GenderCare: London private clinic with a winning business model

by SunMum

The author is a UK academic and mother of a son who experienced sudden onset gender dysphoria. She has attended the Gendered Intelligence parents support group, and her son consulted Stuart Lorimer at GenderCare.  She can be found on Twitter as SunMum@Mum3Sun


The business model of a private gender clinic in the UK looks a dead cert. To start with, you need demand, and the rising demand for gender reassignment services offers that in abundance. The NHS offers a gender reassignment pathway, but demand in recent years has outstripped the resources of a publicly funded health service. Waiting lists at the main adult provider, the Charing Cross Gender Identity Clinic, the UK’s ‘oldest and largest adult clinic’ founded in 1966, are currently about 12 months from the first referral. Referrals have ‘almost quadrupled in 10 years, from 498 in 2006-07 to 1,892 in 2015-16’ according to the Guardian in July 2016.

At the Tavistock and Portman, the only NHS service for children and adolescents with gender dysphoria, referrals have increased ‘about 50% a year since 2010-11.’ In the year leading up to this Guardian report, the rate of change in child referrals showed ‘an unexpected and unprecedented increase of 100%, up from 697 to 1,398 referrals’.

In the same 2016 Guardian article, Charing Cross GIC lead clinician James Barrett comments jocularly on this sudden increase in demand:

‘It obviously can’t continue like that forever because we’d be treating everyone in the country, but there isn’t any sign of that levelling off.’

Now this is a rather strange comment, given that only five years before, in 2011, Barrett stated that rates of gender dysphoria were stable and unchanging. Citing a 1996 study, he presented the condition as vanishingly rare: ‘It seems that the incidence of transsexualism is very roughly 1 in 60000 males and 1 in 100000 females, and it seems to have remained constant’. Given that ‘treatment is drastic and irreversible’, Barrett insisted that diagnosis must be entrusted to the experts of the gender identity clinic:

The least certain diagnosis is that made by the patient, made as it is without any training or objectivity. This uncertainty is not lessened by the patient’s frequently high degree of conviction. Neither does the support of others with gender dysphoria help, since conviction leads people to associate with the like­minded and to discount or fail to seek out disharmonious views. [ James Barrett, Advances in psychiatric treatment (2011), vol. 17, 381–388 doi: 10.1192/apt.bp.109.007484)

 

Pitching the service: Respect and Authority

GenderCare, headed by Stuart Lorimer, is a private London gender clinic mostly staffed by clinicians employed at Charing Cross GIC: endocrinologist Leighton Seal, psychologist Christina Richards and speech therapist Christella Antoni. These are professionals who have reputations at stake.

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And while GenderCare does offer some Skype and email consultations, prospective patients or parents of gender confused young adults can be reassured that this is not an online clinic like that run by Helen Webberley, a Welsh GP whose Online Transgender Medical Clinic displays no more relevant qualifications than a one hour e-course in ‘Gender Variance’ designed by a transactivist organisation for GPs.

Twitter contains some negative reports of Webberley’s outfit: ‘A guy I know was rushed into hospital with liver failure because of Dr W’s incompetence, not having his bloods reviewed meant he was on too high a dosage of testosterone & literally nearly died.’ According to one young person, Webberley ‘has this weird online ‘grooming’ thing going on, contacting young people via social media’. Of course, Twitter testimonials do not constitute actual evidence and should be viewed with caution. Yet it’s clear to anyone who spends time investigating that young people are discerning as they sift through their choices and look for medical help they trust.

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The GenderCare website by contrast is reassuringly respectable: these are ‘Specialists in Gender Care’, genuinely experts in their field. The site and FAQ frequently remind us that patients will be seen by a team of medical experts  The FAQ emphasises hormonal treatment,  with assurances that the letter needed for medical transition will be prepared as quickly as possible.

What would be the hurry? It appears that, since 2011 when Lorimer’s Charing Cross colleague James Barrett insisted on the ‘drastic and irreversible’ nature of medical transition and the caution that the ‘least certain diagnosis is that made by the patient’, there has been a sea change in the field. Now Barrett presents gender dysphoria as a condition with no parallel. It simply is what it is, and gender specialists are sui generis: neither psychiatrists, nor endocrinologists, but what it says on the can: ‘gender specialists’. Barrett compares gender dysphoria in a 2016 blog post for the BMJ, to ‘the Australasian Platypus’[full article behind paywall]:

The first specimens were dismissed as a joke of some sort.

