Sonia Appleby, 62, claims her bosses' actions left her unable to fulfil her role as a Named Professional for Safeguarding Children at Tavistock and Portman NHS Centre
A whistleblower is suing the NHS's only children's gender clinic for allegedly ostracising her after she raised concerns over a private doctor who was providing puberty blockers to under-16s.
Sonia Appleby, 62, claims her bosses' actions left her unable to fulfil her role as a Named Professional for Safeguarding Children at Tavistock and Portman NHS Centre.
She said that in 2016 she began to have a 'drizzle, then a trickle, then a stream' of concerned staffers at the trust and beyond complaining about Dr Helen Webberley, who runs the private practice Gender GP from abroad.
In late 2017, the General Medical Council temporarily stopped Dr Webberley from working as a doctor in Britain while they conducted an investigation into a string of complaints around her work with trans patients, which came from doctors working within the NHS Gender Identity Clinics.
The accusations were that she was failing to follow the approach favoured by NHS doctors, which she says is a model criticised time and again 'for being overly restrictive and even discriminatory to trans individuals'.
Ms Appleby today told a remote tribunal hearing some clinicians had been worried about the work of Dr Webberley, who was 'prescribing puberty-blocking drugs in ethically dubious practices to Gender Identity Disorder Service (GIDS) users'.
She added: 'Dr Webberley was a private GP who was prescribing puberty blockers and also to the best of my knowledge cross-sex hormones to patients at GIDS - these were children who were identified as being on the waiting list.'
Ms Appleby, who is still employed by the trust, said she raised concerns with children's mental health services, GPs, and parents to remove their patients from Dr Webberley's care.
She said she was ostracised by NHS bosses after she raised health and safety concerns about the use of puberty blockers in October 2017, and claims staff were told she had an 'agenda'.
The employment tribunal is unusual in that the complainant is still working for the trust
In her witness statement to the tribunal, Ms Appleby said: 'The problem for GIDS was that some children and young service users were turning to Dr Webberley whilst under GIDS care, but clinicians did not have a procedural reference as to how to manage private clinicians prescribing in such circumstances.
'This was an immediate and alarming safeguarding risk and should have been dealt with immediately but was not.'
She added while giving live evidence via videolink: 'This was not the first time I cared about what the Gender Identity Disorder Service was doing.
'I was supporting their services and I was supporting staff in relation to their safeguarding concerns.
'Staff were highlighting a particular problem, Dr Webberley, and it seemed to me there was a problem for staff to think about. This was a problem that was predictable given the services provided by GIDS.
'At first it was a drizzle, and then it became much of a trickle, and then a stream of people concerned about Dr Webberley.'
She also said she raised concerns with the General Medical Council about Dr Webberley because she felt there was an absence of safeguarding processes from the carer.
Ms Appleby said that in 2016 she began to have a 'drizzle, then a trickle, then a stream' of concerned staffers at the trust and beyond complaining about Dr Helen Webberley (pictured), who runs the private practice Gender GP from abroad
The social worker said she also 'commended' the joint referral by GIDS and University College London Hospitals NHS Foundation Trust to the GMC about the doctor.
Ms Appleby said: 'One of the huge challenges in this field is the lack of safeguarding procedures to help us with these matters.
'What we can do is we can appropriately alert other agencies who have more immediate contact with the child.
'I do believe concerns were raised with the [General Medical Council] about Dr Webberley if she was in fact giving out prescriptions ''off-licence'', as it were.'
Yvette Genn, representing the trust, said: 'But if they're going to a private provider, it's not in your control.'
Ms Appleby admitted that she had waited to approach the director of the service, Dr Polly Carmichael, which she says led to accusations she had an 'agenda' against the service.
Yvette Genn, for the trust, said: 'What I'm suggesting to you is that if this is accurate and correct then you ought to have in pursuance of your obligations according to your job description gone to work with the service at a much earlier stage if this is true?'
Ms Appleby responded: 'It was an accumulating problem so in 2016 I was less bothered about it than I was in May 2017. When I was less bothered, there were limited numbers and the appropriate safeguarding actions were undertaken.
'What I was doing in 2017 with my line manager was actually trying to enable the service to adopt a strategic solution to the problem that needed to be remedied.'
Emails about the trust director's concerns that Ms Appleby had an 'agenda' against the service, which had no response from the safeguarding worker, were also raised at the tribunal.
Ms Appleby said: 'I wouldn't have deliberately not responded to Polly. [My line manager] responded, and said there isn't an agenda. There was nothing to be anxious about as we were trying to assure ourselves as safeguarding leads.
'I was concerned that she was confused that there was an agenda.
'In recent times, agenda has taken the form of a particular idiom. It's a kind of name-calling. You will hear the word agenda a lot in these proceedings.
