The Cass Review: Interim report

Let’s have a look at the NHS’s interim Cass Review report. The NHS commissioned the Cass Review over concerns about the care children and teenagers were receiving at the Tavistock Clinic, including whistle-blowing by staff working there, and a report by NICE (The National Institute of Health and Care Excellence) in 2021 that found: “The evidence for using puberty blocking drugs to treat young people struggling with their gender identity is ‘very low’”.

The interim report found that:

“We need to know more about the population being referred and outcomes. There has not been routine and consistent data collection, which means it is not possible to accurately track the outcomes and pathways that children and young people take through the service.”

“There is lack of consensus and open discussion about the nature of gender dysphoria and therefore about the appropriate clinical response.”

“Because the specialist service has evolved rapidly and organically in response to demand, the clinical approach and overall service design has not been subjected to some of the normal quality controls that are typically applied when new or innovative treatments are introduced.”

“A fundamentally different service model is needed which is more in line with other paediatric provision, to provide timely and appropriate care for children and young people needing support around their gender identity. This must include support for any other clinical presentations that they may have.”

Dr Hilary Cass is an honorary Consultant Paediatrician at Evelina London Children’s Hospital, a former President of the Royal College of Paediatrics and Child Health from 2012-2015, and also acted as the Senior Clinical Advisor for Child Health for Health Education England.

What is more likely, that Dr Cass is stupid, or a horrible bigot who hates trans people, or that she is a seasoned professional who can understand and analyse all of the information available, rather than treating academic papers like cards in a game of Top Trumps?

Doctor wrongly prescribed sex change treatments to seven patients

A retired consultant physician wrongly prescribed sex-change treatments to seven transgender patients - one who was aged just nine and another a teenager who took their own life few months later.

Dr Michael Webberley provided puberty blockers and cross-sex hormones via GenderGP, an online gender clinic which he ran with his GP wife Dr Helen Webberley.

A Medical Practitioners Tribunal Service (MPTS) panel found a number of charges proved against him after he was accused of failing to provide good clinical care to seven patients between February 2017 and June 2019.

In several cases, he’d taken care of the patients after restrictions had been placed on his wife’s practise.

But several doctors raised concerns about his treatment with the GMC (General Medical Council) and he was later suspended.

Following the panel’s conclusions, his wife tweeted: ‘My heart and soul goes out to my husband. While he was in hospital today having a big operation, he was sent the damning list of proven allegations that the GMC have found against him.

'He hasn’t been able to tell his side of the story and he wasn’t able to be represented or to ask experts who truly understand the needs of trans people.

'I know that he has helped so many trans people, and I know that you will wish him well in his retirement. He has served the NHS for a long and hard career. 

'His patients have always loved him, as I do.’

With all seven patients, he was found guilty of providing or allowing treatment that was 'not clinically indicated’ or had been prescribed without adequate tests, examinations or assessments.

The tribunal found he had acted 'outside the limits of his expertise’ as a consultant gastroenterologist and without the necessary qualifications and training in general practice, transgender medicine or paediatrics.

And he failed to adhere to a recognised training pathway in transgender medicine and to obtain consent for treatments.

Dr Webberley, who didn’t attend the hearing and was only legally represented for the preliminary stages, also failed to establish an adequate multi-disciplinary team (MDT) and had reached diagnoses of gender dysphoria based on inadequate examinations or assessments.

The tribunal heard about one nine-year-old patient - know as Patient V - who’d been born a biological girl but identified as a boy.

Dr Webberley diagnosed the patient as suffering from gender dysphoria based on a questionnaire that was 'inadequate for the assessment of a minor’ and without performing an adequate mental or physical examination.

He then prescribed puberty blockers - which pause the physical changes of puberty - off-licence and without considering alternative treatments or adequately assessing the balance between the risks and benefits.

The panel also looked at Dr Webberley’s treatment of a 17-year-patient - referred to as Patient W in the tribunal - [I’m taking out the patient’s (alleged) name here, even if it is in the public domain, I don’t think it’s appropriate] who took his own life in September 2018 by stepping in front of a train.

Patient W was transitioning from female to male and first contacted Dr Webberley in June 2018. 

Patient W first contacted Dr Webberley in June 2018 after he had become unhappy at the long waiting lists for NHS treatment elsewhere. 

