It has been some time since I spoke about the ongoing investigation into my care of transgender patients. As such, I figured now was as good a time as any for an update.

I will provide a little background for those who are new to the story.

In May 2017, I was temporarily prevented from working as a doctor by the General Medical Council (GMC) while they conducted an investigation into a string of complaints around my work with transgender patients.

The complaints came from doctors working within the NHS Gender Identity Clinics. The accusations all relate to me failing to follow the approach to care that is favoured by NHS doctors, a model which has been criticised time and again by the trans community for being overly restrictive and even discriminatory to trans individuals.

Because the UK does not have any published guidelines, postgraduate training programme or consultant speciality in this field, I carried out extensive research into practices in other countries as well as reviewing recommended guidance from WPATH and the Endocrine Society.

Australia, Canada and parts of North America, all operate a more progressive approach to trans healthcare so, with no ‘home-grown’ alternative available, I opted to use their evidence-based, published guidelines as the cornerstones of my approach to trans healthcare. All of these documents are available to view on the GenderGP website.

The GMC was given 18 months to investigate the concerns that had been raised, a generous timeframe which, it was felt, allowed for the perceived challenges associated with this ‘tricky’ subject to be resolved.

In January 2020, well past the due date, the investigation was concluded. I am still waiting for the verdict. We are now 38 months on and myself and my patients are no closer to a conclusion. I have not been able to practice medicine in any capacity since I was restricted from doing so more than three years ago.

In April 2020 the GMC informed me that the next step was for me to be sent to a Medical Practitioner’s Tribunal who will be tasked with deciding whether the way I provided gender-affirming care to transgender patients was in breach of what the UK considered to be Good Medical Practice.

I await this hearing with anticipation, excitement, and not a little fear. It will be the first time that all the cards will be laid openly on the table. The clinicians who raised a grievance against me will have to justify their complaints. The experts who have given evidence will have to explain how they reached their conclusions. My patients and their parents will have a voice – a chance to testify in my defence. The GMC will be asked about their duty to set the standards of medical education in this area. And I will finally be able to tell my side of the story.

My messages will be clear:

• I will explain to the panel exactly why providing appropriate care to this patient group is life-saving.
• I will explain to them that the GMC, who are responsible for setting the standards of medical education, have failed to do so in relation to trans healthcare.
• I will ask how, without UK published guidance, doctors can even begin to feel comfortable enough to help their patients.
• I will demonstrate why I had to look outside of the UK to look for best-practice guidelines for transgender healthcare – rather than standing idly by while they suffer the years of waiting to be seen on the NHS.

I founded GenderGP in 2015 after discovering an entire community of people floundering, self medicating, suffering. As a doctor, my desire has always been to support my patients towards the best outcome. I tried to work with UK regulators to agree on standards and achieve registration, there was an unwillingness to support progress in this area. I genuinely believe that there were active barriers put in my way.

Initially, I was told by the Welsh Regulator, Healthcare Inspectorate Wales (HIW), that GenderGP could continue to provide services to patients while we worked out the necessary registration. I had explained that the patients were unable to access care anywhere else without extensive waiting lists. Despite being told this, in May 2018, HIW took me to court and were successful in bringing a conviction for providing services without registration: it is worth noting that in his closing remarks the judge acknowledged the reduction in harm to transgender patients that my service was providing.

Moving forward

Anyone who knows me knows that I have broad shoulders, but that was a step too far. I took the difficult decision to transfer the ownership of GenderGP and all its assets to Harland International, an LGBTQI company based in Hong Kong.

As Harland International is registered outside of the UK, it is confidently able to operate under international law to provide gender-affirming support and healthcare, to everyone who needs it, wherever they may be in the world. My role as owner and director was over, but I stayed on as a fierce advocate to the trans community and advisor to the business.

As the founder, I am still involved in the business side of the organisation, working out how to deliver the best care to the greatest number of people. I am still unable to practice medicine and consult with patients, but I am still 100% connected and committed to this community. Much of my work is done from my house in Spain.

I also continue my campaign of education and advocacy to improve healthcare for trans people at home and abroad; we have formed some amazing links with other providers to the trans community around the world and I couldn’t be more proud of what GenderGP has come to represent.

So, for clarity and to directly address the misinformation out there:

• GenderGP has all the necessary licensing and registration needed to operate.
• My name has not been struck off the medical register.
• My license to practice medicine has been temporarily suspended while the GMC investigates concerns raised.
• Myself and my previous company, Online GP Services Ltd, have a prior criminal conviction for operating a healthcare service in the UK without registration.
• GenderGP does not have any conviction and it fully operates within the law.
• GenderGP proudly provides gender-affirming care to all trans people who are unable to access their public healthcare services. Regardless of colour, race, religion, sexuality or gender.
• And finally: I do not regret a single thing because I know, as much as those who are bringing the charges against me know, that those providing care through GenderGP have indeed saved lives.

I hope this helps. As always, I am very willing to honestly answer your questions. This is an important fight to have and I look forward to standing before the Medical Practitioners Tribunal Service (MPTS) and to the fair hearing that I – and the trans community – feel is well overdue. As soon as I have a date I will share it and I hope I can count on your support.