Helen Webberley of GenderGP Opens US Gender Meds Service
Webberly lost her license in the UK for practicing an affirming model of care. Assigned Media interviewed her about a newly announced expansion into her US.
photo courtesy of Helen Webberly
by Riki Wilchins
Follow Riki’s trans news ticker at @rikiwilchins.bsky.social
In 2015, Helen and Mike Webberley started GenderGP, a private telemedicine service providing hormone therapy prescriptions to patients in the UK. For a monthly subscription, patients can access a no-frills option for medical transition care on an informed consent basis. Webberley is a highly controversial figure in the UK and has been the subject of frequent sensationalized tabloid attacks. Her medical license was suspended in 2017, a decision Webberley fought and was eventually overturned. On November 16 she announced on GB News that her for-profit service was now operating in the US. Riki Wilchins interviewed her about her experiences in the UK and the plans to bring GenderGP to the US.
Assigned Media: You and Mike were a wife/husband doctor team starting one of the first telehealth services for trans people in the UK, GenderGP. And because of regulators, you had to register first in Wales, then Spain, then Hong Kong, and finally Singapore. But they still came after you and suspended your medical license after authorities accused you of not warning an 11-year-old trans patient about their future fertility risks—though there are no such risks from a year or so on blockers. The Appellate Court agreed you did indeed warn them, but you both still lost your medical licenses in the end. It looked like in the post-Cass Review era, they were making an object lesson out of you to scare off other clinics.
Helen Webberly: What nobody had done, and what they still haven't done, is set any standards for trans medical care. So, doctors don’t know what they are or aren't allowed to do. When my NHS colleagues complained to my regulatory body, there were no standards or rules. [The patient] had already been put on blockers by the NHS’s Tavistock Clinic. But my General Medical Council did not like it, and since no one had made any rules, they used me and my husband to make the rules. And I did warn the patient, and the case eventually it went to the High Court which agreed with me and told them, What are you talking about? So they were overruled and they were wrong.
AM: So the whole thing really just to make an example of you for something you didn't do.
HW: Yeah, basically. The NHS doctors who were running the Tavistock didn't like me coming in with a new affirmative approach. They were still basing theirs on Everyone's going to grow out of it so you shouldn't really do anything. But that wasn't my experience. WPATH was saying that, once you've hit puberty and had a longstanding history of gender incongruence, it's not going to go away. But NHS didn't like my affirming approach, so they referred me to the regulator.
AM: Meanwhile right-wing Telegraph newspaper was staging undercover stings, calling up GenderGP and posing as fictitious clients who were either underage or didn't have their parents permission or something like that. And then publishing these lurid articles, basically trying to take you down.
HW: They were so proud of themselves. They managed to get an actor and their mother to go through the assessment and all the video consultations. They had a really good story and they got a prescription for testosterone. And I'm like, Well, did you put it on, did you actually rub it onto your arm? And they're like, No, no. And I'm like, Well done—you just told a lovely lie to pretend that you were trans and you didn't actually take the medicine. So what's has been done? You know a [cis] girl wouldn't dream of putting testosterone gel on their arm because they don't want to grow a beard and have a voice dropped.
AM: One of the knocks on GenderGP was that you were too quick with prescription pads and too slow to do things like routine follow-up blood work. Is there any truth to that?
HW: No. Accessing care has been made so difficult. You have to wade through years and years of assessment just because it's transgender care. So these patients had been coming to their gender identity for years, and by the time they want care—particularly young people—they’ve gone through all of their struggles with parents and society and they’re really ready: in many ways more than ready, actually desperate. So then you’re supposed to put them through another two years of waiting and assessment like the NHS was doing to validate their gender identity.
As for the panels and panels of blood tests, many people can't afford that. And you actually don't do anything with the results anyway. It’s just kind of tradition to tick all the boxes on the bloodwork panel. So we said, why don't we just do the blood tests that people need, when they need them, which is what medicine should be like. This is not complicated medicine. But because it's transgender care, everyone was like, Oh my goodness, no.
AM: I read on your website were you said something like, These are just people who need a hormonal adjustment. This is not like brain surgery or open heart surgery. And the regret rate is still around 1%, which is lower than other medicine that I know of (not to mention lower than for getting married or having kids).
HW: I couldn't agree more. And when they don't get the care, they just end up doing it themselves. Which is so much worse. I've never heard of DIY medication before I came into this field. I’d never heard people saying, Okay, if you won't help me, I'm just going to go and buy it. And I'm like, No, let me help you. It's much better that I help you than you go and buy it online.
AM: You had the option to sit for your medical license and recertify, but you’ve pointed out that even today, the UK still does not offer any training or certification in trans care that doctors can take, even though it’s your primary area. You can train in cardiology, rheumatology, neurology, but you can’t train or get certified in affirming care in the UK.