He said in an email that he wanted to transition as soon as possible as it would have a 'massively positive impact’ on his mental health.

'I have been waiting to go on hormones so long now and it means so much to me,’ he added. 'I am so happy it is finally happening.’

Bur Dr Webberley diagnosed Patient W as gender dysphoric without checking information with his GP.

The tribunal also found that Patient W was prescribed testosterone when it wasn’t clinically indicated and without establishing whether the risks were lower than the risks to the patient’s mental and physical health.

Patient W had been diagnosed with Asperger’s Syndrome and had 'complex’ and long-standing mental health issues but it 'did not appear’ that Dr Webberley was aware of them and he’d failed to obtain the patient’s medical records, the tribunal concluded. 

Patient W took his own life just three months later.

Dr Webberley also wrongly prescribed puberty blockers off-licence to another patient, aged 11, who was transitioning from female to male.

He claimed that he’d only provided a 'bridging prescription’ to the patient - known as Patient T - until NHS care could be provided.

But this was rejected by the tribunal who found he acted as the 'treating clinician’ without an MDT in place.

The tribunal found that GenderGP’s operating method was 'motivated by efforts to avoid the regulatory framework of the UK’, including regulation by the Care Quality Commission and Healthcare Inspectorate Wales (HIW).

Although the clinic had operated without a recognised GP following his wife’s suspension in November 2018 and kept on using the same name, the tribunal deemed his actions were not dishonest.

Dr Webberley, who’d faced 89 charges in total, was also found guilty of failures to provide good clinical care to 18 other patients who received androgen treatment for male hypogonadism - a condition when not enough sex hormones are produced by the body - using a company called Balance My Hormones.

The charges related his failure to hold face-to-face consultations, to conduct any examinations or obtain medical histories before inappropriately prescribing medication, and making inappropriate diagnoses - but some charges were not proved.

In summary, the tribunal found that on no occasion had Dr Webberley disagreed with diagnosis sought by each patient.

Tribunal chair Tim Bradbury said that ’ in every case the patient was prescribed the treatment which they had sought at the outset’.

Dr Webberley’s 'apparent intention’ was 'to prescribe according to the patient’s wishes’ and not by following an adequate and critical objective assessment before making a diagnosis and concluding the treatment was clinically indicated, he said.

There was a 'pattern of substandard care’ which underlined Dr Webberley’s lack of qualifications, training or experience, Mr Bradbury added.

But he acknowledged that the transgender patients felt 'let down’ by the NHS and 'due to inherent delays’ had sought private treatment through GenderGP.

The tribunal will now decide if Dr Webberley’s fitness to practise has been impaired and, if so, what sanctions he will face.

GenderGP have been contacted for comment.

In April, an MPTS tribunal cleared his wife of wrongly prescribing sex-change treatments to three young transgender patients.

The GMC had accused Dr Helen Webberley of acting beyond the limits of her competence as a GP with a special interest in gender dysphoria and of failing to follow professional guidelines.

She admitted several charges relating to her conviction in October 2018 for illegally running an unregistered clinic while treating 1,600 transgender patients and gender dysphoric children from her home in Wales.

Dr Webberley, from Abergavenny in Monmouthshire, was later fined £12,000 and suspended.

She then moved Gender GP to Spain, where she now lives with her husband, but they are no longer listed as directors.

In December, the High Court refused an application by the GMC to extend her suspension for a further eight months, although an order means she can only practise under strict conditions.

In response to the tribunal’s decision in her case, she said: 'Transgender healthcare has sadly become shrouded in politics and division, and I know how important the outcome of this hearing is to the community and those doctors who care for them.’

She added: 'I have seen the enormous difference that gender-affirming care can make on people’s lives, and I am very proud of the advocacy work we have done.’

Gender referrals for children three times higher in Blackpool

Children in some parts of England are up three times more likely to be referred for potentially life-altering gender hormone treatment, research has found, amid concerns of a postcode lottery surrounding the procedure.

A survey of health authorities across the country found huge disparities in the number of children being referred by the NHS for gender dysphoria.

It comes amid growing concern at the number of potentially vulnerable children wrongly being given gender hormone treatment and how health service staff deal with under-18s who question their gender identity.