But then more came, and alive and kicking at that. There followed a mighty taxonomological struggle. They were reptiles or perhaps some sort of bird, surely, as they were warm blooded, laid eggs and were venomous. On the other hand, the fur argued for mammals, but they didn’t have proper breasts, the defining feature of the mammals, and that business of being venomous is more of a reptile-like thing, is it not? And they do lay eggs…but warm blooded…perhaps a bird of some sort…?

In the end, it was all solved by everyone admitting that the Platypus was real, important, couldn’t be dismissed and didn’t fit any existing category very well. It got its own, special category where it has paddled, very happily, ever since, albeit joined by echidnas and some long-extinct fossilised forebears.

The comparison is witty and memorable, but leaves us no wiser. Lorimer also subscribes to what we might call the Platypus model of gender theory (‘a variety of clinical specialisms might lay reasonable claim to ownership of gender care but, like the platypus, it’s its own creature, distinct and different’. Although trained as a ‘Liaison psych’ he believes that ‘ultimately, it’s about pragmatism – who has the appropriate skill-set to do the work.’

For gender identity, there is no well-founded theoretical model, no objective test: we simply have to believe in the authority of the expert. Believe me because I say so. For the young people who visit GenderCare, diagnosis by a gender specialist offers confirmation and validation of their internal sense of self. YouTube videos about ‘my first visit’ to GenderCare form a genre of their own, revealing the overwhelming power of this validation. One young person reports

‘It were a really positive experience. He were very validating and he shouldn’t have been because I obviously know that someone validating your experience isn’t necessary. But hearing him saying the words saying he’s diagnosed me, he’s signing me off…It’s like all my Christmases come at once.’

There are many transition YouTubes made by young clients of Dr. Lorimer; they are moving videos, in which these young people freely admit they suffer with self harm and sometimes suicidality. A single visit to GenderCare can apparently provide a rapid remedy. The process is quick and simple: when blood tests are in and the letter comes through, a young woman who desires to transition FTM can start testosterone. One has already got ‘syringes through the post’, the ‘sharps bin’ and the needles:

‘I don’t know if you’ll be able to see this. Look at the fucking size of that needle. Look at it compared to the size of my finger. Well clearly I’m not needle-phobic. But fuck, it’s huge. I’d hit myself in the face with a brick if it meant starting on testosterone.’

Pushing at the boundaries

In taking on private work, Lorimer would need to protect his professional reputation and adhere to legal and medical regulations.  This may at times present complications. In 2014, according to a post on ‘The Angels’ (a trans support forum), the UK’s Care Quality Commission (CQC) raised questions about the ‘grey area’ of his private practice, prompting Dr Lorimer to temporarily stop seeing clients.

Lorimer Care quality commission 4.jpg

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Leaving aside the question of what may or may not have happened in 2014, the key regulatory boundaries with gender reassignment are to do with time (how quickly hormones are dispensed) and age (those under 18 are treated in a different way from adults). For much of 2016, the GenderCare website warned that hormones are not normally prescribed on a first visit. That is certainly not the belief expressed on Twitter today:

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The burgeoning youth market

GenderCare’s FAQ tells us they primarily treat over-18s, although some exceptions are made. Lorimer confirms this on Twitter:

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Earlier in this post, we saw that some young people on Twitter were freaked out by what one calls ‘this weird online grooming thing going on’ by Helen Webberley’s outfit. The respectable GenderCare would surely do no such thing. But Lorimer too has a social media presence through which he touts for business, a Twitter voice seemingly designed to speak to the young – especially trans men. Here we find him mythologizing the joys of testosterone:

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Parents know that when young people want something, they want it Now! And for some young women the thing that is needed, and needed quickly, is testosterone, seen by dysphoric adolescent females as a panacea for all ills.

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About ‘two thirds’ of his patients, Lorimer explains are ‘trans men’:

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Like the proverbial high court judge, I need to make my way over to the Urban Dictionary . But Lorimer is the doc who talks to young people, who plays knowingly with the idea of ‘A girl’s body and the way she carries it.’ Looking at YouTube or at Twitter, you would think that Stuart Lorimer was an expert on adolescent gender dysphoria. But this apparently is not the case:

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Lorimer may have ‘extremely limited experience of children/adolescents’. But it takes a very limited dip into the sea of adolescent angst freely available on Twitter and YouTube to realise that GenderCare clients are in the throes of the kinds of relationship and body issues that many adults remember. These are not strange young people, but people suffering from a horribly familiar set of feelings. Of course, we don’t know the age of all those who tweet of vlog about their GenderCare appointments. They might simply be youthful in spirit, but young they certainly appear to be. These don’t sound like people who are approaching ‘drastic and irreversible’ bodily alterations with maturity, discretion or objectivity:

 

Perhaps most troubling is that in 2016 Lorimer arrived on Tumblr, overwhelmingly a place for young people (very popular with ages 13-18), with a GenderCare Tumblr site. Lorimer seems anxious. Why? Is it because he knows he’s rather old to be on Tumblr?

