Friday 12 July 2024, the High Court is asked to judically review the ban by the former Health Minister’s on the prescription and dispensing of puberty blockers to transgender adolescents that was implemented on 29 May 2024.
In written submissions, it was said that Atkinson “proceeded without taking clinical or other scientific advice on those views and overruled officials who had wanted wider consultation”.
Medical experts start in Medical School. They undergo comprehensive training to acquire the knowledge, skills, and professional attitudes necessary to become competent and compassionate doctors. By the end of Medical School, these doctors of the future have a good idea of what area of medicine interests them and where their skills are best suited.
After Medical School, the newly qualified doctors enter training posts to teach them the fundamentals, they shadow more senior doctors and provide supervised care to patients, every day learning something new.
After the initial training jobs the junior doctors move into more specialist posts to focus on their career pathway. Some will be A&E doctors, some surgeons, some will be GPs, and some paediatricians - a wide variety of specialties to suit all types of doctor and all types of patient needs.
This is how a doctor should learn how to be a specialist in the care of transgender children and adolescents. This is how a doctor becomes the expert that Victoria Atkinson should have consulted before making her apparently rash, seemingly single-handed, decision.
Where are our experts? What training and education would they have had? What qualifications, what courses, what exams, who would have trained them?
And here lies the problem in the UK. There is no formal training in UK medical schools about how to provide medical care to transgender people. I don’t mean ‘use these pronouns’, and ‘be respectful’, I mean ‘how do you manage someone with gender dysphoria and how do you safely manipulate their hormones?’ How do you meet the needs of your patients who are transgender?
There is no medical school formal training and there are no postgraduate training courses, no hospital training posts and no formal qualifications.
While surgeons have to sit and pass the MRCS, physicians take the MRCP, general practitioners have to have the MRCGP to practise in the UK, paediatricians take the MRCPH.
The Royal College of Paediatrics and Child Health website states that their membership exam is an essential component of training for paediatricians in the UK which is approved by the General Medical Council (GMC) as meeting the required standards. But the curriculum does not include the standards required for the management of paediatric transgender patients.
The syllabus for paediatricians specialising in endocrinology covers these aspects of puberty:
The management of puberty suppression in transgender children, as advocated for by gender experts across the world, is missing.
With approximately 7,600 young people on the waiting list and no specialised training for doctors to manage this patient cohort, how can we justify excluding this group from necessary care?
The General Medical Council, ‘We have a duty to make sure medical education and training in the UK is of a high standard. We provide approval and quality assurance for postgraduate training. We also have a responsibility to make sure undergraduate education meets our standards.’
And that is why we are in such a mess in the UK, with no experts to call upon. If you don’t create experts you can’t call on them to assist, and decisions get made by non experts, and look at the damage that follows.
The lack of training and experience was noted by the World Professional Association of Transgender Health when they made an official statement following the publication of the Final Report of the Cass Review:
‘Hillary Cass is a paediatrician with hardly any clinical experience or expertise in providing transgender healthcare for young people. Furthermore, Hillary Cass lacks significant research qualifications or research expertise in transgender health.’
Dr Helen Webberley is a UK doctor and founder of GenderGP. She advocates for accessible, gender-affirming care and works to improve education and support for trans healthcare worldwide.