HW: We didn't get taught this at medical school. There’s no education, so doctors don't have any knowledge. And that's not fair for the patient, who needs standardized, evidence-based, research-driven care. But in the UK, we’re just listening to people saying trans people shouldn't exist and you shouldn't treat trans children.
AM: So as you say on your website, you realized that you didn't need a medical license in order to go out and advocate for trans kids.
HW: I think I can reach more people now every day just by doing this. If I was in a clinic, I'd be seeing one patient. I’d make a big difference in that one patient's life, but by doing this, I can make a lot more difference to a lot of people and to healthcare professionals and the public. I get messages every day: Thank you so much for your support. If you weren't here doing this, I think I'd have lost. I'd have lost the will to live. It's incredible how many people I can reach doing this kind of work compared with being a doctor.
AM: So even without your license, GenderGP was still operating in the UK—what drove your decision to go international?
HW: Because the UK is just transphobic. So we are now all over Europe: the Netherlands, Spain, France, Germany, and so on.
AM: And what drove the decision to do a nationwide expansion into the US at this point?
HW We were helping some US members, but we wanted to make it a bit more formal. So we created a network of US doctors and we have software we've created which helps doctors make the right decisions based on evidence, rather than based on fear. So that was our journey.
My theory, my philosophy has always been that you do need medicine, but this isn't a medical condition. Do you know what I mean? You do your own diagnosis: I'm not diagnosing anybody with gender incongruence—although I know you have to a tick a box for diagnosis to get medical care. But the only person who knows what their gender identity is, is you. So I don't overmedicalize it. So many doctor appointments, so many psychology appointments. And obviously you have to pay for a lot of that. Why do you need them? The only appointment, the only assessment I think that we should do is How would you like me to help you? But actually people who know exactly what they need, just need access to safe prescription medication and blood tests and so on. And people should be able to access that easily.
AM: So that’s what GenderGP offers. I know it’s a membership basis, so let’s say I joined. I don’t know how you can do it at $29 per month for a price point– which in my experience is a pretty aggressive pricing model.. So I’ve paid for my membership and become a member, and gotten my interview and assessment by a doctor in the GenderGP network. When we both agree I need hormones or blockers, I get a prescription. Where can I actually get that filled?
HW: There's a network of physicians who will create the prescription depending on where the member is. And then there’s a network of online pharmacies that will fulfill it. There are also services like DoseSPot whose software is used by doctors to electronically send pharmacies prescriptions.
AM: I understand you’re rolling out in the whole US in three stages. The first is California, New York, Washington state, Arizona, Colorado, Illinois, New Jersey, Massachusetts, and Minnesota. And Stage 2 (more challengingly) will be Virginia, Louisiana, Oregon, Wisconsin, Oklahoma, Kentucky, South Carolina, Alabama, Maryland, Connecticut, Nevada, Arkansas, Michigan, and Kansas. Then the remaining states in a planned Stage 3. Obviously members in states like Kansas or Oklahoma in stage 2 are going to have a very different set of challenges than those in California or Illinois.
HW: People find a way, you know? They will find a way. People who live in that state over there, if they need to get their meds every three months, they'll go to another state to do it. We know people who do that.
The question is, what’s banned in a particularly state? Is it the doctor that's banned from doing it? Is it the pharmacy that's banned from dispensing? Is it the patients, that's banned from accessing it. All of those things are part of it. But people find their way. In the UK, we know parents who go over to the EU on holiday to Spain and France and Germany and get their prescriptions. For personal use, you can bring it back, I think 3 to 6 months perhaps. And with blockers, it’s obviously an injection, so they go abroad, get their injection, and come home again.
AM: I live in Florida where it was difficult for a while, and one service just told me to go on vacation to NYC or DC for a weekend and they’d be glad to prescribe them while I was there.
HM: Exactly. It’s about autonomy and informed consent. That’s the basis of medical ethics. And then people say, Oh, no, but the other bit of medical ethics is, “First, Do No Harm.” But not taking action here causes immense harm. In good medicine, you let the person decide what it is that they would like to achieve, you make sure it's safe for them, and you help them do it the best way. And if they need psychological intervention, let them ask for it, because it might support their life.
But just because you're trans doesn't mean you need to have a counsellor or a psychologist. You don't.
AM: Thank you. And thank you for standing up under immense pressure and being a voice for transgender kids.
Riki Wilchins writes on trans theory and politics at: www.medium.com\@rikiwilchins. Her two last books are: BAD INK: How the NYTimes SOLD OUT Transgender Teens, and Healing the Broken Places: Transgender People Speak Out About Addiction & Recovery. She can be reached at TransTeensMatter@gmail.com.