being used in big centres, the children in the pediatric association, in America, the Children’s Hospital in Melbourne, Australia, the huge centre of excellence for transgender care in San Francisco, they all, so by standard international evidence-based guidelines. And in there, it just very clear puberty blockers. The use of puberty blockers is to stop puberty so that the body doesn’t develop and they are reversible, and they are well evidenced and safe. So that is what then the international guidelines has been going on for many years. And had any of those individual clinics been taken to task on it, they would have been able to say those three things, they are safe. They are well evaluated. They are reversible. We have been using them long enough to know the long-term effects. However, what we know in the, in the UK is that the NHS doesn’t have any published guidelines. They don’t use those international guidelines. They’ve made their own clinic protocol. And if you read the clinic protocol, that was then put in front of the judge said, professor Butler says, we don’t know the long-term effects. Polly Carmichael says we don’t know the long-term effects. They might. The information leaflet says they might affect the brain and the bones. And the NHS website was changed in June 2020. So June this year, it used to say, puberty blockers are reversible. Now it says, we don’t know. So all of that’s put in front of the judge says, says to the judge, these people don’t know whether these drugs are reversible or safe, and that is what he made his dissemination on. So the rest of the world understands the medical evidence and use that in their clinic protocols. But the Tavistock, because of their blind stubbornness over the years to follow proper international guidelines, has now left our, left the children in the UK, very, very vulnerable.

Marianne Oakes:
I said on the day, one of the things that made me angry was how could the Tavistock let this happen? How did it even get to court that knowing that the court case was coming up, how could they let this happen? Because I just can’t believe they couldn’t be prepared. And I think it was 1997 they started serving children. What have they done with all that data?

Dr Helen Webberley:
That is exactly what the judge said. The judge said, okay, so you used to prescribe to puberty blockers to 16-year-olds. And since 2011, you’ve been prescribing them to children as young as 10. So what’s happened to those children. What are the outcomes? How many 10-year-olds, how many 13-year-olds, how many 16-year-olds? What’s happened and the Tavistock couldn’t produce any data. So once again, for a clinic that’s providing care, which is emotive, political, and in their own inflammation, leaflets and consultations, they’re telling parents and telling children, we don’t know if this is safe or not. How can they not provide data to back it up? And so the judge was like, I’m so surprised you do not have data on this, on this very important matter. And again, it just made the concept that a young person could consent to this treatment around so much uncertainty. And the judge was baffled. Don’t forget; the judge doesn’t know, maybe in his experience, never met anyone with gender dysphoria. It wasn’t about that. It was about the information provided by the Tavistock could a young person consent? And he said, no, because it’s so nebulous. And, and it’s a travesty. I mean, some people are saying that did the Tavistock do this on purpose? You know, why were the NHS commissioners not there? Why were Mermaids not there? Why were we not invited? Did they do this on purpose? And that’s what some people are asking. You know, I absolutely hope not. But you know, why were they not able to fight their case?

Marianne Oakes:
It, it, it feels like huge ineptitude that, that’s how it feels. I’m sure. Well, I don’t know. I don’t want to defend it. I, like I say, I was just so angry that they could let this happen that they couldn’t be prepared. And actually, everything that you say it is they didn’t believe in their own treatment.

Dr Helen Webberley:
Yeah. Isn’t it, you know, that’s what we hear when people think, when people on social media and what have you, you know, that, that cage, that rattling that robust uncertainty, are you sure your child is gender dysphoric? Are you sure you want the child to go down this route? Are you sure that you want that child to have that medication? That uncertainty is now washing through into the courts. And the courts are like, when, if you’re that uncertain, you shouldn’t be prescribing.

Marianne Oakes:
Yeah. Given, given this evidence that you don’t trust what you’re doing. So we can’t blame the courts. Actually, this isn’t an issue with the courts. What I was going to say, shall we answer some of the questions because I’m sure we could run it for an hour just about the ineptitude?

