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GMC Verdict - The Movie - Sarah, The Bringer of Tea
25th May, 2007
06:25 pm

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GMC Verdict - The Movie
You know those courtroom drama films? The ones where the bad guys have brought a case against a plucky hero. The evidence is played out, and the bad guys pretty much twirl their moustaches in the court room, but their lawyer yells "Objection! My client is not the one on trial here!" whenever it's pointed out. Our hero is basically a good guy, but the letter of the law has him, and the law is the law. It's all looking bleak...

And then the verdict is in, and the judge stands up and does something truly amazing, and hands down a verdict worthy of Solomon. It satisfies the legal stuff, in theory handing victory to the moustache-twirling bad guys, but it's a hollow one because they get no advantage from it. Instead all they have done is air their dirty laundry in public and open themselves to scrutiny. Meanwhile the defendant gets a sentence that satisfies the need to have justice "be seen to be done", but actually results in them walking away smelling of roses. The camera pans out over crowds of cheering little-people, for it is they who have really won, and the credits roll.

That only happens in films - it's not real.

Only it is real. It happened today at the GMC, and I had the privilege to be a part of it.

I arrived nice and early, and took up my favourite seat. It faces the doors by the lift lobby and allows me to see who comes in and out, as well as the lawyers and their clients going to and fro. It affords me an excellent opportunity to people-watch.

Everything got off to a slow start, as the usual suspects arrived - Mr Tyson (prosecution), Mr Hopkins (defence), Russell (the good doctor) and this time, for the verdict, Professor Green and Doctor Barrett of Charing Cross GIC (dark lords of the Sith). The latter two used their privilege as complainants to scurry away to consult with Mr Tyson in private, which handily avoided them having to share a room with the scary trannies.

Others for the public gallery turned up. In addition to some familiar trans-faces from the long weeks of evidence, reiko_j and zoeimogen too, one Charles Kane arrived, as did a number of people from the press association, and the BBC. David Batty of the Guardian, who has shown such a keen interest in tabloid-style reporting on this case, apparently couldn't be bothered to turn up.

For a little while, Charles Kane held off talking to us, and I don't think any of us were quite sure what to make of him. After a bit we did get talking though, and I must say that I'm a lot more sympathetic to him having met him in person than I was after watching the TV documentary about him, which I don't think portrayed him terribly kindly. It seems he's suffered quite a lot of indignity at the hands of Charing Cross during his "second transition", and is now on good terms with Russell again - they shook hands when Russell came in, and Charles had even wanted to speak in Russell's defence as a character witness.

One of the press women came over and talked about an interview with Charles Kane. I think they'd already arranged it before. She then turned to where the group of us were sitting and asked if any of us would mind talking to them afterwards. We were all decidedly cautious. Firstly, we wanted to know who she represented, and she said she was from the press association - they would syndicate their reporting. Approval that she wasn't from The Guardian was generally voiced, and some of us, myself included, said we may be willing to talk to them afterwards depending on what happens, but we wouldn't do it on camera and didn't want our names to be used. I know this violates Sarah's rule zero - "Don't talk to the media ever", but this did seem like a good time to make an exception, especially if, as we feared, Russell was going to be found guilty (if they were going to acquit, they'd have probably done it on Thursday because they wouldn't have had to spend time deciding on a penalty and reading through the evidence presented in mitigation).

The panel came through, with best poker faces on, and nobody seemed to know how which way things were going to go. The minutes ticked by in the waiting room until a 10:00 start failed to materialise. The panel came out at 11:15, apparently after finishing what they had been doing, and we were informed that things would begin at 11:30.

We were all ushered in to the public gallery, and without further ado the chair of the panel started to read the verdict. This started off with a rather telling few titbits - this panel has, all the way through, been very precise with words, and there's much to be gleaned in what they don't say too. The "smart money" this week seems to have been on the verdict concentrating on communication between Dr Reid and GPs, and early indications were that this was exactly what was going to happen. The chair, Mr Shaw read from their prepared material (added emphasis mine)

In reaching its decisions, the Panel wishes to make it clear that it has not sought to adjudicate on the merits or otherwise of the Harry Benjamin International Gender Dysphoria Association guidelines or the adequacy or otherwise of NHS treatment of transsexuals. It has considered your practice with reference to the standards set out on good medical practice published by the GMC

At this point, I started to feel suddenly very positive. Given the length of time they were deliberating, I'd more or less resigned myself to them finding him guilty, but was hoping that they'd do it on the basis of how he ran the logistics of his private practice with respect to dealing with patients' GPs, and not seek to rule on how a world renowned expert in the field should actually approach treating transsexuals. Right at the start, there it was - about as big a hint as possible that this was exactly what was going on.

