1. So how has my case finally ended? I have been under investigation since December 2016, and unable to work since May 2017. I have been suspended for two months for serious professional misconduct, or if I appeal then I am suspended until the appeal is decided (over a year).
2. They did not take any action on anything except the allegation of not discussing fertility adequately. Not even the conviction because they realised I was in a hard place surrounding that. Here are the fertility facts:
3. Allegation: ‘Following an initial consultation with Patient C on 9 November 2016 you failed to provide good clinical care in that you advised Patient C as to the risks of GnRHA GnRHa before commencing treatment without discussing the risks to Patient C’s fertility’
4. Here is a record of all the discussions that took place around fertility prior to Patient C starting on blockers:
5. Letter from me to GP after the clinic appointment: ‘We fully discussed the role of blockers which would prevent further female puberty developing and would give us the chance to decide which puberty would the the best one for Patient C around the age of 14 or so….
6. ‘We didn't talk about fertility, it got mentioned and then we forgot to talk about it’
7. Email from me to Mum: ‘Hi, apologies for the delay. One of the things we haven't discussed is fertility, is this something you have discussed and have full knowledge of or is this something we need to explore a bit further?’
8. Mum to me: ‘Thank you for all the information..I’m aware of the procedure for egg retrieval/egg donation and its drawbacks fertility wise having undergone fertility treatment myself in the past.’
9. Mum to me: ‘’I was more interested in the comment that Dr Webberley made below that the process can be done WHILST on blockers? That didnt seem possible to me and just wanted to check it out?’
10. Me to Mum: ‘It is still possible to have egg retrieval while on blockers, and yes, fertility should return if blockers are stopped. We can revisit this as we go forward. Let me know if you have any queries.’
11. Mum to me: ‘Egg retrieval while on blockers? I didnt realise that..I imagined it would be done in a similar way to IVF..stimulating the ovaries to produce follicles, then harvesting. Surely that would be difficult whilst on blockers?’
12. Me to Mum: ‘The process by which they harvest eggs is to make you go through a very strong female cycle to make as many eggs as possible ready to pop out of the ovaries…..
13. ‘When they are just about to pop, they put you to sleep and the surgeon will go in through keyhole surgery to collect them and they are then stored in the freezer…..
14. ‘Unfortunately, it is not very effective as once the eggs are retrieved from the freezer they are not as fertile as they had been inside you…..
15. ‘It is an unknown quantity as to how long after starting testosterone fertility is affected….
16. ‘Some people, as you may have seen in the news, go on with masculinisation treatment and then temporarily stop it in the future in order to conceive or to retrieve eggs for IVF and then restart their treatment…..
17. ‘However, we have to assume that any treatment has the potential to make you completely infertile and that this may be permanent…..
18. ‘The costs vary but I know it is a few thousand pounds, you can sometimes get a much cheaper deal if you are willing to share the eggs; so half the eggs are kept in the freezer for personal use and half are donated to women who are unable to produce their own eggs.
19. ‘The best thing to do to get an idea of costs and timings is to contact your local private hospital and see if they can give you some more information on that, as it varies throughout the country; get as many quotes as you can to feel comfortable.
20. ‘Your GP will be able to refer you on the NHS and the length of the process will vary.’
21. GIDS Advice on their consent form: ‘Your GP can refer you to the local fertility clinic for further information. Some young people choose to wait to start with the blockers until they have found out more about fertility preservation and/or had their fertility preserved.’
22. My witness statement given to the tribunal: ‘Patient C was prescribed blockers which are fully reversible. However, I also recognise that patients who start their gender-affirming care more often than not proceed on to gender-affirming hormones…
23. ‘which can affect fertility in the long run. I had recognised that I had not adequately discussed fertility preservation with Patient C and his mother at our consultation and went back to clarify further in writing….
24. ‘The discussion around fertility is a continual one over many years, with many trans adolescents being much more able to enter into these discussions once the acute fear of pubertal development has subsided because of blocker treatment…..
25. ‘and they can take more time to consider the next stages. Fertility preservation in patients that are assigned female at birth can take place while they are on treatment…..
26. ‘and that full discussion can happen at any time before gender-affirming hormones start, or even when they are established on testosterone treatment...
27. ‘Equally, when patients present desperate for gender-affirming hormones, it can be difficult to have meaningful discussions about long term decisions.
28. ‘In my experience I have known many people start hormones which relieve their acute distress and dysphoria and then they later temporarily stop hormones to either store gametes or even to conceive.’
29. These are my reflections on the findings of fact that I gave to the tribunal…..
30. ‘Fertility is a hugely important consideration, which is shown by the email that I sent the mother of Patient C because I had forgotten to discuss it during the consultation….
31. ‘and I answered the further questions that she had. It is vital to have ongoing discussions regarding this. This discussion should be an ongoing, lifelong consideration.’
32. And I gave them some evidence of my CPD on fertility as this is important for insight and remediation. In 2020 I published a paper on fertility preservation for trans people….
33. ‘The study found that financial barriers mean many transgender and gender-diverse people cannot access fertility healthcare. Many participants suffered low self-esteem and struggled to envisage an accepting healthcare system, making them less likely to seek advice….
34. ‘Many patients favored adoption over gamete storage. Younger patients (<18) often had very definite views on gamete storage. Many older patients without children would consider gamete storage and adoption, once their transition is complete.’
35. Tribunal finding: ‘Nevertheless, the Tribunal did not consider that Dr Webberley has developed sufficient understanding as to the significance of how she failed Patient C in regard to discussing fertility, and as to how she can be sure that this will not be repeated…..
36. ‘It therefore determined that her fitness to practise is impaired by reason of her misconduct in failing to discuss the risks to Patient C’s fertility with him on public protection grounds…..
37. ‘Notwithstanding these points, which the Tribunal consider diminish the seriousness of the finding of impairment, the Tribunal found serious misconduct and that Dr Webberley’s fitness to practise is impaired by her lack of insight...
38. ‘In the Tribunal’s view that finding means that it would not be appropriate to close this case with no action…..
39. ‘Dr Webberley needs to demonstrate to a Medical Practitioner’s Tribunal that she has developed the necessary insight and remediation to enable it to conclude that there is no risk of repetition….
40. ‘The Tribunal, therefore, finds that a suspension order on Dr Webberley’s registration to address the impairment found on public protection grounds arising from paragraph 5(d)(iii) of the Allegation is the appropriate sanction in this case.’
41. Point of fact: What is serious professional misconduct? ‘Serious professional misconduct is an act or omission falling short of conduct properly to be expected of a doctor as established by the rules and standards ordinarily to be expected…..
42. ‘No doctor of reasonable skill exercising ordinary reasonable skill as a professional man would do this. Alec Samuels medico-legal journal 2005’
43. So I am considering my options. It is an overall huge win when you think about the horrible accusations the NHS doctors initially made about me, but it still irks. I am not the one who is a risk to patient safety!
44. If I appeal I will be suspended for a year or more and it will be costly in money, time and emotion. If I don’t appeal then I accept my conduct was serious enough to warrant all of this investigation and the hardship I have faced over the last 5+ years.
45. Will I ever be able to be a doctor again, I doubt it. But I will continue to fight for justice, for you and for me. Thanks you all for holding my hand along the way. 🏳️⚧️💜🏳️⚧️
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