Dr Helen Webberley:
Someone said, how can they challenge mental capacity? Everyone has the capacity unless stated otherwise. The government are contradicting their own legislation. So, so what, what the, what the judge was saying was in the UK, we have Gillick Competence, which means that that a young person can consent on their own if the information that they’re given is comprehendible to them and they’ve got the support around them. So the judge was not saying at all, that a young person under 16 can’t consent to treatment, but what the judge was saying was that given the way that it’s being presented to the child by the Tavistock’s guidelines is that how could a child possibly be able to consent to all of that? And one of the real failings that I’ve determined from this, and this is my opinion, is that the Tavistock of the only centre in the UK in the only sense of treating trans youth, where they have this stepwise approach, you have to have blockers, you have to have them for at least a year. You have to have them until you’re 16. And then only once have you had that, you’ve had those, are you allowed to move on to the second step. And so, so the judge said, okay, so you’re saying there are two very distinct steps here. And the Tavistock said yes. And he said, okay, well, how many of your young people didn’t go onto the second step? And the Tavistock couldn’t provide the answer or the numbers. And which left the other, the others, the claimant said, we know that everyone goes onto hormones. And the Tavistock didn’t have anything to counter that with. So he said, so, so these are not two steps. Then you’re basically saying that anyone who goes on to blockers goes onto hormones and then probably surgery. And he said, how can a young person consent to all of that at age, for example, 10. So it’s, once again, you know, the international guidance is really, really clear on all of this, you know, treat the person individually, which says, which step do you need to start with? Which treatment step? But the Tavistock’s blinkered, set protocol has left them very vulnerable. And so when the judge said, how can a 10-year-old consent to all of that, all in one, go fertility, sexual relationships, all of that for the future, he was like, well, how can they? But it’s not, that’s not how it is in practice. And the Tavistock, couldn’t back it up.

Marianne Oakes:
Just to clarify what I’m hearing in there, and I might be wrong is that when you consent to go onto blockers, as you are consenting to everything else, because unless you can prove to the Tavistock, that your intent is to do the other things, then they’re not going to put you onto the blocker. And that to me is a travesty. The whole point of a blocker is to allow somebody to explore their gender, to give them the calm space, to take away the fear of what’s common so that they can explore their gender, then speak to them again. When the time’s right, I’ll allow them to come back and say, do you know, I’m now ready to look at the next stage, would that?

Dr Helen Webberley:
Right. And again, they fell down on that because it was used against them. So Polly Carmichael was asked, what is the, what is the purpose of puberty blockers? And she said the purpose of punitive blockers is to give the child space to think. However they said to her, but actually, if you look at WPath and Endocrine, they say that the purpose of puberty blockers is to stop puberty and stop body changes. And so there was so, you know, it’s almost like they weren’t, that the judge was kind of saying, you’re not even using them for the right indication. You’re saying it’s to give space to think, which we know is a secondary thing. The reason when we give them, or they are given to stop puberty and stop the body changing. And then that gives peace and time to think. But again, the Tavistock, the way that they run their service has left them vulnerable in that situation as well.

Marianne Oakes:
So basically the developed guidelines over the last 30 years of their own guidelines. And in 2020, they’re not fit for purpose. And they’ve been caught out in the courts.

Dr Helen Webberley:
And not only just not fit for purpose, but they didn’t have, haven’t got any data to back it up. So in 2011, they changed from their old protocol, which was no puberty blockers since 2016 to the early intervention program, which we know has saved lives. So now, if you are a youngster who’s just about to go through puberty or in the early stages of puberty, through the NHS, you are allowed to have puberty blockers. And that has definitely saved lives. We know that, but the court said, okay, so you changed in 2011, where’s the data let’s have a look at what the results of that were. What’s happened to the young people that you’ve given puberty blockers to since 2011, the under sixteens and the Tavistock had to say, we haven’t published the data yet. And it’s like, well, what have they been doing? It’s 10, nearly ten years, nearly ten years. And the excuse that they gave was that one of the authors was busy because of COVID. I mean, honestly,

Marianne Oakes:
Well, ten years. So we’re saying, let’s just say there was an 11-year-old, ten years ago, who is now 21. You, you know, you’re not telling me, we couldn’t look at what the long-term effect of the blockers was on that child. And actually, the argument might be that that child might not have reached 21 had they not got the blocker? You’re not. I just can’t believe they couldn’t put the hands on the data.