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Tumblr is full of accolades for GenderCare. And whilst one might think a need for hormones and surgery would be necessary only for those who strongly believe themselves to be the opposite sex, evidently even ‘nonbinaries’ are supported in their quest for medical intervention via GenderCare:

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Lest readers think this nonbinary stuff is hyperbole, Dr Lorimer (aka The MXMaster) confirmed the Tumblrite’s observation on Twitter last August.

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The market potential for ‘nonbinaries’ must be unlimited.  Who amongst us fully conforms to gender stereotypes? And GenderCare isn’t the only UK gender clinic cashing in on the ‘enbie’  market:

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Let’s see: Can you spot the difference between ‘non-binary’ and ‘binary’ mastectomy?

But returning to GenderCare, one of the more ironic aspects of all this is that Lorimer himself is certainly old enough and wise enough to see beyond the teenage rush for bodily alteration. A highly flattering image of Lorimer appears on the website of photographer James M. Barrett (not the gender clinician this time but a photographer who specialises in beautiful images of gay men). The photographer’s Facebook page comments sagely on the contemporary rush for bodily alteration:

 ‘In popular culture, there is an extraordinary urgency to take charge of our bodies and minds, and to “become the person that we were always meant to be”! It is as if we can rewrite our lives and give birth to new selves, simply through the power of positive self-belief, and some bloody good cosmetic work on our physical appearance! It is not just a practical idea that looking more attractive might increase our pulling power or lift our spirits. It is the fantasy that if we could just become achingly beautiful, then we will also be unbearably desirable, and our whole lives will be transformed from ordinary to unique. And of course, digital photography plays right into this fantasy, allowing us to perform virtual nick-and-tuck manipulations, and to airbrush a veneer of youthfulness onto our imagined selves. The images in this portrait series have also been heavily worked in post-production, but the effect is meant to suggest something very different: a harsh beauty that resonates with uncertainty, doubt, restlessness, world-weariness, perhaps mid-life crisis…but which also carries a tender intimacy, resilience, ruggedness, and a new-found robustness that comes from surviving a crisis.’

Wise words. And we know that Lorimer subscribes to this aesthetic. Not only has Barrett photographed him but under another image a ‘Stuart Lorimer’ comments: ‘Fantastic portrait!’. In his own photograph, Lorimer looks great: retouched, digitally improved, there is no necessity for cosmetic surgery, drugs, or scalpels.

For professional purposes, simpler photographic techniques suffice:

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Now Lorimer knows, for certain, that Tumblr is for young people:

‘Tumblr, like lycra is probably not for anyone over 30 –yet here I am. Every fibre in my fortysomething being is screaming at me “GO! THIS IS FOR YOUNG PEOPLE!” but I’m resisting that because I think it may be useful for me to tout for lucrative business, as head of GenderCare, to have a presence here.’

Why? Maybe because young people use Tumblr to explore sub cultures of body hatred and body alteration. Lorimer is careful to add a disclaimer that he does not represent his ‘NHS employers or my GenderCare colleagues’.

But there is no escaping the fact that this is the official GenderCare Tumblr. There is no doubt that he is advertising transition services. In this location, Lorimer does not share his wise appreciation of the power of digital photographic enhancement to act out our fantasies. Instead he offers age-appropriate ‘links to things I find diverting that are not especially relevant (cute animals)’:

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Don’t worry, young person about your first trip to get T. You will meet a cuddly gender doc wearing a pink suit.

lorimer-pink-suit

After all, this is all a game, a joke. Fun. Isn’t it?

Well I for one don’t think it is. My son, you see, became seriously depressed in his second year at university and developed sudden onset gender dysphoria. No earlier signs, easily the most ‘boyish’ of my boys. But after a romantic rejection and drug experimentation he developed depersonalization, googled his symptoms, found they were a symptom of trans, stopped washing, seeing his friends, his handwriting changed, he made odd repetitive hand movements, he became angry and he stayed up all night. I thought he was having a breakdown. His GP thinks it is depression or maybe schizophrenia. But, urged on by a counsellor, I in my naivete paid out for an assessment at GenderCare. After all, the clinicians were the real thing, weren’t they? They all worked at Charing Cross GIC in the NHS. They couldn’t be just cynical or stupid, could they?

