At the coalface of teenage gender change

A few weeks ago, Keira Bell, a very unhappy young British woman, who had lived as a transgender man for several years, won an important court battle in England. The upshot of the court’s decision was that England’s only gender clinic could effectively no longer supply children under 16 with puberty blockers and sex-change hormones, pending an appeal to a higher court.

The judge wrote a scathing assessment of the state of transgender medicine. He found it very “surprising” that so little attention was being paid to whether teenagers really understood the implications of the life-changing medications they were taking.

Did that stop the tsunami of teenagers, mostly girls, who are changing their gender in the UK?

Perhaps not. An undercover investigation by the London Telegraph has found that an online clinic run by suspended doctors is willing to organise sex-change drugs and puberty blockers – without a face-to-face consultation.

The website, GenderGP, circumvents the law in the UK by using overseas doctors and exploiting a legal loophole. Despite Brexit, UK pharmacies still accept prescriptions for drugs such as testosterone even when they have been given out over the internet by doctors in the European Union.

The Telegraph’s reporter posed as a 15-year-old girl who wanted testosterone to change her gender to male. GenderGP directed her to a doctor in Cairo, Yasmeen El Rakhawy, who told her that it was “excellent” that she knew that she did not want children. The doctor said that no more Skyping would be necessary “At no point will the medical consultations be, you know, required regularly. It’s only if there’s ever a concern,” the Egyptian doctor said.

The next port of call was an unnamed Romanian geriatrician who supplied a prescription for testosterone.

“The process had been relatively simple,” said The Telegraph. “All it had taken was three Skype appointments and some emails, which she [the reporter] had been able to do from her bedroom. The clinic had not required proof that her parents knew of her plans.”

The “clinic” – which seems to be just a website with a help desk – defended its practices. According to The Telegraph:

It said that it treats children according to “stage not age”, and that there may “occasionally be compelling reasons” to prescribe cross-sex hormones to a 12-year-old who is “completely aligned with their gender identity”.

It added that it assesses patients’ capacity to consent in a number of ways, including email messaging, questionnaires and consultations, but that “not all parents are supportive, and when a young patient is able to consent to their treatment in their own right, then that treatment can be appropriate and necessary.”

“GenderGP operates according to a gender-affirming model of care. Transgender patients of all ages who come to our service can be assured of receiving belief, support and compassionate access to medical care,” it said.

Critics of transgender treatment for children and teenagers have complained that the doctors and psychologists who facilitate it are so convinced that it is medically necessary that they are ignoring medical and ethical safeguards. The Telegraph’s investigation confirms that this is the case.

The on-line counsellor told the reporters that these children are not required to have counselling sessions. "It's not mandatory," she said. "We do not force children to have therapy because we believe if they don't want it there could be a time later in life where they need it and they won't access it because their experience of it was traumatic."

Staff at GenderGP unquestioningly accepted the reporter’s story that she was really male. They told her: “we’re not worried about your truth because there’s no debate about that”.

The brazenness of the people who run GenderGP is astonishing. The site was founded in 2015 by Helen Webberley a doctor who felt passionate about the plight of transgender children. If they did not transition, she believed, they were at serious risk of suicide. In 2017 her medical registration was suspended – after complaints from other transgender doctors. She felt that the official guidelines were “overly restrictive and even discriminatory”. The General Medical Council did not buy her arguments.

Her husband, Mike Webberley, continued caring for her patients. Then he was suspended as well.

The Webberleys vowed to keep providing transgender care for the 1600 -- 1600! -- patients at GenderGP. They moved their operations out of reach of English law to Malaga, in Spain, and organised the shady work-around described by The Telegraph.

Despite the lack of counselling offered by GenderGP’s online service, Helen Webberley had the audacity to state in a gay newspaper that:

All medical intervention carries with it risks, benefits and side effects, which is why all potential outcomes should be thoroughly discussed with the patient to allow them to make an informed choice about their care.

The only thing that can explain the cognitive dissonance between this sensible statement about informed consent and the appalling lack of it in her website is fanaticism. The Webberleys appear to be convinced that there are almost no risks in transgender treatment which outweigh the risk young transgender patients will commit suicide if they are not started on puberty blockers and cross-sex hormones.

And, by the way, there is precious little data to back up the suicide argument.

Helen Webberley concluded her op-ed by giving a two-fingered salute to English law: “At GenderGP we will continue to assess capacity to make decisions, as we always have done, based on all the information available to us. If ever we need the court to assist us in that, then we will ask.” 

Perhaps the Webberleys are a special case. I suspect not. Around the world, purveyors of transgender medicine are so fanatically convinced that their approach is correct that they believe that they are above the law. Now it appears that not even stripping them of their medical credentials will stop their self-appointed crusade.


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