A retired gastroenterologist wrongly prescribed sex-change treatments to seven transgender patients, one of which was just nine years old, a tribunal has heard.
Dr Michael Webberley provided puberty blockers and hormones via GenderGP, an online gender clinic which he ran with his wife and fellow GP, Dr Helen Webberley.
A Medical Practitioners Tribunal Service (MPTS) panel found him guilty of various charges after he was accused of failing to provide good clinical care to seven patients between February 2017 and June 2019.
In a number of cases, he had attended to patients after restrictions had been placed on his wifes practice.
But several doctors raised concerns about his treatment with the General Medical Council (GMC) and he was later suspended.
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.
It also ruled that he failed to adhere to a recognised training pathway in transgender medicine and to obtain consent for treatments.
Dr Webberley also neglected to establish an adequate multi-disciplinary team and had reached diagnoses of gender dysphoria, the condition of feeling one's psychological and emotional identity to be at variance with one's birth sex, based on inadequate assessments.
The tribunal heard about one instance involving a nine-year-old patient who had been born a female but identified as a boy.
Dr Webberley diagnosed the patient with 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.
A 17-year-patient was transitioning from female to male and first contacted Dr Webberley in June 2018.
The patient had become unhappy at the long waiting lists for NHS treatment.
Dr Webberley diagnosed the patient with gender dysphoria without checking information with their GP.
The tribunal also found that he prescribed testosterone when it was not clinically indicated and without establishing whether the benefits of taking the hormone outweighed the risks to the patients mental and physical health.
The patient had been diagnosed with Aspergers Syndrome and had complex and long-standing mental health issues but it did not appear that Dr Webberley was aware of them as he had failed to obtain the patients medical records, the tribunal concluded.
The patient took their own life just three months later.
Dr Webberley, who had 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.
In summary, the tribunal found that on no occasion had Dr Webberley disagreed with the 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 Webberleys apparent intention was to prescribe according to the patients wishes, he said.
There was a pattern of substandard care which underlined Dr Webberleys 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.
The tribunal will now decide if Dr Webberleys fitness to practice has been impaired and, if so, what sanctions he will face.
GenderGP have been contacted for comment.
In April, an MPTS tribunal cleared Dr Webberly's 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.
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