The Charing Cross duo, sat in front of us seemed to realise this too. The arrogant body language we'd seen from Richard Green on Tuesday was not in evidence. He and James Barrett (who I recognised from his photograph) sat there looking a bit cowed. I started to dare to hope, and perhaps even to smell blood.

Furthermore, the bit I highlighted in bold, about the adequacy or otherwise of NHS treatment seemed to be a key phrase. Coupled with the way the questioning of the character witnesses had gone on Tuesday and Wednesday, and the way the lay member of the panel, Mrs Golding, had managed to ask the awkward questions that the complainants almost certainly didn't want asked throughout the long weeks of the proceedings, it was obvious which way the wind was blowing. There was a message being sent out to Professor Green and Dr Barrett, sat facing the panel - We know about you; you are on notice.

I kept looking at them through the next few minutes - they seemed to be occupying less and less physical space as time went on.

Mr Shaw continued - he read the salient bits of the findings of fact, which those members of the press hostile to Dr Reid seem to have fixated on. However, this ended in summary with the nub of what the GMC panel considered to be the problem:

The panel considers that the seriousness of your misconduct lies in your lack of caution in initiating hormonal and surgical gender reassignment in these patients without more careful and thorough investigation and assessment.

In other words, he didn't dot enough i's, or cross enough t's.

He then stated that the panel had found Russell guilty of serious professional misconduct. After the build-up to this point, this didn't really surprise any of us. The part we were all waiting for had arrived - what were they going to do about it?

They started out by saying that they didn't think no action was appropriate. That's fair enough - if justice is not "seen to be done", then the whole business could be portrayed as a "whitewash". The point at which we knew it was all-over for the complainants was when the following was said:

In all the circumstances, the Panel does not think it would be in the public interest to deprive the community of an experienced and otherwise well respected doctor.

The Charing Cross doctors wanted him silenced and banned from practising in the field of gender identity. They said so, via Mr Tyson, their barrister, on Tuesday. It was now obvious that they were going away empty handed. A sense of triumph started to spread through the public gallery at this point.

There then followed a list of conditions which Russell must operate under for 12 months, after which they would be subject to review. Essentially, he has to notify the GMC of any new job he gets. He has to work in an NHS hospital, of GMC-approved clinic (that's probably not as onerous as it sounds - Russell certainly didn't seem to be a problem when we discussed it later). There were some restrictions on practice - he's not allowed to prescribe hormones on the first appointment and without "independent verification of the patient's history of gender dysphoria", and "before communicating with the patient's GP", but there's a getout clause - he has to justify any departures.

The remaining conditions were simply about documentation requirements - keeping logs of gender dysphoria patients.

There was one more crucial part of the ruling - it was stated that patients B, E and F, who had remained in role after transitioning, had not suffered harm. I suspect one or more of them was hoping to come out of this with a ruling that they could use in legal action against Russell. This may well have protected him against that.

And then it was all over. We all started back to reception, in order to raid the coffee machine before anyone else got to it. Russell went off to talk to Mr Hopkins for a debriefing, and I suppose Barrett and Green did the same with Mr Tyson. They were the first to come out - we spotted them walking down the corridor toward us, looking slightly broken and deflated. They opened the door and tried to repeat Richard Green's trick of Tuesday of slinking out without making eye contact with any of us. This time I was a little more prepared, and as they slunk round to the lifts, trying to avoid the crowd of somewhat exuberant transwomen, I seized my chance, and sang out, loudly so they definitely heard, "Poor lambs - they didn't get anything they wanted!"

They moved over to the lift and waited - the door to the lift lobby was propped open. I continued:

"Bye bye! Mind how you go now! Hope to see you back here again soon!"