Dr Helen Webberley:
And so, not only did they not provide the data, but they didn’t provide the evidence. Where were the 200 young people whose lives have been saved by the Tavistock clinic, and whose puberty has been suspended? And they haven’t had to go through the body changes that they would have had to had they not been allowed to have that puberty buckets of 16. Where were all these people, where were the voluntary organizations, where were Stonewall, where was Mermaids? Where were they with their banners saying, judge, please, you’ve got listen, because they might be young, these people giving consent, but that this is what they’re consenting to? They’re consenting to stop their bodies changing in this way. That’s what they’re consenting to with puberty blockers.

Marianne Oakes:
The reason for not calling, you know, the charities such as Mermaids. You know, I’m baffled as to what the motivation was although part of me believes that this is about, did you think it was arrogance that their expert status would be enough to carry them through and they don’t need anybody else to support?

Dr Helen Webberley:
I don’t know, Marianne, I don’t know. I mean, that’s a valued judgement, but it’s, you know, I’ve always been surprised that an organization, such as GIDS doesn’t work really hand in hand closely with, with an organization, such as Mermaids. They are a charitable organization, a support organization for parents and children and a medical organization for parents and children. And why ever are the two not married up? That’s a very big, big question for me. Why aren’t, why aren’t they signposting for Mermaids on the GIDS website? And then in the time of need, when we actually needed to have those voices from Mermaids there, they weren’t there. But Transgender Trent was, you know, they became the experts in the case, and you know what they’re like, you know, they portrayed themselves as experts in giving parents and teachers education. And we all know how awful and how transphobic that education is. Yet in the court, they spoke very eloquently and convincingly.

Marianne Oakes:
Well, well, just one other point on that as well. One of the questions in my mind, what was the motivation behind the people pulling, bringing this case, you know? That really was just to damage, this is about erasing trans people from society and the genuinely I saw photographs outside the court and the, you know, the branding that these people have heard about you know, what it is to be a woman, you know you know, it was there clear they did, they’ve even used the media opportunity to reinforce that, but nobody’s questioned that. The media have not gone and dug deep and said, you know, so what’s motivated, you know, what happened to the Keira Bell, you know, has she been through conversion therapy? I don’t know, and I’m throwing out accusations there. But nobody has questioned their motivation. So, that was another sub part of the reporting, at least.

Dr Helen Webberley:
The reports. Absolutely. And it, and it just goes to create more damage. And the damage is our faith in the media. And that’s Marianne, that is why you and I sit here, and we give evidence-based proper advice and judgment. And that’s, you know, someone’s just said Helen and Marianne, and your amazing behind the scenes team, you are lifesavers, life improvers, I’m eternally grateful on behalf of everyone you have directly and indirectly helped in this broken system and across the world. And that’s what gives us the will to go on, isn’t it, Marianne? And to fight. And there’s a lot of people saying my goodness, if the Tavistock had been able to be attacked in this way, then is GenderGP at risk? And I just want to go back to, I mean, I was the founder of GenderGP, I am not medically involved at the moment, but heavily involved in advocacy. And GenderGP has been criticized by the NHS for not following NHS protocol. Had we followed the NHS protocol, we would be in the same position now. However, GenderGP decided early on that they were going to follow international best practice, published, evidence-based guidelines, and that’s what they do. And when you do that in medicine, you provide safe and effective care because you’re doing what everybody else does in, in super-specialized clinics across the world. You’re not following one clinic in London, which has been heavily criticized already. So people have been worried that you know, GenderGP might have been under attack. But everybody knows that I myself have been under attack from the very clinicians that were in court that day for this case. But we have stood firm, and GenderGP will stand firm for the rights of children, adolescents, adults, elderly folk, anybody. And we’ll keep fighting for as long, for as long as it’s needed.

Marianne Oakes:
It’s a shame that we’re talking about healthcare and fighting, you know, that, it does feel like a wall sometimes. I was just going to ask you how, and if you don’t mind, playing devil’s advocate, you know, if we were in the position of the Tavistock, do you think we could provide the evidence to support our treatment?

