28 January 2021
The Rt. Hon Matt Hancock MP,
Secretary of State for Health,
House of Commons,
London,
SW1A 0AA
Dr Helen Webberley
Founder – GenderGP
Dear Mr Hancock,
- The UK is falling behind in its care for transgender people.
- Transphobic attitudes in senior officials with influence are adding to the risk of harm.
I am writing to you in my role as advocate for transgender people, in response to accusations made by Baroness Nicholson against both myself and GenderGP, the organisation which I founded, in 2015.
Her letter to you prompts the need for an urgent discussion. It is widely recognised that this population is already subject to unacceptably high rates of self-harm, suicide and low mental health scores. UK patients are at increased risk, as a result of transphobic views, outdated clinical protocols and widespread misconceptions.
Recent CQC inspections and a High Court Judgment have raised serious concerns about the current NHS provision of healthcare for trans youth.
Our petition campaigning for better trans healthcare has amassed more than 25,000 signatures and counting. We cannot let personal opinion, bigotry or ignorance prevent this incredibly resilient group of people from accessing the care they need.
Please allow us to arrange a suitable date and time to meet and discuss this matter. Trans healthcare is not fit for purpose and urgent action must be taken.
Dr Helen Webberley
An open response to the claims made by Baroness Nicholson in her letter
On 18 December 2020, Baroness Nicholson of Winterbourne wrote to you highlighting what she describes as ‘loopholes’ in the care being provided to transgender patients through GenderGP and to criticise and cause alarm regarding that care provision, specifically in relation to individuals based in the UK.
I would like to highlight that the Baroness is herself no stranger to controversy when it comes to her views on the transgender community.
Indeed she was involved in a very public exchange with model and activist, Munroe Bergdorf, which resulted in hundreds of letters of complaint being written to the standards commissioner in 2020.
In addition, the views of the Baroness on trans people and same-sex marriage resulted in Nicholson’s humiliating removal as the honorary vice president of the Booker Prize.
It’s important, therefore, to be clear that her letter to you was written with the express aim of preventing trans people, who she believes to be “weird creatures” from accessing care.
I will address each of her claims in turn:
- Nicholson: Puberty blockers are not ‘fully reversible’
The suppression of puberty using GnRHa puberty blockers are classed as a ‘fully reversible intervention by the World Professional Association for Transgender Health [WPATH]
- Nicholson: Puberty blockers do not ‘buy time’ they are the first stage of a medical pathway from which few children depart
In their joint statement, issued in response to the ruling, world leading experts in transgender healthcare WPATH et al explain that: “The aim of puberty suppression is to prevent the psychological suffering which stems from the undesired physical changes that occur during puberty, and to allow the adolescent time to carefully consider whether or not to pursue further transition when they are eligible.”
- Nicholson: ‘There is no convincing evidence that puberty blockers alleviate distress.’
In their joint statement, issued in response to the ruling, world leading experts in transgender healthcare WPATH et al explain that:
“‘although treatment for young transgender adolescents involves uncertainties, as is the case in many fields involving young people, several studies demonstrate the clear mental health benefit of gender-affirming medical treatment (including puberty blockers). Withholding such treatment is harmful and carries potential life-long social, psychological, and medical consequences’.”
- Nicholson: ‘The pathway of puberty blockers and cross sex-hormones has serious physical consequences, including the loss of fertility and full sexual function, with profound long-term consequences;’
The benefits of gender-affirming care are well-attested, as are the consequences of withholding that care which may ‘prolong gender dysphoria and contribute to an appearance that could provoke abuse and stigmatization’. When considering gender affirmative care – as is the case with ANY treatment – the patient must be given ALL of the facts so that they can come to an informed decision.
The Baroness suggests that trans people who undergo treatment will experience a: loss of fertility and sexual function. While we know that this is a risk, and one that is discussed at length with any patient undergoing any kind of treatment that may impact their fertility, there is plenty of evidence to suggest that this is not the inevitable outcome of gender affirming hormone treatment.
- Nicholson: “The treatment is ‘experimental’.
Gender-affirming care has become a well-established part of evidenced-based best practice in the treatment of transgender patients over the past decades. While we all welcome more research in this area, we fully understand the harm that comes to young people who do not have access to this care, compared with those who do.
In its 2016 statement, the WPATH clearly states that ‘These medical procedures and treatment protocols are not experimental: Decades of both clinical experience and medical research show they are essential to achieving well-being for the transsexual patient.
In her letter the Baroness calls for you to:
- Nicholson: “close the loophole allowing the harmful dispensation of puberty blockers and similar drugs to vulnerable children and young persons.”
