When the hearing resumed the Tribunal requested more information from Mr Jackson QC with regard to the allegations surrounding the GenderGP website. The Chair said they would “value further submissions in relation to this allegation and the evidence in support of that alleged duty.” Dr Webberley’s counsel, Mr Stern QC vigorously objected to the GMC being allowed more time to make a case – after they closed their case.
Glad to see IS still, rightly, pointing out the GMC has had our years to build and make its case. If the evidence isn’t there at this point, they haven’t done that and never will. https://t.co/ijZ6PYgzil
— 🇵🇸A Certified Professional Disaster (she/they) (@27_PointFive) September 20, 2021
The Tribunal recessed to consider and decided to accept Mr Stern’s objections. They then retired to make a final decision on what allegations were unfounded. When they returned the Tribunal announced that 11 of the allegations were unfounded. Some of the allegations the GMC made against Dr Webberley were almost farcical and had no basis in law – there was no duty to do the things that Dr Webberley was accused of not doing. Surely when this hearing ends questions must be asked about why the General Medical Council is making baseless allegations about medical Doctors.
People were saying there should be an inquiry into @NHSEngland‘s handling of Bell v Tavi? Well there should be an inquiry into @gmcuk suspending a Dr cutting off care of her trans patients. Then 4 YEARS later not having a case for 50% of the “charges” https://t.co/iyURBNDmif
— James Billingham (@oolon) September 20, 2021
Mr Jackson QC then asked to submit further documents as part of the GMC’s (closed) case. Mr Stern QC argued that it would be unfair to allow the GMC to enter new evidence at this late stage, and that the GMC’s own experts had not been asked to speak to these new documents. Mr Stern also pointed out that as Dr Webberley is unable to communicate with her legal counsel once she begins to give evidence, it would place her at a disadvantage to introduce new information that she cannot seek counsel about.
The @gmcuk, is, once again, making up the rules as it goes along, in contradiction to established legal practice. They seek to introduce new evidence post cross examination. Its a matter of principal & fairness. Without these rules they can do whatever they like without rebuke https://t.co/7nHscBytNi
— TransHealthNow (@DadTrans) September 20, 2021
Unfortunately the Tribunal decided to allow this new evidence to be submitted. Day 32 saw Dr Webberley sworn in to give her evidence. Mr Jackson QC asked Dr Webberley about the difference between her approach and that of the Tavistock. Dr Webberley responded by saying that she triaged all her patients, as opposed to Tavistock which triages people with a family therapist and social worker. Mr Jackson QC put it to Dr Webberley that it was a necessary requirement for a psychologist or psychiatrist to assess a Patient before initiating puberty blockers or gender affirming hormones. Dr Webberley replied that gender incongruence is not a mental health disorder and that there is no such requirement in the UK for a mental health assessment.
44. This shade is beautifully subtle:
The NHS – being held up as the gold standard by SJ – delegate triage to more junior HCPs.
— A Mere Solicitor 🐢 (@truesolicitor) September 21, 2021
Mr Jackson QC asked if it was Dr Webberley’s position that a diagnosis is not required prior to starting treatment. Dr Webberley stated that only an assessment was required to establish if someone fulfilled the requirement for treatment, likening trans patients to someone seeking contraception. “They don’t need a diagnosis, they just need to understand the pros and cons of having the treatment.”
*THIS* is what sets Dr W apart from the NHS / GMC / Tavi.
— TransAndProud (@TransLibertyUK) September 21, 2021
Dr Webberley reiterated that her model of care came from her experience as a GP with a specialist interest in sexual health. Dr Webberley explained that she doesn’t feel that trans patients need to be treated any differently to other patients to which Mr Jackson QC replied that he wasn’t suggesting they should be treated differently. Later Mr Jackson QC suggested that cis and trans children who take hormone therapy should be treated differently. Dr Webberley disagreed with Mr Jackson’s assertion.
They shouldn’t be treated differently he says, before immediately saying that there should be a discrete model of care (ie, a separate one) for them, which implies that they will be treated differently or else there would be no reason for it to be separate. https://t.co/78FkBPSSB3
— Zesstra (@ZesstraDyrr) September 21, 2021
‘Trans is different, amirite?’
Iteration ivecompletelylostcount https://t.co/FyRof2S31H
— TransAndProud (@TransLibertyUK) September 21, 2021
Questioning Dr Webberley’s expertise, Mr Jackson QC queried Dr Webberley’s qualifications to treat trans patients. Dr Webberley said that there is a lack of structured training options and that as the GMC guidance stated that if there was a gap in a GP’s knowledge they should undertake CPD and learning, which is precisely what she did. Dr Webberley said managing hormones in adolescents was a part of normal GP training and therefore not outside her area of competence.