Dr Helen Webberley:
Well, I mean, medically, when you’re, when you’re dealing with a medical condition that is so emotive, so political, you would be foolish not to have evidence to back yourself up. So the data that we talked about, numbers, data outcomes, really important. And now that GenderGP has been running for more than five years now that we’re not collecting that data and publishing it ourselves. So this, this quarter we’ve had one publication accepted, We’ve put three more forward. At the WPath for the last two, three biannual meetings, we’ve presented data, it’s vital to back up. What you’ve you can’t just say we do this because we think it’s right. You have to do it, say we do this because, and this is why we know it’s right. And actually, then you have comments such as this GenderGP has helped my son know to no end, and he’s now 19 waiting top surgery next week, without you helping, he would not be the young man he is now. And Marianne, you know, we did a petition didn’t we? Because you know, one of the things I’m really passionate about that the failure of this case was that they didn’t ask the community to come with them. Where was the community? Where was the voice? Where were the crowds? We’ve got someone here saying I’m working in an acute medical ward for a few years. I would love to organize a protest. Where was the protest for this case? And I’ve forgotten what I was going to say. I got so passionate then that I forgot what I was going to say. It’ll come back to me.

Marianne Oakes:
Something’s happened to my Zoom here, Helen.

Dr Helen Webberley:
Are you still there? I can still see you. I think, I mean, one of the things that we, what do we want? We want the voice we want. We want community. We want people to stand up. We have a petition that’s been asking for signatures to support interim solutions for NHS care. We’ve put that forward. We’ve talked to organizations, and now that petition is going to be produced. We’re going to present it to the Women and Equality’s Commissioner. We’re going to ask them to, to open up a consultation. We want them to ask who it matters to. We want them to ask the parents and the young people who are affected by this. So please, anybody listening to this, and now we’re in the future. Let’s put your name to it, to put, get your banner out. Let’s, let’s start demanding the care that we need in this country.

Marianne Oakes:
I did find it really interesting how empty it was outside the courts. And you know, sometimes I just think we’ve got to be visible on the day, you know, and I’m guilty. I wasn’t there. I wish I had been. But there was a little part of me that just felt no way is this going to pass through the court, you know, affect the care of people. When I heard the news, I was just absolutely shocked. So maybe this, this might be a moment, hopefully, you know, people will be galvanized and we can’t just rely on trans people and the parents. We need to factor the wider families. We need the teachers. We need the people that have witnessed the transformation in the children to come forward and speak as well because our voice isn’t big enough on its own. We, you know, there’s a whole raft of people out there that could be speaking out for at this time. So spread the word.

Dr Helen Webberley:
I think, I mean, there’s, I’m just looking at some of the comments that are coming from people who are watching. Someone has said that a load of Mermaids kids made a painting to go in the Leeds Tavi waiting room. It sat on the floor in a corner for three years until the Tavi finally put it on the wall that tells you all, you need to know about how the Tavi views Mermaids. I think that’s really sad. Sorry about that. Can you please tell the Mermaids kids to make GenderGP a poster and we will share it with absolute delight. Someone else has said, I really want to go to GenderGP here, but funds are so tight. I’ve got five other children, plus my assigned female at birth boy. I think I’d have to start a diet for myself to get in there. And, you know, I watched what GenderGP, how GenderGP reacted to this over the last two days and what I’ve learned about the team that has developed GenderGP is that they are solution-focused people. They are like, right, we’ve got a problem. We’ve got a cry about it. What are we going to do about it? And straight away what we saw the charitable fund being set up, inviting people to apply for funding. We totally understand that private care is unaffordable. And I know that the GenderGP ethos over the years has been to make it as accessible and affordable as, as possible. But of course, it’s not a publicly-funded organization. It has to be paid for the people who work for it have to be paid. So so they’ve set up a fund, and people have contributed their hard-earned pennies and pounds. And you know, some have made some wonderful donations, and even just, you know what it’s like one pound a month helps. And then there are people who are now applying for that fund. So we, nobody wants any person to go without care. And this care should be being provided by the NHS. And I’m really interested to know what the NHS commissioners, the NHS have a duty to provide this care. The Tavistock said, okay, we’re stopping, who’s providing, someone’s got to step in here. We can’t just let trans youth suffer. And, and then pick up the pieces in 10 years time. And someone else has made a comment, which is really important. You know, what’s so frustrating is the NHS is swamped and is using private contractors elsewhere. Why not here? So what they’re saying is, and I’ve said this lots of times before, is if you’re waiting for a cataract operation, if you’re for a hip operation and the NHS waiting list is too long, they get you in at the local private hospital on Saturday morning. So, and then the NHS has a duty to that. The NHS has a duty to every single person in this country to receive the care that it needs when they need it. And if they have to pay private, if the NHS has to pay privately for you to receive that, that’s your right. But Marianne, it goes back to the banners and the posters and the shouting and the asking. We’ve all got to stand up strong together. Cisgender people who feel that this is a travesty, transgender people who feel this is a travesty. And then people like me who’ve got some knowledge on both sides of the equation. Time to raise the banners really high.

