Inside the world of private trans healthcare

• The US state department said Antony Blinken met with Chinese President Xi Jinping today in Beijing.
• Pakistan arrested 12 alleged human traffickers in connection with the sinking of a migrant boat in the Mediterranean that killed hundreds. 
• Swiss voters backed a new climate law committing the country to net-zero carbon emissions by 2050. 

In March this year the British High Court rejected a previous ruling against Helen Webberley, a trained GP in her mid-fifties who had had her medical licence suspended by the General Medical Council. 

So what? The ruling means Webberley is free to practise again. She is the founder of Gender GP, a private online service offering trans healthcare to adults and young people. One newspaper labelled her one of Britain’s most controversial doctors.

• She had no gender specialism before founding the company.
• She has a criminal conviction for operating without a licence.
• Her clinic continues to operate even so.

“I love being the kind of person that will sit on the edge of the bed and hold that person’s hand and say ‘I understand this is really scary for you and I’m going to do all I can to help you,’” she says in Tortoise podcast Gender GP: Inside the world of private trans healthcare. 

There is currently limited specialist help available on the NHS for young people seeking treatment for gender dysphoria, a condition in which a person feels a mismatch between their biological sex and their gender identity. 

• The Gender Identity Development Service at the Tavistock in north London is being closed down after an official review last July raised serious safety concerns about the system. 
• The first new clinic, a southern hub led by Great Ormond Street Hospital in London, is expected to open in the autumn; the northern hub led by Alder Hey children’s hospital in Liverpool will launch next year.
• No new young people are currently being seen on the NHS, but 250 are being added to the waiting list every month. It stands at around 8,000. 

Into this breach steps private medicine: Webberley set up Gender GP in 2015 after treating one patient who came to her surgery in south Wales. 

Late 2016 – Webberley treats her first young patient, prescribing testosterone to a 16 year-old. She later meets a 12 year-old who came to be known as Patient A. Patient A had already been prescribed puberty blockers by the Tavistock, but under its rules the patient had to be 16 to get cross-sex hormones to start puberty as a boy. Webberley treats Patient A. 

2017 – the General Medical Council blocks Webberley from practising medicine over her treatment of Patient A and two others. 

2018 – she gets a criminal conviction for operating a medical practice without a licence. Gender GP moves its registered office to Hong Kong (it’s now registered in Singapore).

2022 – her husband, Michael Webberley, who sometimes took on his wife’s patients, is struck off by the GMC for a “catalogue of failings” over how he treated young people and prescribed puberty blockers and cross-sex hormones. 

2023 – the high court rejects the ruling against Webberley which found she’d failed to give proper advice to a patient about the impact of hormone treatment on their future fertility. The judge says the ruling is not a verdict or endorsement of the work of Gender GP. 

The online clinic continued to operate throughout, using remote therapists and doctors. The clinic says it has nearly 10,000 patients on its list, more than 1,000 of them under 18.

Wild West. One mother said her child was prescribed testosterone by Gender GP after a single hour-long consultation. Other experts say that diagnosing gender dysphoria is difficult and can’t be done in a single therapy session. But Tortoise also met families who say they have been helped by the service – that in the absence of the NHS something is desperately needed. 

Some children are accessing hormones without any medical advice at all – in the most extreme case, a mother discovered her daughter’s drug dealer was selling her testosterone. “All the institutions… I don’t trust any of them,” she said. “It’s like the Wild West in my head now.”

People involved in setting up the new NHS services say it could take five years to clear the backlog, with each hub expected to launch with around 50 staff. Every step will be rightly scrutinised by parents, patients and politicians. 

But the almost impossible question of how to care for young people with gender dysphoria shouldn’t be left to those willing to offer medication on demand. Webberley describes herself as a “doctor peddling in business”. Patients deserve better.