The survey found that on average clinical commissioning groups refer 32 children per 100,000 for treatment, a more than 15-fold rise since 2010.

But in some parts of the country referral rates were up to three times higher than the national average — a figure that could not be accounted for by statistical chance. Blackpool, for example, had a referral rate of 115 children per 100,000, 3.6 times the national average, and Brighton and Hove had rates 2.4 times higher than would be expected. At the other end of the spectrum Luton and Hounslow in west London had some of the lowest rates of referral in the country — about 0.2 per cent of the national average.

Sources close to Sajid Javid, the health secretary, said he wanted “geographical differences” to form part of a review into NHS gender identity services for children being led by Dr Hilary Cass, former president of the Royal College of Paediatrics and Child Health.

In 2010, 138 referrals were made for gender dysphoria, which can lead to children receiving puberty-blocking drugs and hormones that encourage masculine or feminine characteristics. This increased to 2,383 in 2020.

Two thirds of those presenting are now girls in their early teens, whereas a decade ago it was largely young boys. About a third have mild to severe autistic traits or other types of neurodiversity, and children in care are also over-represented.

The latest research was compiled from freedom of information requests by Nikki da Costa, a former Downing Street official, and Professor Michael Biggs of Oxford University. She said it was important for the information to be made public so MPs and local councils could scrutinise what was happening in their local areas rather than relying on national figures.

“Bill Maher storming it on the matter of ‘regional transness’ coming at the exact moment an article points out similar middle-class hot spots exist in the UK….Netflix firing all their woke staff…Warner Brothers uncancelling JK Rowling…this is going to be the best birthday ever!”

GLINNER’S BIRTHDAY-EVE TWITTER

Holy shit, seriously, you need to watch the Bill Maher segment! He describes paediatric transition as “experimenting on children”, mentions Sweden and Finland stepping away from puberty blockers, mentions bone density, fertility, and sexual function, and the ACLU calling for the censorship of Abigail Shrier’s book. At the end he says children are being used as “cannon fodder” in the 'culture wars’!

I’m posting this video from the 2021 LGB Alliance conference separately from this post about Dr Az Hakeem as it is really worth watching in its own right.

It covers a lot of subjects, including safguarding in schools, and sex and relationships education, and how these things have been hijacked by trans and pro-porn (ie, ‘queer’) ideology.

Dr Hakeem’s section starts at the 01:02 mark (and is less than 20 minutes long), and listening to him talk about his practise, it is really, really obvious that he is not ‘transphobic’ in any meaningful sense of the word (he also talks about the institutional homophobia of the Tavistock).

Dr Hakeem’s comments at 01:12 on sub-cultures are worth hearing too: his idea is that before social media, sub-cultures were based around music (Hakeem was a ‘post-punk goth’ as a teenager), and were about being rebellious and subversive; now instead of music-based subcultures, we have people identifying as non-binary, which is ‘goth, mark 5’:

Goth, mark 1 = post punk

Goth, mark 2 = The Cure

Goth, mark 3 = shoe-gazing

Goth, mark 4 = emo

Goth, mark 5 = non-binary

There’s also a surprise guest appearance from Baroness Emma Nicholson in the Q&A section at the end!

The accidental vindication of Doctor Az Hakeem

This is one of those great blunders trans rights activists can’t help making.

I met Doctor Az Hakeem and Stella O’Malley (who is being smeared in a similar way in Ireland by the deeply dishonest Mick Barry) only this Friday along with some other fascinating people, Helen Joyce, and Heather Brunskell Evans among them, and while he couldn’t tell us about the patient that Strudwick had interviewed without breaking doctor-patient confidentiality, he did let us know that Strudwick’s hitjob was coming. He seemed entirely nonplussed about it…carefree, I would say, and now I know why.

Poor old Patrick Strudwick has, along with Nancy Kelly, proved that basic talking therapy would be made illegal in the world that they’re fighting for. I was about to explain all this in a post when I saw that Dennis Kavanagh had already written the piece. He very kindly gave me permission to re-publish it here.