Marianne Oakes:
Can I just ask then, because you made a really good point there and amongst all of that, but it was all good points, but something really stuck with me. If I was the parent of a child now that is going to be suffering mental health issues are potentially suffering mental health issues. If they now go to their GP, the GP can no longer say, well, I’m going to send you GIDS. And so the only option they’ve got two options, one of them is to start the child out themselves and potentially prescribe blockers. Oh, you’re going to send them to CAMHS who are already overwhelmed and who will say, well, we don’t deal with gender. It’s left a massive void, doesn’t it? All it’s done is to put the rest of the services on depression. Do I understand that correctly?

Dr Helen Webberley:
And you know, what you’re going to do is bring me around to one of my other, really, really, really big hobby balls or whatever you want to call it is that a doctor prescribing a blocker is not in any way illegal. So when that young person goes to their GP and says, GP, you have to help my young person here. You have to help my child, my adolescent, or me. If it’s about the person themselves. Please help me because you could prescribe me a blocker and that will stop my body changing while all this mess is sorted out. And I understand what the blocker will do because I’ve read every single thing about it. And I understand it. I would like you to prescribe me that blocker and that GP has got a decision to make them yes or no. And whatever decision that GP makes will they have to live with that for the rest of their lives. And if they are taken to task on that later on, they will have to defend that position. And I don’t want any of my GP colleagues to be in the position that I’m in now with GMC investigations for treating young people. But actually, we need more people like me saying, do you know what I’m going to put my neck on the line here? And I’m going to do the right thing for the patient. You know, that 12-year-old that I put my neck on the line for those years ago is 16 now doing really, really, really well. If I hadn’t stepped in and done that treatment, who knows what might’ve happened. And we need more like you said, we need more trans people we need more cis people, we need more healthcare professionals to say, well, we can’t just say no, no treatment.

Marianne Oakes:
They can’t sit silent and not get training, or, you know, educate themselves in this area because this isn’t going away. No court ruling that’s happened this week is making this problem go away. It’s just going to grow and grow and grow. So somewhere in amongst all of this, the NHS, CAMHS, whoever, they’re going to have to do something, because it’s just not going anywhere. The cat’s out the bag now. The cork’s out of the bottle, you know, it’s happening. You know, we’ve got to get used to it. One other point I just wanted to say again, you’re inspiring me today, Helen. Ultimately a doctor making a decision not to help a child could have ramifications for them. They’re okay ramifications for you when you got reported to the GMC, am I allowed to mention that? So the truth of the matter is that the people that were reporting you to the GMC have now been disclosed that in court. So the threat to a GP helping a child would be greatly reduced, would that be fair to say?