Firstly I would like to address the misinformation surrounding the use of puberty blockers as being harmful. This is a myth often perpetuated online but leading experts worldwide agree that: “[puberty suppression and subsequent gender affirming hormones] is the most widely accepted and preferred clinical approach in health services for transgender people around the world.”
Secondly, Nicholson’s use of the term “vulnerable” in relation to trans youth is indicative of the negative approach taken in the UK to the care of this patient cohort.
While Gender Incongruence has become the preferred term for the ‘medical diagnosis’ of what it means to be transgender (ICD-11) and the term Gender Dysphoria has come to describe the distress, pain, anguish and discomfort that can be felt by the presence of this incongruence – it does not automatically follow that transgender individuals are vulnerable and to class them as such is disrespectful.
Indeed research shows that when an individual is affirmed in their gender their life satisfaction scores are on a par with their cisgender counterparts.
In her letter, Nicholson links the tragic suicide of Jaydon Lowe to GenderGP, implying that the organisation was in some way responsible. Despite media coverage seeking to do the same, this is wholly untrue. Our organisation attended the coroner’s inquest and heard first hand about the significant impact on Jaydon caused by the delays to treatment on the NHS. These delays only ceased when Jaydon came to GenderGP. Tragically by that time it was too late.
GenderGP
GenderGP is a global organisation which provides health and wellbeing services to transgender people and those who care for them. Our organisation comprises medical and therapeutic gender specialists from all over the world who are regulated in each area of their specialism.
- Nicholson: “The recent High Court decision of Bell v Tavistock, provides clear and compelling case for the Government to close this loophole and end these hazardous practices.”
Since the judgement, this particular case has received a great deal of interest due to the alarming lack of defense that was put forward by the NHS service provider. We have gathered much of the information together on our website, should you be interested in finding out more. For a topline overview you can read this article.
In a joint statement following the Bell V Tavistock ruling, the European Professional Association for Transgender Health (EPATH) supported by all the major International players (WPATH, USPATH, AsiaPATH, AusPATH and PATHA) openly stated that the ruling that was made on evidence provided by the Tavistock: “will result in significant harm to the affected children and their families.”
Much focus is placed by the Baroness on what she describes as a regulatory “loophole” that allows certain medication to be dispensed by UK Pharmacists.
GenderGP is an international organisation and as such it operates according to international protocols and is not bound solely by UK regulation. All doctors and pharmacists who work with the organisation are fully regulated in their own countries.
GenderGP will indeed continue to dispense to its service users. The Baroness took the information directly from the GenderGP website where it was published in full.
Nicholson goes on to review the manner in which GenderGP service users are “assessed” and the ways in which medications are prescribed. All of this information can be found in full on our website.
We address all of the points raised in the articles by the Times and the BBC here:
On the matter of pharmacies: Any patient in the UK is able to choose which pharmacy their medication is dispensed from and all UK based pharmacies are heavily regulated by their regulatory body, the GPhC.
Baroness Nicholson clearly does not understand the controlled substance schedules and the impact that her extreme recommendations would have on healthcare in all areas, not just trans-related healthcare which is the subject of her attack.
A word of clarity on the matter of my conviction and suspension
My license to practice medicine in the UK is subject to an interim order of suspension while the General Medical Council examine the differences in the care I provided to my transgender patents and the protocols and processes followed by the NHS service. No finding of fact has been made against my medical practice.
Of note, there has since been a finding of fact by the Care Quality Commission against the protocols and policies of the NHS child and adolescent service itself: https://www.bbc.co.uk/news/health-55723250.
Regarding my conviction, Online GP Services Ltd was convicted of “carrying on a healthcare agency without registration” between 2015 and 2018. As director of the company, I received the same, despite all executive decisions only ever being based on harm reduction. There has been no finding of any fact against my medical practice. Following this conviction, Online GP Services Ltd, GenderGP and all its assets were acquired by Harland International Ltd.
Again news of my investigation has been covered at length by media outlets and on the GenderGP website. If you would like to know more visit: https://www.gendergp.com/gendergp-history.
Conclusion
While other countries, such as Australia, New Zealand and parts of the US are actively working to improve the healthcare options for transgender people, it seems that the UK is allowing a minority of passionate anti-trans fanatics to do whatever they can to prevent progress in this area.
In matters relating to healthcare, medical experts and worldwide research should be the main deciding factors – this is not a matter for opinion or indeed an opportunity to play politics.
Dr Webberley
28 January 2021
Photo by Art Lasovsky on Unsplash