I was astounded when my son came back telling me that he would be starting hormones in a few weeks. I emailed GenderCare and asked whether I could supply some contextual information. Lorimer contacted my son to ask permission (since he was 22 at the time). Son said yes, so I sent off a timeline of events, including details that I thought might be relevant to a diagnosis, including a series of recent traumatic events. Lorimer duly wrote a report saying he was a bit worried and wanted a second opinion. The second opinion was with his colleague at Charing Cross GIC, James Barrett (not the photographer, who could only have beautified my beautiful son digitally acting out his fantasies). As Barrett had no access to context (this time son said No), he had an avuncular chat with son (cost £200) and advised on choosing a new name and the right to access female toilets. My son, who a family therapy team thought was ‘struggling with his decision to transition’, now repeatedly refers to the fact that he has been ‘diagnosed by two gender experts’. But in this matter, there is no diagnosis: doctors simply echo back to patients their own self-diagnosis. And the first doctor to offer him that external recognition was Stuart Lorimer.

GenderCare combines accessibility to the young through its active presence on social media, with a show of clinical expertise. The recent news that the Charing Cross GIC would be run within the Tavistock and Portman NHS trust led Lorimer to comment on ‘that potentially big plus. Possibilities for great cross-fertilisation between child and adult services.’ He wouldn’t notice the crassness of the metaphor, because what Lorimer is breeding is a business model; the fertility of confused young people is neither here nor there.

cross-sterilisation

UK’s “Gendered Intelligence” has been indoctrinating students for the last 7 years, Daily Mail “can reveal”

Children as young as four are receiving lessons from transgender campaigners – including a man who revealed to primary school classes that he is a ‘trans man’ and was ‘assigned female’ at birth.

Thousands of pupils have had the controversial classes, in which they are encouraged to explore their ‘gender identities’ and are questioned on what being a transsexual means, The Mail on Sunday can reveal.

Up to 20 primary schools a year pay for the classes, given by campaigners’ organisation Gendered Intelligence. Parents’ groups have reacted with concern that pupils may be ‘frightened’ by the workshops, while experts warned the lessons may confuse young children.

What is a “campaigner’s organisation” (aka “trans activist group”) doing in UK schools?

A look through its extensive website and blog makes it clear that Gendered Intelligence has been embedded with, and partially funded via, the National Health Service, the London Museum, UK lottery funds, and the pharmaceutical company Burroughs-Wellcome for many years. In fact, young people affiliated with Gendered Intelligence literally wrote the book used by the NHS to indoctrinate teachers, kids, and providers about “trans kids.” (See page 3).

Why is the Daily Mail only “revealing” this now, 7 years after the group’s inception? Better late than never, I guess.

Gendered Intelligence has confirmed it teaches pupils of all ages in primary schools, from reception class – where children are aged four and five – up to Year Six, where pupils are aged ten and 11. The workshops cost an undisclosed sum and have been available since 2008.

The Mail on Sunday has seen footage of Gendered Intelligence conducting workshops with primary classes, in a video available for teachers to hire at the cost of £20.

Gendered Intelligence’s founder Jay Stewart, who is giving the class, asks the pupils if they think ‘life will be hard at school if you’re a boy at school who likes doing “girlish things”?’

Mr Stewart then asks the class what they think the word ‘transgender’ means and he follows this by revealing he is a ‘trans man’. He says: ‘When I was assigned at birth, I was assigned female when I was born. So I am transgendered. So have you got any questions for me?’

Let’s see. If I’m a 4-year-old girl, but I’m jealous of my boy classmates, or I like to play with trucks and wear my hair short, maybe I can actually turn into a boy, just like this important, authoritative adult I’m seeing in this film did!

At the second school featured in the film, Westerhope Primary, also in Newcastle, Mr Stewart again tells the pupils that he is transgender – despite teachers asking him beforehand not to do so.

Wow, are those teachers just horrible transphobes? Or do they maybe understand that little kids tend to look up to and EMULATE adults, especially ones they see on a cool video?

Have no fear, though. The Mail reporter tells us the transphobic teacher relented (caved?) and decided it was “right” that Stewart revealed his identity. But at least one psychotherapist, Dilys Daws said:

‘What can get confused is that children who just happen to be unhappy at the moment actually fixing on this being about their gender, when it might be to do with the relationship with a parent.

What is Ms. Daws driving at here? Could a kid decide they are trans for reasons not necessarily to do with some innate gender?

Margaret Morrissey, of pressure group Parents Outloud, said four and five-year-olds were ‘far, far too young’ to receive the lessons. She added: ‘We’re in danger of frightening children and making them feel they ought to feel like this.’