GMC – ‘But Trans is Different’
Dr W – ‘Nope, my GP training in managing hormones covers it easily’ https://t.co/DXKisAwnqW
— TransAndProud (@TransLibertyUK) September 21, 2021
Mr Jackson QC proposed the idea that without NICE guidelines a Dr should not prescribe to which Dr Webberley replied that she didn’t think it was fair to expect her patients’ to suffer just because there are no NICE guidelines on how to treat them. This line of questioning highlights the deficiencies that existed for trans people during this time period. Why were there no NICE guidelines and did the lack of guidelines mean other GPs felt unable to treat trans patients, who then possibly had nowhere to go for their healthcare needs. Many times through the hearing it has been stated by various commentators online that the wrong Dr stands accused, surely those that failed in their duty to provide guidance to healthcare practitioners should be held accountable for the harm they have caused.
@gmcuk what guidelines? Individual GIC’s have their own guidelines and they’re all different.
Remind me who is actually behind the complainant against DrW?
Surely not the GIC drs who don’t approve of DrW’s patient centered approach? https://t.co/wbLE2ENtOk
— Rebecca (@BecciCath) September 21, 2021
Mr Jackson QC appeared to be blindsided by the idea that Professor Butler and UCLH had no guidelines informing their care of trans patients and he swiftly moved his line of questioning elsewhere. Unfortunately Mr Jackson then suggested that ADHD is a condition that needs to be “resolved” before gender affirming treatment can be initiated, again showing a lack of understanding or sensitivity for people with ADHD (a condition which cannot be “resolved”).
You can’t resolve neurodiversity. This is ableism. And KS is a self-confessed conversion therapist. https://t.co/Qihwgy5o8H
— Jenny Gray 🏳️⚧️ (@Grayface_Ghost) September 21, 2021
In response to Mr Jackson QC’s suggestion that mental health issues should be stable before a trans person could be considered able to consent, Dr Webberley again pointed out the Catch 22 bind in which trans people find themselves when seeking help from healthcare professionals. It is often the lack of affirming healthcare that causes instability, and that cannot be resolved until gender affirming care is provided, but gender affirming care is denied due to instability. A quandary that largely doesn’t exist for other (cis) patient cohorts.
Aside from the obvious catch-22 here, there is also another where gender dysphoria is defined by distress, so you have to be upset but not TOO upset. https://t.co/ER5xHD8XEj
— Chad (@kitation) September 21, 2021
Mr Jackson QC suggested that Dr Webberley’s practice was to be unduly led by patient wishes, again something Doctors of cis people are rarely accused of doing. It was clearly not Mr Jackson’s day when he again said the quite bit out loud, “Your acceptance of the Patient being the person who knows best leads you to prescribe sooner rather than going through the hoops, I suggest this shows your failure?”
Is it too much to ask for that we move beyond this paternalistic view that trans people are not to be trusted with their own healthcare?https://t.co/xvVaSsjFP8
— Zoë Hamilton (@zoeswipe) September 22, 2021
In response to the idea that she was rushing to give trans patients what they want, Dr Webberley patiently explained that trans people don’t just wake up one day, realise they are trans and rush to the Doctor for hormones. It is often a long slow process that has even led to the point where they visit a Doctor.
An important distinction. GMC would have you believe that anyone can just walk through the door and get hormones the same day. It doesn’t work that way and never has. https://t.co/Y4WP3TIXoY
— Myla (They/Them) (@mylafish) September 21, 2021
Dr Webberley spoke at length about the harm caused by not treating trans patients in need, stating that she often wondered if she would have ended up before the GMC as a result of the harm that may have occurred if she didn’t prescribe to the then-suicidal Patient A.
Dr W: Within trans HC, I’ve met families who had lost children to suicide whilst waiting for medical intervention and I’d had never seen that before in my career.
— Live Tweets (@MPTS_Hearing) September 21, 2021
Mr Jackson QC repeatedly asked Dr Webberley about the importance of an MDT in treating trans youth and Dr Webberley replied that sometimes the delays caused by public health MDTs can result in harm. In previous witness testimony of Dr Kierans, from the Northern Irish KOI service, the hearing heard that children have to first see CAMHS before they can be seen by the KOI MDT, and that there are waiting periods to get a KOI appointment and waiting periods to see the endocrinologist followed by a mandatory 1 year period on puberty blockers, all of which are required before adolescents can access gender affirming hormones.
@MyWebDoctorUK showing what patient centred healthcare is all about.
Absolute disgrace that the only Dr taking patient centred approach to trans youth is put under 4 year investigation. https://t.co/n4laOeB42b
— FierceMum (@FierceMum) September 21, 2021