There was no response - they more or less fled the scene. Two lords of their domain, used to telling people like us exactly how it was going to be, and exerting control over our lives, sent packing with their tails between their legs by a bunch of transwomen over whom they had precisely zero power. Damn, that felt really good!

Russell came back out, and after exchanging congratulations we all set off for a nearby eatery for a coffee, him leaving the building flanked by supporters. The media were waiting outside, and there's a picture on David Batty's story (remember he wasn't there). zoeimogen and reiko_j are in it, but I managed to avoid appearing in it, being out of frame to the left, talking with the woman from the Press Association.

As Russell set off, a few of us stayed back to give the press a few very carefully chosen quotes. Different outlets will choose which bits of this story they use, but Chanel 4 News have one report which includes the snippet:

One transsexual woman, who did not wish to be named, said: "We can't afford to lose Dr Reid. If he had been stopped from practising, people would have died."

If I remember correctly, that's not entirely accurate, but it was close. I know because the "transsexual woman, who did not wish to be named" was me.

My take on this whole affair is this: The complainants thought they could use their own regulatory body to settle a personal score. By airing their dirty laundry in public like this, they have done nobody any favours, and do themselves no credit. They expected the GMC panel to do their dirty work for them, and rubber stamp what they wanted. This was arrogant - they assumed the GMC could be cowed as easily as the desperate people who are referred to them, but the panel had other ideas - they took their job seriously and did it to the letter. The GMC panel wasn't on the side of Dr Reid, but they weren't on the side of the Charing Cross doctors either. They were on the side they were supposed to be on - ours, the patients' side.

I managed to catch Mr Shaw and Mrs Golding after the hearing was over, and thank them both for the professional way they handled this hearing. They did what they needed to do in order for justice to be seen to be done, but they also did what was right for the public, and for transsexual people. At a stroke they seem to have diffused this situation and set the scene for Dr Reid to return to practice in the not too distant future, where once again he can do what he does best. They've also put the Charing Cross regime on notice that they don't have carte-blanche to treat transpeople however they wish, and perhaps destroyed a little bit of the veneer of invulnerability they like to project. By their own action they;ve introduced a whole generation of transpeople to the concept that the GMC can, and will act on our behalf, and do what's right by us. I do hope Dr Barrett didn't have any patients this afternoon - he was probably in a lousy mood.

[the Panel] determined that it would be ... in the public interest as well as your own interests if you were to return to practice...

Judging by the mood Russell was in when we parted company, I don't think that day is all that far away.

(64 comments | Leave a comment)

Comments
 
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From:nobmouse
Date:25th May, 2007 07:22 pm (UTC)
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While I've yet to read a full transcript of the decision (I'm going to write to the GMC for a copy if it doesn't turn up in one of the law journals) it does seem that Dr Reid has had a slap on the wrist while Charring Cross, as predicted, now find their days numbered.

Witness statements from this case can, and probably will, be used in evidence against them when someone brings a case against them - and I'm sure there will be one soon enough.
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From:auntysarah
Date:25th May, 2007 07:23 pm (UTC)
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PDF here.
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From:sebastienne
Date:25th May, 2007 10:24 pm (UTC)
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gods, but i do feel like i'm watching something big happening.

thanks, as ever, for the fascinating read!
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From:auntysarah
Date:27th May, 2007 07:20 am (UTC)
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You're welcome!
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From:julieisfree
Date:25th May, 2007 11:28 pm (UTC)
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Nicely reported Sarah! Thank you for your follow up. It's encouraging when things work out properly. Score one for the good 'guys'
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From:auntysarah
Date:27th May, 2007 07:23 am (UTC)
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I think this is pivotal - the complainants clearly wanted a ruling on the applicability of the HBIGDA Standards of Care, and an "endorsement" of their approach to treating GID, and didn't get one. This is an important and defining moment for GID treatment in the UK - the approach pioneered by Russell has been tested in a court, and has mostly held water.
From:radio_brigit
Date:26th May, 2007 01:33 am (UTC)
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thanks sarah ,
i enjoyed reading your account ,
i really hope those fuckers are on notice ,
i look forward to the day when the're on the stand ,
under scrutiny ...
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From:auntysarah
Date:27th May, 2007 07:24 am (UTC)
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Some people clearly get through the CX system and come out the other side fine, but I've seen too many people get damaged by them, when it was totally unnecessary. Terry Reed said it best in her evidence - they're neglectful.
From:thursdaily
Date:26th May, 2007 01:35 am (UTC)
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Not that David Batty's absence meant that he didn't file a story anyway. Which, of course, demonstrates the impeccable accuracy, honesty, impartiality and lack of bias for which he is renowned.
From:thursdaily
Date:26th May, 2007 01:35 am (UTC)
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PS: nice picture of zoeimogen, though
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From:darwinian_woman
Date:26th May, 2007 05:57 am (UTC)
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*is hopeful*