Interesting. Parents Outloud is a “pressure” group, while Gendered Intelligence is…an activist a (no pressure!) “campaign” group.

Mr Stewart said: ‘It’s so important to be teaching children in schools that they can be anything that they want regardless of the gender that they have been given at birth.

It’s so important to tell little 4-year-old children that they can be or have anything they WANT. Because kindergartners don’t ever engage in magical thinking. Little kids don’t ever confuse fantasy with reality.

Gendered Intelligence are very serious about their work. In a blog post this past July, members laid out their vision of the future indoctrination education of all students in the UK schools:

Compulsory introduction of information concerning trans identities and issues into PSHE would give trans* young people the language to talk about and understand their gender identity, as well as reducing the amount of transphobia stemming from ignorance. It is also important to include trans people and the discussion of the issues they face in other areas of the curriculum, for example studying the work of trans writers and artists, or influence figures such as the actress and trans activist Laverne Cox, this provides role models for all students.

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What’s next? Uniformed Thought Police patrolling and monitoring classrooms?

Strict policies should be in place for challenging transphobia, as there are with other types of prejudice and discrimination, this includes deliberate misgendering. Once students have been educated on what transphobic actions are and why they are harmful, as well as the appropriate way to discuss trans issues, a zero tolerance policy should be adopted. If both students and staff are encouraged to consistently challenge transphobic actions, it will soon become clear that transphobia is not tolerated, creating a safer environment for trans young people.

In addition to providing posters for schools (only one pound!) like the one pictured above, with helpful pink-in-dress, blue-in-pants stereotyped stick figures, the folks at Gendered Intelligence are busy with many other projects. They run the “whatmakesyourgender” blog with a number of important initiatives, such as helping kids realize they are just fine as they are might very well need packers, pills, padding, or makeup to express their gender identity.

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We each use many objects in order to manipulate our bodies and express our gender identity. Gender can be thought of  in terms of  ‘boy’ and ‘girl’, but also in terms of ‘boyishness’ and ‘girlishness’. Sometimes we call this ‘masculine’ and ‘feminine’.

Not only do they educate the ignorant on the science of “gender” and what it means to be “boyish” or “girlish.” They are also involved in the arts, some of it generously funded by the grant-making arm of pharmaceutical giant Burroughs-Wellcome (see Excel spreadsheet, with 30K British pounds to “Drawing Gender, Drawing Sex, Drawing Bodies” earmarked for Jay Stewart.) Odd. Why would a pharmaceutical company have an interest in funding a drawing project run by trans activists? No conflict of interest there.

And there’s much, much more than a slick website, school programs, youth (ages 11-25) support groups, and summer camps. The Wellcome [as in, you know, the pharmaceutical company–Burroughs-Wellcome] Collection features a comic exhibit by the Transvengers, a group of 13-19 year old Gendered Intelligence members. Comics!  A sure way to appeal to today’s anime-obsessed youth. And like most of the Orwellian propaganda helpful information distributed by trans youth organizations, these comics turn common sense on its head. They sound like they are about breaking the gender mold, but then….if you’re not into gender roles and stereotypes, how come you need to “transition” to the other sex?

trans avengers

Seems there is no end to the money available to fund activities the staff of 12 has been working on all these years. And the busiest one of all must be director and Gendered Intelligence co-founder Dr. Jay Stewart, who, besides being the star of the preschool video presentations that help children question themselves and reject their own bodies discover their true gender identity,

carries out and oversees the main activities that take place across the organisation. Recently Jay has led on the projects: ‘What makes your gender? Hacking into the Science Museum’ – a £10,000 project funded by Heritage Lottery Fund with the Science Museum, London – and ‘GI’s Anatomy: a life drawing project for trans and intersex people’ – a £30,000 project funded by the Welcome Trust carried out in collaboration with Central School of Speech & Drama, London Drawing and the Gender Identity Development Service, Tavistock Clinic, NHS Trust. Jay also delivers much of the youth group sessions and is a mentor.

A mentor. That sounds benign. Kind of like Big Brothers/Big Sisters? Except we are talking about a “mentor” who was born female but now has a beard and the other accouterments of medical transition. If you’re a little girl “assigned female at birth” and you really don’t like those itchy girl clothes and feel like the boys are having all the fun, Jay tells you “that you can be anything you want regardless of the gender you were given at birth. How exciting is that?


The UK organization Schools Improvement is asking for feedback on the role of Gendered Intelligence in the UK schools. (See bottom of linked page.) Have an opinion? Let them know, especially if you’re a UK resident.