GP who ran gender identity clinic wins appeal against suspension

Helen Webberley, a GP who ran a gender identity clinic online, has won a High Court appeal against a tribunal decision to suspend her from the UK medical register for two months.1

A medical practitioners tribunal decided in June 2022 to suspend her briefly after a hearing lasting 85 days spread over nearly a year, in which most of the charges against her were found unproved. The tribunal imposed the sanction on public protection grounds for failure to advise an 11 year old patient who was assigned female at birth, but identified as male, of the risk to fertility.2

But a High Court judge has allowed Webberly’s appeal, concluding that the tribunal’s analysis of the issue of serious misconduct was “wrong.” Mr Justice Jay added, “The [tribunal’s] thinking was confused, clearly wrong in places, and it omitted reference to important evidence.”

By the end of the lengthy tribunal hearing, he said, the only charge that mattered was whether Webberley had failed to provide good clinical care to the child, referred to as patient C, in advising of the risks of puberty blockers before commencing treatment without discussing the risks to the patient’s fertility.

Jay said there were no long term risks to fertility from puberty blockers but that at least 90% of patients who took blockers went on to take cross sex hormones, which could affect fertility. Webberley had not discussed the risk to fertility with C, but in an email which she had asked her administrative assistant to send to C’s mother the risk had been explained.

The judge said the allegation in the charge was unclear. It was not clear whether the complaint was that there was no discussion at all or there was a discussion but not with C. Webberley had not been asked any questions about the adequacy of her consent form, and no expert witness was asked about it.

In its reasons for finding serious misconduct the tribunal omitted any reference to an email from the administrative assistant to C’s mother, which “could not have been clearer,” said the judge.

Webberley should have discussed the risk to fertility with C directly, he added, but “it is far from clear to me that what did take place should be strongly criticised.”

Jay said that the case was an exceptional one and, although he had decided that Webberley’s appeal should not be dismissed, he could not allow the appeal on the basis that he was able to decide for himself whether her practice amounted to serious misconduct. The General Medical Council argued that the case should be sent back to the tribunal to decide whether Webberley’s failure to discuss fertility risks amounted to a lack of good clinical care.

But if the case went back to a tribunal, the judge said, she would have a “reasonably good chance of not being suspended at all.” It would be “disproportionate, if not oppressive,” to put her through further significant delays and another hearing. The appeal must be allowed on the ground that the tribunal’s determination on the issue of conduct was wrong.

Had the tribunal not made the errors at the earlier stage, he said, the decisions it reached on impairment of fitness to practise and sanction were reasonable and fair, based on its evaluation of Webberley’s insight or lack of it. The case was “as far from being a hatchet job as it would be possible to be.”

In a postscript, he noted, “This appeal does not raise any wider issues about the wisdom or otherwise of administering puberty blockers to the younger age group who wish to undergo interventions for gender reassignment with full parental agreement.”