Dr Helen Webberley:
Tell you what, if that was the outcome that GPs, paediatricians, endocrinologists found themselves coming to, if that was the conclusion that they came to today, I would be absolutely delighted. You know, I really would. And actually what the Tavistock did was by keeping it so super-specialized for all these years and not letting GPs or paediatricians prescribed this kind of medication because they want, they kept it to themselves for so long has meant that they put themselves up as a super-super specialist. And if it is so super-specialist, it must be dangerous. And that again opened it up. So it laid him in court, but if it’s so dangerous, how can the child from scent to it? I’ve got some other questions coming through. So, my 14-year-old male to female was about to be referred to an endocrinologist after three years at Tavi, what will happen now? So I hope that the Tavistock and Portman and the doctors that work there are going to put some very quick measures in to stop the damage and hurt that is going to be caused by their very quick decision-making and cancelling appointments. Until they do, if people want the GenderGP team to help them, gather as much of that evidence that you’ve possibly got. If you’ve got reports, assessments, letters, you know, put together a case and we will ask the GenderGP medical team, whether they will step in using the charitable fund. We’ve got someone saying, is it possible to set up a regular small donation by direct debit or regular standing order to the charitable fund? Absolutely. And I will ask Aby, the communications officer, to share information about how people can do that. And I know that the team at GenderGP are all saying the same thing. How can I give some hours of my time to help these people? How can I give some of my services for, how can I help? And I think, Marianne, I really seeing people plugging together saying, how can we help? And it’s heartwarming. And what we want to see is the NHS doing the same. How are we gonna help?

Marianne Oakes:
Can I make a suggestion here as well? If anybody wants to organize events through parent groups and that kind of thing, you know, bake-offs I don’t know, whatever you wanted to do, anything like that. I’m sure it’s going to be gratefully received. That this isn’t about people having to dig into the pockets, especially with, you know, the common year, the results of the pandemic, the economy, people losing jobs, you know, it’s going to become hard, but you know, we’re a community, let’s be a community. You know, if my local village wants to raise money for a defib machine in the old foam box, they organize events. They do it as a community. Now more than ever, we need the community to start, you know, helping itself because we can’t certainly in the short-term rely on the NHS.

Dr Helen Webberley:
Absolutely. And I think the other thing, Marianne, that you and I are always talking about is education, isn’t it? And I know that again, that GenderGP had produced a GP Guide. So if there are GPs, practice nurses, paediatricians who are out there going, actually, I don’t want a trans youth to suffer because of this, what can I do to help? Am I allowed to help? Then I think the guide that’s been created and a lot of work has been going into it, which is just again, not just saying yes, you can, because I think you can it’s yes, you can. And these are the reasons that you can rely on. And that’s just so important in this modern age, isn’t it? This is why it’s safe to do so. This is why you’re allowed to do it. This is why it’s the right thing to do. And this is why. Really, really important.

Marianne Oakes:
There’s no excuse for ignorance basically. And you know, taking the GP Pack to your GP will chip away at that potential resistance. But one point I wanted to make, and this is something that I’ve been reflecting on throughout this year if I’m honest with you because I’ve faced one or two things myself through the health service, that somehow I get a sense that we are a distraction. That sometimes, when we do go to see the GP, they will pacify us. You know, I’m under the gender clinic now at Sheffield, and they’ve, they’ve taken responsibility telling me what the dose is. And we’re kind of, you know, it’s almost like we’ll just pass you on, everything’s a pass on. And actually, I think a great big block has been put in the road for GPs to be able to do that now. And again, you know, we’ve got to start and be valued that this is real. The starting points with a lot of health professionals, mental health professionals is: are you sure? There’s not a trans person I know that’s never been sure. The only thing that makes them unsure is, will you believe me? And you know, if we can start and generate that understanding that I am a trans person in front of you, that you’re taking no risk with me because I am a trans person, I am not a cis person making a mistake. If we can change that mentality now would be a good time to start.

Dr Helen Webberley:
But it’s really interesting you bring in that uncertainty because Quincy Bell in the case gave evidence, and I’m focusing, the psychiatrist attended a talk of the gender spectrum as a way of persuading me not to pursue medical transition. So that was, that was Quincy Bell’s experience of going through the Tavistock that actually they were trying to be persuaded not to pursue medical transition. And now fast forward, however many years, it wasn’t since that consultation with that psychiatrist, they are questioning again, whether that medical intervention was right. You know, so, and we know a lot that way that we hear a lot of reports that the Tavistock like to rattle cages, taking time, making sure it’s right, making sure that this is the right decision. And now it’s actually come back to bite them in the bottom if I may because it’s that uncertainty that they have allowed through these years in front of a judge has allowed him to say, maybe you’re not certain so how can this young person be certain?