That’s TWO gay people of colour whose livelihoods Stonewall have now targeted.And as to Dennis’s contention that Doctor Az has a credible legal claim to make against Nancy Kelly, I want to use this opportunity to tell the doctor that the second I tweeted about a Pink News story accusing me of supporting conversion therapy, they took it down, without even the need of a solicitor’s letter. Nancy Kelly has made a grave mistake.

Anyway, over to Dennis!

Must be an interesting gig being Stonewall’s lawyer, certainly not one lacking in excitement or “challenges” as they say. That was my reaction, at least, to this statement from the CEO on Sunday. It’s the gender borg queen in full cancellation mode attacking a (surprise surprise) homosexual man on the basis of an article that conveniently appears just at the point where it might serve her political interests. As will become clear, this amateur hour defamation is dubious in the extreme and one doesn’t have to dabble in conspiracies to regard the timing as deeply suspicious. As I’ll demonstrate, this has the appearance of a coordinated hatchet job and for Her Majesty here to describe it in the terms she has done is what us lawyers would describe as “unwise”.

The political background

For anyone new to this issue, Stonewall are currently furious that the British Government accepted arguments made by organisations like the Gay Men’s Network,Sex Matters, Transgender Trend etc. regarding the misleadingly called “conversion therapy ban”. The nub of it is basically this: gay conversion therapy has a long (and deeply saddening) history, it happens infrequently now (thank goodness) but there’s nothing wrong in principle with banning it particularly in the case of young gay people facing conversion therapy practices often carried out overseas. (I should add though I personally know about five lads who’ve been through this awful experience both here in the UK and the USA).

“Trans conversion therapy” is by contrast not a thing. Patients presenting with gender dysphoria can and should have access to high quality talking therapies so a “ban” in these circumstances would simply criminalise therapists trying to help vulnerable young people who in the main grow up gay. The point is essentially this: conversion therapy by gender is still conversion therapy and these bans world wide have seen gender non-conforming children mass medicalised by doctors scared of prosecution.

We weren’t alone in this concern, the statutory regulator for the Equality Act, the Equality and Human Rights Commission said the following in their response:

“We are supportive of measures to end harmful conversion therapy practices, but the likely significant and wide-ranging implications of the Government’s proposals for a legislative ban for criminal and civil justice, clinicians and therapists, families and religious organisations require careful and detailed consideration. The consultation document contains no clear definition of what will amount to “conversion therapy” caught by its proposals, nor of the meaning of “transgender” – a term which has no clear legal meaning, is potentially wider than the concept of gender reassignment in current UK law, and is understood by different people in different ways.

Nor does the consultation address the possible need to consider a differentiated approach in relation to sexual orientation and being transgender so as to ensure, in particular, that clinicians and therapists are not prohibited from providing appropriate care and support for individuals with gender dysphoria.Given the documented lack of evidence about conversion therapy in relation to being transgender, recent attention and litigation on the implications of medical and surgical transition, and the ongoing NHS-commissioned independent review of gender identity services for children and young people led by Dr Hilary Cass OBE, we consider that these matters require further careful and detailed consideration before legislative proposals are finalised and the implications of them can be fully understood.”

As you can see, strategically this left the gender borg with two significant problems. First, they could point to no evidence of anything outside therapy that might constitute a social harm. Second, various organisations has cottoned onto the fact the ban had potentially disastrous implications for the free exercise of clinical judgment. (Let us just put to one side that Stonewall is in theory a gay rights charity and you might think it would be concerned by homophobia being identified as a safeguarding risk at gender clinics. The truth of the matter is Stonewall has no concern for young gay people facing that life changing and deeply damaging risk and is now obsessed with biology denial to the point it’s taken leave of it’s senses.

It’s important to recognise what a hammer blow the government’s decision to break apart the CT ban was. Everywhere else in the world this trick has worked, the gender borg have snuck “trans conversion therapy” bans onto statute books leaving the mostly kids who play with the wrong toys staring down the barrel of life long medicalisation. The UK Campaign to protect young gay people was unprecedented and while there’s still a way to go, we should all be proud of what we’ve achieved.

How do you solve a problem like having no evidence?

Anyway, what do you do if you have no evidence for your claim and no way of answering the charge this is just going to lead to the harassment of doctors?

