It seems David Batty, Guardian “journalist”, has come out of his self-imposed retirement on writing about Trans issues to produce a rather obviously spun story on Doctor Richard Curtis, a private doctor who practices in London.

For those not aware of the history, David Batty has a history of attacking anyone or anything involve in Trans healthcare, including articles about Russel Reid’s GMC hearing, a matter that is now regarded by much of the community as a witch-hunt against him by other doctors. I don’t have many details of the latest complaint beyond what was in the Guardian article, but it has been confirmed that one of the complainants is Dr Barrett. Yes, the same Dr. Barrett who was involved in the complaint against Russell Reid many years ago.

So with that background, let’s have a look at today’s article. Here’s what he’s detailed the complaints as, and I’ll deal with them point by point with reference to the WPATH Standards of Care (PDF Link) .

Commencing hormone treatment in complex cases without referring the patient for a second opinion or before they had undergone counselling

There is no requirement for a second opinion or counseling prior to prescribing hormones, despite the attempt to insinuate that there is. The requirements are persistent gender dysphoria, capacity to give informed consent, being an adult (Kids have different rules) and other medical or mental concerns being “reasonably well-controlled.” (Page 104)

Administering hormone treatment at patients’ first appointments

See the above list of requirements for HRT. There is no reason not to prescribe hormones if the persistent gender dysphoria is well documented. (For example, the patient may already have transitioned, may have seen other doctors before going private or may have been on NHS waiting lists for an extended period of time)

Referring patients for surgery before they had lived in their desired gender role for a year, as international guidelines recommend

This is routine, as for transwomen genital electrolysis (Hair removal) cannot be rushed due to the growth cycle of hair, meaning some months of advanced planning is needed. The international guidelines (I.e. the WPATH SoC) state you cannot have surgery prior to the 12 month point (Pages 105-106) but make no mention of referrals.

I am assuming this is referring to genital surgery. For top surgery (Either breast enlargement or removal, depending on which way someone is transitioning) the requirements are less strict. (Page 105)

With one patient allegedly undergoing surgery within 12 months of their first appointment

There is no minimum treatment period, only a minimum period of documented real life experience which does not need to be under the care of a doctor. If there was a violation, why isn’t the surgeon concerned also be under investigation by the GMC, or the doctor who issued the second required signature for surgery?

He is also accused of administering hormones to patients aged under 18 without an adequate assessment

There is also a later reference to referring to prescribing at 16 and probably the point of greatest concern, but it’s not clear where the cutoff between adolescent and adult care begins. In terms of the WPATH SoC, it simply states the “age of majority in the country concerned” as being the cutoff between adolescent and adult provisions. The is no clear age of majority in the UK, and even the General Medical Council’s own guidance isn’t clear if it’s at 16 or 18 (Or younger) for medical purposes.

Finally…

Wrongly stating that a patient seeking gender reassignment had changed their name.

If we’re having to drag what sounds like an administrative error (And this happens more often in the NHS than private practice) then we’re really grasping at straws.

He goes on:

One of the most serious cases concerns a female patient who regrets switching to a male role. She underwent hormone treatment and had her breasts removed. The woman is one of the complainants in the current GMC investigation.

There’s nothing in here to suggest malpractice. Just a statement that someone regretted transition. Of course, there are those who will be horrified that someone had their “breasts removed” and no doubt this paragraph is designed to stoke the emotions of such readers.

Of course, Batty knows what is and isn’t acceptable and is no doubt aware of these holes in his character assassination of Dr. Curtis. He’s been after us for long enough and knows about the WPATH Standards of Care. He even quotes them later on in the article, despite the fact they indicate many of the “complaints” he lists are not themselves malpractice but rather a list of potentially routine tems that those with no knowledge of the topic might see and an example of why Trans healthcare, either NHS or Private, is fundamentally Evil.

Is all this noise significant? At this stage we don’t know. Even Batty may not know, because I’m sure if he had hard examples of WPATH SoC guidelines, he would have published them with glee. A sentence later on in the article revels that the council still have to even decide “if there is a case to answer” so really we just don’t know yet.

Whatever happens, there needs to be a mechanism for resolving what is acceptable care that does not jeopardize careers, reinforce outdated and harmful practice, facilitate witch hunts and damage access to healthcare for the whole Trans community.