'More than several years later, the agenda has taken on a kind of name-calling.
'At the time I was concerned Polly seemed to be possibly upset, confused as she said, but now four years later I think that having an agenda has a particular resonance. From my own experiences, it's not a helpful word.'
The tribunal also heard that despite working part-time, Ms Appleby did not raise these concerns with other safeguarding leads.
Ms Appleby admitted: 'I wouldn't call it a dereliction. I do accept I did not make an appointment [with Garry Richardson] in October which is a natural point when I should have followed it up.'
While there is a lack of long-term data, the Endocrine Society said puberty blocking drugs stunting growth was a myth after finding hormone treatment to halt puberty in adolescents with gender identity disorder does not cause lasting harm to their bones.
Professor Simona Giordano, director of medical ethics at the University of Manchester, has also said there is nothing unethical about puberty blockers.
She said in a previously published scientific paper: 'There is nothing unethical with interfering with spontaneous development when spontaneous development causes great harm to the child.
'Indeed, it is unethical to let children suffer, when their suffering can be alleviated.'
The employment tribunal continues.
Why did the NHS let me change sex? Keira Bell tells her story in the hope that it will 'serve as a warning to others'
IT engineer Miss Bell is pictured outside the Royal Courts of Justice in London
In an interview earlier this year, Keira told the Daily Mail what happened to her, in order to highlight her plight and, she says, serve as a warning to others.
Keira was brought up in Hertfordshire, with two younger sisters, by her single mother, as her parents had divorced. Her father, who served in the U.S. military in Britain and has since settled here, lived a few miles away.
She was always a tomboy, she said. She did not like wearing skirts, and can still vividly remember two occasions when she was forced by her family to go out in a dress.
She told the Daily Mail: 'At 14, I was pitched a question by my mother, about me being such a tomboy. She asked me if I was a lesbian, so I said no. She asked me if I wanted to be a boy and I said no, too.'
But the question set Keira thinking that she might be what was then called transsexual, and today is known as transgender.
'The idea was disgusting to me,' she tells me. 'Wanting to change sex was not glorified as it is now. It was still relatively unknown. Yet the idea stuck in my mind and it didn't go away.'
Keira's road to the invasive treatment she blames for blighting her life, began after she started to persistently play truant at school. An odd one out, she insisted on wearing trousers — most female pupils there chose skirts — and rarely had friends of either sex.
When she continually refused to turn up at class as a result of bullying, she was referred to a therapist.
She told him of her thoughts that she wanted to be a boy.
Very soon, she was referred to her local doctor who, in turn, sent her to the child and adolescent mental health service (CAMHS) near her home. From there, because of her belief that she was born in the wrong body, she was given treatment at the Tavistock
Keira had entered puberty and her periods had begun. 'The Tavistock gave me hormone blockers to stop my female development. It was like turning off a tap,' she says.
'I had symptoms similar to the menopause when a woman's hormones drop. I had hot flushes, I found it difficult to sleep, my sex drive disappeared. I was given calcium tablets because my bones weakened.'
Keira claims she was not warned by the Tavistock therapists of the dreadful symptoms ahead.
Her breasts, which she had been binding with a cloth she bought from a transgender internet site, did not instantly disappear. 'I was in nowhere land,' she says.
Yet back she went to the Tavistock, where tests were run to see if she was ready for the next stage of her treatment after nearly a year on blockers.
A few months later, she noticed the first wispy hairs growing on her chin. At last something was happening. Keira was pleased.
She was referred to the Gender Identity Clinic in West London, which treats adults planning to change sex.
After getting two 'opinions' from experts there, she was sent to a hospital in Brighton, East Sussex, for a double mastectomy, aged 20.
By now, she had a full beard, her sex drive returned, and her voice was deep.
After her breasts were removed, she began to have doubts about becoming a boy.
Despite her doubts, she pressed on. She changed her name and sex on her driving licence and birth certificate, calling herself Quincy (after musician Quincy Jones) as she liked the sound of it. She also altered her name by deed poll, and got a government-authorised Gender Recognition Certificate making her officially male.
In January last year, soon after her 22nd birthday, she had her final testosterone injection.
But, after years of having hormones pumped into your body, the clock is not easily turned back. It is true that her periods returned and she slowly began to regain a more feminine figure around her hips. Yet her beard still grows.
'I don't know if I will ever really look like a woman again,' she said. 'I feel I was a guinea pig at the Tavistock, and I don't think anyone knows what will happen to my body in the future.'
Even the question of whether she will be able to have children is in doubt.
She has started buying women's clothes and using female toilets again, but says: 'I worry about it every time in case women think I am a man. I get nervous. I have short hair but I am growing it and, perhaps, that will make a difference.'
By law she is male, and she faces the bureaucratic nightmare of changing official paperwork back to say she is female.