Thank you for bringing us the coverage you have of this, Sarah - when I saw the BBC news article ("Sex change doctor found guilty"), my stomach turned - but your post has put things in their proper context, and has really made my day :)
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From:auntysarah
Date:27th May, 2007 07:26 am (UTC)
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Happy to have helped!
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From:kasumi_astra
Date:26th May, 2007 07:42 am (UTC)
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Thank you very much for the wonderful report! I'm rather surprised that the CX doctors seemed pleased in the Guardian report - it seems to show that it's all a PR game that is lost or won. That makes me feel quite angry.

I can't contribute to the CX investigation, although I wish I could- I've never been. I'm considering complaining about the waiting times at the Porter Broook clinic in Sheffield. I'm determined to pitch in to exposing the deep flaws in the service, and the injustice facing trans people today.

Here's to the next three years - here's hoping we can return the favour to Charing Cross :-)
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From:auntysarah
Date:26th May, 2007 08:54 am (UTC)
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Thank you very much for the wonderful report! I'm rather surprised that the CX doctors seemed pleased in the Guardian report - it seems to show that it's all a PR game that is lost or won. That makes me feel quite angry.

The media were waiting outside on Euston Road waiting to ambush anyone coming out. I guess it was a last ditch effort by Barrett to make it look like they got something out of this. In reality all they got was a headline - "Sex Change Doctor Found Guilty". They just don't say what he was found guilty of, which was essentially not doing the paperwork properly. That should scare them more than anything - their admin is notoriously atrocious.
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From:auntysarah
Date:27th May, 2007 07:32 am (UTC)
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*hug* You're welcome hon.

I'm still waiting my initial referral to CX from Oxfordshire PCT based on my initial clinical psych assessment in Aug 2005

If you ever get one, are you going to go along for the laugh?

I still struggle to see how this condition (at least from an MTF pov) can be so seriously mis-diagnosed, there are so many things we have to face that would/should stop people going down the wrong path, from regular reviews , the (intitally reversible) effects of hormones, the social aspects...I struggle to see, in the UK at least, how the "Transvestite gone too far" situation can happen.

I think some people treat the RLE as a bit of a joke. When they end up finding themselves postop, with no preparation, I guess there's a potential for things to go quite badly wrong, psychologically.
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From:minnesattva
Date:26th May, 2007 10:03 am (UTC)
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That's fantastic. Thanks for documenting all of this for us, One Transsexual Woman. :-)
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From:auntysarah
Date:27th May, 2007 07:33 am (UTC)
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You're more than welcome! :-)
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From:gerald_duck
Date:26th May, 2007 10:20 am (UTC)
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I know of the GMC from doctors' perspectives; I've seen some of their previous judgments; they've always struck me as being at least as fair-minded as any court.

From what I knew of this case it had always struck me as being in essence a technical violation by a very good doctor in a small proportion of cases, the complaint being brought by mean-spirited rivals. Malpractice is most emphatically not Dr Reid's general character. Thus, his being found guilty but slapped on the hand as lightly as circumstances allowed seemed to me the likely outcome.

I'm relieved I'm right. I'm also relieved I didn't jinx things by stating this expectation before the fact. Maybe I should have put it in a sealed envelope or something. (-8
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From:auntysarah
Date:27th May, 2007 07:35 am (UTC)
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I know of the GMC from doctors' perspectives; I've seen some of their previous judgments; they've always struck me as being at least as fair-minded as any court.

