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Day 39 saw Mr Jackson QC close the GMC’s case against Dr Webberley. Day 40 was Mr Stern QC’s opportunity to refute the claims made by Mr Jackson QC and to finish laying out the defence case. Mr Stern QC began by acknowledging how much he had learnt about the issues trans people face, “To many of us who knew little of the circumstances surrounding those who identify as a gender other than their birth assigned gender, before being involved in this case, it has been a learning curve. That learning has extended to the unfortunate polarity of views for some members of the public as well as some members of the medical profession. However, no one could fail to be moved by the words and voices of those who have suffered because of the consequences of gender dysphoria.”

“This is the oddest of cases, no one has suggested that these patients did not suffer. No one has suggested that the treatment for gender dysphoria is not puberty blockers and gender affirming hormones. No one has complained about Dr Webberley, quite the contrary. Each of the mothers is glowing in support of Dr Webberley”

Mr Stern QC’ asked an important question, one that is often asked by members of the trans community. “At its most basic level, doctors providing potentially life-saving treatment do not usually get brought before their regulator. Why, in the provision of care to transgender youth, are the principles turned on their head?”

Mr Stern QC said, “Being transgender is neither a disorder nor a mental health condition. Being transgender is not the problem, but waiting for transgender care can have a severe impact on mental health due to the distress of living in a body that does not align with a person’s identity.”

Mr Stern QC questioned the credibility of the GMC’s experts, Dr Dean who spoke outside his area of competence and Dr Kierans who was called an expert but only 57 of her patients were given medical intervention over the 7 years KOI has been in existence, a rate of approximately eight per year. As Dr Bouman pointed out, seeing so few patients doesn’t qualify one to be called an “expert”. Mr Stern said he was incredulous over the appearance of Dr Agnew as an expert witness as by his own admission Dr Agnew had never treated any patients for gender dysphoria and had no experience at all in this area of healthcare.

Mr Stern QC pointed out that many aspects of the GMC’s case remain unproved and some are confusingly unclear, “Even at this stage following final submissions from the GMC we are still unclear as to the GMC’s case. What is their case with regard to prescribing by Dr Webberley? With regard to Paitent A it is alleged prescribing of Testosterone was not ‘clinically indicated’ because of Paitent A’s age? Mr Stern QC pointed out the inconsistencies of the GMC’s argument, at once declaring that only paediatric endocrinologists can prescribe blockers and gender affirming hormones while also suggesting that Dr Webberley should have done the same course a nurse in order to prescribe blockers and gender affirming hormones. Mr Stern also pointed out that the GMC’s own expert witness, Dr Dean is not a paediatric endocrinologist either, but a GP and he prescribes.

Mr Stern QC referred to Patient A’s poem that he shared with Dr Webberley,

Coerced to be someone I’m not,
Makes me want to free myself from this pain,
Where darkness is my every day,
And I never feel sorrow again.

I am a human being,
With thoughts and feelings too,
Please let me live as the young man I am,
Why, oh why, can’t you?

Patient A told the Tribunal, “Dr Webberley was able to help me during a very difficult time of my life. I am very grateful to her, I believe that she saved my life.”

Mr Stern QC said, “The notion that Dr Webberley ‘failed to provide good clinical care’ to this patient is so far removed from reality that it is positively insulting.”
“She undertook the care of this vulnerable 12-year-old. No one who heard Mrs A and A could fail to be moved by his story. Mrs A made it clear in her statements that Dr Webberley was their only option.”
Mrs A stated, “Without the care Dr Webberley provided to Patient A, he would not be alive today.” She set out how UCLH would not assist her and her son & how they had to find out for themselves how Patient A could start puberty & develop as male.

The Tribunal heard how Professor Gary Butler had contacted Mrs A by letter, “Professor Gary Butler told Mrs A that Dr Webberley had been ‘suspended on many counts of bad practice & illegal supply of medicines’. Dr Webberley had not been suspended but had been placed on conditions & second, the letter does not indicate on what basis Professor Butler was saying medicines were being illegally supplied. This must have been an alarming letter for Mrs A to receive. Professor Butler wrote indicating that provision of Testosterone by Dr Webberley had caused Patient A’s trouble rather than cessation of it as reported by Mrs A.”

Regarding the allegation that Dr Webberley should have used an MDT, Mr Stern QC asked , “Where does it set out that there needs to be these six, seven or eight visits of a certain length? Ultimately it is a gatekeeping exercise, it is one where the medical practitioner can tell you if your identity is approved of or not, that’s what it seems to come down to in essence, and there are those who believe that’s an appropriate process and there are those like Dr Webberley, Dr Bouman and Dr Schumer who understand that patients know their identity and themselves best. We do know that lengthy processes causes delay, and that this leaves thousands of adolescents in a state of serious distress.”

Regarding the allegation relating to Dr Webberley’s training and learning, Mr Stern QC stated that the GMC has not set out where the shortfall is or where that lack of competence is evidenced in the treatment of patient A. “Was it a lucky coincidence that she provided the appropriate dose of testosterone? Was it a lucky coincidence that her assessment of A was a correct assessment?” Mr Stern QC asked, “Was it a coincidence that recommencing A on testosterone was the correct treatment and that he was able to thrive and succeed in his life?”

Mr Stern QC stated that the GMC were unclear as to why they felt that Patient B’s gender dysphoria required a ‘psychological assessment’ to ‘confirm a diagnosis of gender dysphoria’. Patient B had been living as a male for two years, had changed his name by deed poll, had supportive parents and was sixteen years of age. “In what way does the GMC say that there was a doubt?” asked Mr Stern.

Mr Stern read from letters of support sent on behalf of Dr Webberley, including one from the lawyer mother of a young trans child, who said that Dr Webberley had helped her family where the NHS had failed them.

Mr Stern closed Dr Webberley’s case with these remarks, “There is reference to high quality care being dependent on the six C’s which include care, compassion, competence, communication, courage and commitment. The evidence in this case shows overwhelmingly that Dr Webberley provides high quality care through the deployment of all six of these markers.”

What happens next?

The case is scheduled to finish on October 15, that is the last day that this Panel has been booked to sit, and the legal teams have arranged to be available for this case. It is very much hoped that at least the end of this first stage of the hearing process will be complete by that date. However, that may not be the case, and we may have to return to this at another time.

If any of the allegations are found proved, the next stage is to decide whether or not any of the allegations that are found proved do in fact mean that Dr Webberley’s fitness to practice as a doctor in the UK is impaired. It may be proved that she failed to do something that she should have done, but does that mean that she is impaired going forward in her ability to be a safe doctor?

Following the ‘impairment’ stage, the Tribunal must then make a final ‘determination’, with the following options:

  • No further action – Dr Webberley is able to return to medical practice
  • Issue a warning – on how Dr Webberley might conduct or perform as a doctor
  • Agree undertakings – the GMC and Dr Webberley agree limitations on her practice
  • Conditions imposed on registration – limit Dr Webberley’s abilities to carry out medical duties
  • Registration suspended – stop Dr Webberley from working for a period of time and then review again at the end of that time
  • Name erased from the register – remove Dr Webberley’s ability to be a doctor altogether.

We have heard from many people involved in the presentation and decision-making in this case. We are grateful to everyone who has learned, listened, and truly considered the difficulties faced by trans people.

At GenderGP we hope the tribunal will see the clear evidence of Dr Webberley’s competence and expertise when treating her patients, and that the details of current UK practices in relation to trans healthcare that have been exposed by this public hearing, will lead to more equitable and humane changes for all trans people.