Well, if you’re deeply, deeply stupid I guess the answer is you publicly scout around for stories (remember this is aftera demand for legislation was made, not before)

In due course, efforts such as this resulted in the article Kelly links to in her tweet, you can read it for yourself here. What becomes painfully clear in the article is that Dr. Az appears to have done no more than any reasonable therapist/psychiatrist would have done, namely interrogate a claim to a gender identity at odds with the biological sex of the patient presumably because, I don’t know, maybe a whole lifetime of medicalisation or irreversible surgery is sort of a big thing maybe? With decades working in the medicine in the field of mental health, Clive does a much better job than I ever could breaking down the quotes in the article and pointing out why the reported questions are entirely appropriate and responsible.

His excellent video is here:

Above: Clive, the second best thing on YouTube after lol fail videos

As Clive’s video suggests, us gay men are frankly less than impressed at seeing Kelly go after a fellow gay man and some excellent threads in response have been penned today, Malcolm Clarke of LGB Alliance’s here andHassan Mamdani of the Gay Men’s Network here to name but two. Let us be under no illusions as to what is really going on here, for those who don’t know. Dr. Az believes in biological reality and is not afraid to speak eloquently and clearly as to what is really going on in gender clinics. His real crime, and the reason he’s being targeted by the gender borg on cancel mode is that he won’t simply shut up and leave young gay people to the terrible prospect of gay conversion by gender. If you haven’t heard him before, I highly recommend it, here he is speaking at the LGB Alliance conference:

Above: Dr. Az Hakeem (around 1.02) being erudite, morally forceful, decent and pretty damned attractive in my view, should definitely be the next Bond

Back to the law

Given Clive, Hassan and Malcolm have shredded this amateur hour cancel-job the most useful thing I can do it return from whence I came, namely, to the subject of that tweet.

Above: Sort of thing that gives us poor lawyers sleepless nights

The borg may be great at assimilating people, repeating mantras and body modification but I really don’t rate them on the law of libel or the law generally for the following reasons.

1. In stating that the subject of the article is “conversion practices targeting trans people” the clear and obvious meaning is that Dr. Az is so practicing.
2. Such practices are soon to become criminal offences in the case of gay people.
3. Further, or alternatively, such practices would at the very least amount to serious medical malpractice.
4. The meaning is therefore that the subject is a criminal or as close to one as makes little difference.
5. Calling someone a criminal and accusing them of medical practice amounting to a criminal offence can only do “serious harm” to a reputation.
6. Linking the article to a campaign to effectively cause gay conversion by gender obliterates any potential fair comment defence. You are saying people need the protection of the criminal law from a professional. Professionals have money. This may be deeply unwise.

Beyond this, no debate, unfettered access to the corridors of power and cancelling people leaves the gender borg pretty arrogant and ill equipped for adult society. If I were the lawyer for Stonewall I would also be gently making the following points to her majesty:

1. It is wholly inappropriate to comment on any sort of ongoing proceedings.
2. There are no findings of fact in this case by the GMC and the proceedings are sub judice
3. The subject of any investigation could argue you are pushing a political agenda in public and running the risk of potentially influencing an independent tribunal
4. The Charity Commission may well regard that as rather eccentric as should the trustees of Stonewall

Stonewall have become increasingly erratic of late not least in reporting the EHRC to a UN Committee with the help of ongoing legal sitcom character actors “The Good Laugh Project”. That committee contains Uganda (not a haven of gay rights) and latterly Russia (also not a great place for us gays). Even they found the approach odd and told Stonewall and comedy pals to go away. What we see here is that the more and more Stonewall face embarrassment and defeat at every turn, they more and more turn on their own community. Last week they were in court facing off against lesbian and gay rights hero Allison Bailey, on Sunday their CEO goes for a homosexual man.

Gratifyingly, the whole thing seems to be backfiring, Dr. Az is enjoying enormous support on social media and (as people cleverer than me have pointed out), this episode demonstrates that the original Stonewall position of “Of course we don’t want to criminalise talking therapies” was merely their standard level of mendacity.

[Image description: White text on a blue background. The original text has been edited to read, “There’s SUCH THING as a transgender child. Who has the guts to repost this?” The transgender pride flag has been edited over the original text.]

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There’s SUCH THING as a transgender child.
Who has the guts to repost this?

Submitted by @ahumanperson114