There are a few things that happened in there which I don't think it's appropriate to write about here which go further to confirm just how much the panel did have the interests of the patients at heart, and unlike Batty, this included the thousands of us whose lives were saved by our transition, and not just the half dozen "usual suspect" regretters.
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From:pinkdormouse
Date:26th May, 2007 11:40 am (UTC)
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Excellent news. Thanks for reporting more details than anywhere else I've seen.
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From:auntysarah
Date:27th May, 2007 07:36 am (UTC)
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I guess it kept me off the street, turning up for the drawn out procedural bits as well as the couple of juicy moments that the meeja bothered turning up for.
From:madcyclistuk
Date:26th May, 2007 12:33 pm (UTC)

RR case reporting

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Many thanks for doing these journals and to the Transmen who have fed the links to your journals through FTM-UK, an online Transman group of over 350 members.

Until then, most of the info I had came from the media, with the occasional supplements from Andy Levy who was sadly excluded from giving testimony in Russell's favour.

I'm not a great fan of Russell's, which he knows, as he as he and I clashed in 1997 as I was concerned that he was putting people through the system too quickly, without adequate checks. Sound familiar?!? ;-D
He was also working with Fran Springfield who had a "reputation" shall we say...

However, even though I still feel the same way I have been offering support to Russell's case both directly, and via Andy Levy, as I felt if he were to lose this case, the repercussions for Trans treatment in the UK would be devestating.

I think you've confirmed that this case can only be described at best as a hollow victory for Charing Cross and their acolytes and I hope that they FINALLY realise that their ultra-conservative, sausage factory type treatment is no longer compatible with the modern day care of Transfolk.

I know the fear of repercussions from Charing Cross practitioners has concerned both their patients and other, more liberal practitioners in the field, and I hope that both now have the courage to take suitable action against any problems that may arise.

Nic
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From:auntysarah
Date:27th May, 2007 07:40 am (UTC)

Re: RR case reporting

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Thank you, Nic, for the kind words

I think you've confirmed that this case can only be described at best as a hollow victory for Charing Cross and their acolytes and I hope that they FINALLY realise that their ultra-conservative, sausage factory type treatment is no longer compatible with the modern day care of Transfolk.

I really do hope they learn lessons from this. Perhaps a light has come on in Barrett's head? Hopefully in time, he'll come to see this not as a lost gambit, but as a wakeup call and an opportunity.
From:(Anonymous)
Date:26th May, 2007 08:28 pm (UTC)

Thanks

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Hi Sarah,

Thanks so much for posting such a candid and complete account. Although I'm well and truly "woodworked" these days (I completed my physical treatment in Jan 2004), it was Dr Reid who gave me the chance to move forward and deal with the issues I was then facing. Had I been forced to transition before HRT I probably wouldn't have made it.

Although he prescribed HRT for me on the first appointment, by then I'd been using local NHS psychs as counsellors for a good 6 months, and had he not prescribed for me I'd probably have self medicated. As it was I still had a long battle with my PCT before they would honour my prescriptions, but that is (as they say) another long story.

I had surgery early too (10 1/2 months after transition) but that was more an accidental thing as the clinic had a cancellation date and I was trying to fit around my company's sick leave policy. Dr. Reid didn't know about that at the time; my referral was for two months later.

Taken together, I'm one of the cases that "break the rules" the NHS are so fond of. Despite that, I'm happy, respected locallly (especially in my Church, it seems!) and doing rather well in my career. The fact that I didn't follow established care pathways doesn't matter - I took responsibility for my own treatment - a principle I've always followed throughout my life. I'm far from the only one, either.

Thanks again,

Anna-Jayne Metcalfe
http://www.annasplace.me.uk
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From:auntysarah
Date:27th May, 2007 07:41 am (UTC)

Re: Thanks

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Thanks for the kind words, and your comments about the approach at the local NHS level being inadequate are spot on. I really need to sort out meeting with my PCT...
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From:zoefruitcake
Date:26th May, 2007 08:49 pm (UTC)
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better than at times it looked like being :0)
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From:auntysarah
Date:27th May, 2007 07:42 am (UTC)
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Definitely!
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