Marianne Oakes:
Because the starting point with the experts was you might be cis, and we don’t want you to make a mistake, not you are, you’ve waited two years to see me. You’ve socially transitioned. You’ve done everything you can. No, we’ve still got to make it. In an (unclear 47:00) kind of way, you know, having a flawed model where people tell you what you want to hear is not a good model of care for any health professional to follow. Would you agree with that, Helen?

Dr Helen Webberley:
I do. I do. Absolutely. And I think, you know, people are going to be saying, well, what can we do because, okay, so we’ve, I’ve said GenderGP is a solution-focused organization, what can we all do together? And someone’s commented here saying I think GenderGP is now coming into its own and it’s strongly, strongly indicating that change is needed. But whether this government and the CAS inquiry will make it kinder in inverted commas. And I think we do have an inquiry going on at the moment. I know from the GRA consultation, recently, people were saying, do you know what I can’t, I can’t do anymore. Don’t ask me anymore. I can’t be, I can’t do it anymore. You keep asking and ignoring what I say. However, we do have to keep going. And if we are asked to comment or put our opinion forward, show in real terms what this means to young people and adults in the UK and worldwide, what a difference medical intervention does make, then we’ve got to, we’ve got to show it. We’ve got to carry on us asking the question. We’ve got to carry on campaigning. We’ve got to show it in real life. And you know, those people that we’ve had on the podcast who told their story in real life. And particularly the youngsters that we had, it’s really important to show this isn’t something that we can hide away and pretend doesn’t exist. It exists. How are we as a cultured, forward-thinking society going to bring these people into our fold and look after them? And we’ve got to kind of show the world what it means.

Marianne Oakes:
I think that’s, that leads me on to the other thought I’ve had. The NHS or are at least the medical profession within the UK needs to start looking at other models of care outside of the UK. We’ve got to get rid of this specialized you know, Boy’s Club, which is how I view it. You know the reality is that they’re all scratching each other’s backs. And this goes right through transgender health care within the UK, that they’ve got to look at models of care. I say it isn’t a mental health issue anymore. You know, what role does psychiatry play within transgender healthcare? It plays a role for the right patients, but not all patients. And we’ve got to start moving away. And I think that the children now have paid the ultimate price. I want to stop calling them children, the adolescents, you know, they paint this pitch with three-year-olds going through this. It’s adolescents, isn’t it? But yeah, they are now paying the ultimate price.

Dr Helen Webberley:
Yeah. I’ve got a final comment here. And I, I think we’ll leave it on, on this one, Marianne. As everyone knows, we could talk all day. If people have got questions that they want to ask us we will answer if they’ve got medical questions, go to the website, send in your questions with the medical team. GenderGP is here to stay. No one is taking us down. I’m very proud of the organization that I founded. I’m very proud of the care that it provides. We want to provide care to anyone who needs it. Someone says here, and thank you for this comment, and I’ll close on this one, GenderGP heroes, saving trans lives with the important work they do daily. GenderGP were there for me from the start and showed me so much love and care. I don’t know where I’d be today if I didn’t have help from GenderGP, they are amazing fighting for us daily. Thank you, Dr Helen, for putting your neck on the line for us, and thank you to all the GenderGP team for saving lives in capital letters. So I know that we both feel very sad about the outcome this week. I trust that the NHS, that the Tavistock and the NHS commissioners will be appealing, and that they will get gather themselves from evidence and a very strong legal team because there are people that need the NHS in this country. And if there’s anything that they would like us to help with, I’m very knowledgeable, and I’m very passionate, and like, I’m sure I could help. Marianne, thank you for joining me today. Thanks, everyone for listening. And please, you know, let’s, let’s fight this fight together.

 

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