The Times- Teen prescribed ‘dangerously high’ hormone dose by online clinic
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Teen prescribed ‘dangerously high’ hormone dose by online clinic
A teenager was prescribed “dangerously high” levels of hormones that could have resulted in sudden death, a judge said as he warned of the perils of online transgender treatments.
Sir Andrew McFarlane, the president of the family division of the High Court, said in a ruling on Wednesday that there was “very significant concern” over children “accessing cross-hormone treatment from any offshore, online, unregulated private clinic”.
McFarlane had heard evidence from an expert witness that the dosage of hormones prescribed to the teenager by GenderGP after just a single online consultation with a counsellor was so high it was “highly abnormal and frankly negligent”.
Jacky Hewitt, a consultant paediatric endocrinologist based in Melbourne, told the court that in 20 years of practice she had never seen such a “massive” dose given to a child, and that such treatment would be “unlawful” in her native Australia.
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She said that the teenager was immediately prescribed levels of testosterone that would normally be administered only to an adult, after a period of steady escalation over the course of two or three years.
“Not only did GenderGP prescribe this top-end dosage to a testosterone-naive child, but they did so by directing a ‘loading’ [double] dose at the commencement of the treatment,” Hewitt added.
The teenager’s blood was later assessed by Russell Keenan, a consultant paediatric haematologist at Alder Hey Children’s Hospital in Liverpool, who advised that the results were effectively normal when compared with reference points relevant to an adult male.
At the heart of the case was a 16-year-old, referred to in the ruling as J, who was born female before beginning a course of cross-hormone treatment at the start of last year.
The autistic teenager is biologically female and has a history of anorexia and self-harm.
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J’s last testosterone injection was in August and the next was scheduled for November. But further treatment was postponed, with J’s agreement, after the teenager’s father raised objections, which the judge was asked to rule on.
In his judgment, McFarlane delayed ruling on the dispute over whether J, as a minor, had the capacity to consent to life-changing treatment, as it was agreed that no further medical action was required for six months.
It was also noted that there was the possibility that, when the time came, J could continue treatment with a UK provider.
But the judge went on to signal deep concern over the use of online gender-treatment clinics that are based abroad.
McFarlane said that it was “right to record” that if J considered resorting to using GenderGP, which is based overseas, for further prescriptions, “then there will be a need to consider very carefully … his capacity to consent to that particular option and … whether the circumstances are such that the court should exercise the inherent jurisdiction to prohibit him from doing so”.
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GenderGP describes itself as a “worldwide transgender clinic” that provides “advocacy, support, advice, healthcare and access to a range of complementary services, which enable trans people to live their lives more easily”.
The judge said that the “evidence relating to GenderGP that is available … gives rise to additional serious concerns as to the safety of patients accessing cross-hormone treatment from that particular clinic. If a further referral to GenderGP is to be proposed by any party, the court will expect a detailed account from the clinic setting out their proposed course of assessment and treatment.”
And speaking directly to judges in future cases, McFarlane said: “Whilst further evidence may … alleviate the concerns that I have described, on the experience in these proceedings thus far, I would urge any other court faced with a case involving GenderGP to proceed with extreme caution before exercising any power to approve or endorse treatment that that clinic may prescribe.”
Paul Conrathe, the solicitor representing J’s father, called for the government to issue a formal warning to pharmacies not to honour hormone prescriptions from providers such as GenderGP.
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He added that the case had “exposed a dangerous gap in NHS provision, which urgently needs to be remedied”.
GenderGP was contacted for comment.
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GenderGP claims that its mission is to “allow transgender people to live their best lives” (Lucy Bannerman writes).
One of the most senior judges in the country painted a very different picture in a damning judgment on Wednesday, highlighting how the online clinic loaded one vulnerable autistic teenager with so much testosterone that they were at risk of sudden death.
It is the latest controversy around the clinic, which was set up in 2015 by Helen Webberley, 54, a doctor from south Wales, and her husband Michael, 57, a former gastroenterologist. It is able to defy NHS guidelines because it is private.
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Michael Webberley was struck off in 2022 for “wide-ranging failings” in prescribing hormone treatments to patients as young as nine without proper assessments. One teenager was prescribed testosterone without any consultation of medical records. They took their own life a few months later.
A Medical Practitioners Tribunal Service (MPTS) panel found there had been a “catalogue of failings” in relation to his care of the seven patients between February 2017 and June 2019.
None of this is mentioned on GenderGP’s website, in which he describes himself as “a highly experienced and respected consultant physician of 23 years’ standing.”
Helen Webberley is the public face of GenderGP. She was found to have committed serious misconduct by an MPTS panel in 2022.
She was issued with a two-month suspension after being accused of failing to alert one of her teenage patients to the impact of puberty blockers on fertility. However, a High Court judge agreed with Webberley that the tribunal had made errors and concluded that its determination was wrong.
Her appeal was granted and her suspension quashed, leaving her free to practice. The Singapore-registered clinic continues to exploit a loophole in the recently revised guidelines, which say there is not enough evidence to support the safety and effectiveness of the puberty blockers on the NHS. They do not apply to private clinics.
As a private company, GenderGP is financed through fees paid by the families of children wishing to change their gender and does not receive charitable donations or public funding.
Webberley has remained defiant, after the Cass Review found “remarkably weak” evidence base for the treatment. In a message to supporters, she wrote: “Stand your ground, keep your head up and when a doctor denies a child the care that has been proven and evaluated to help, ask them a very simple question. ‘If harm comes to this child, who will I hold responsible?’ ”
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