An open letter to the gmc

Why Transphobia And Racism Ended My Career

Summary

  • I believe that the review into my fitness to practice was solely based on the word of an openly transphobic woman and a series of tweets that she had screenshotted and taken out of context.
  • I believe that a commitment to social justice is a requirement of all doctors, and I am improving the public’s confidence in the medical profession by standing up against injustice, oppression, and inequalities in healthcare.
  • I believe that I have provided ample enough evidence that my social media content is in the public interest.
  • I have been out of work for over two years due to the ongoing nature of this investigation and the impact it has had on my ability to seek employment as well as my mental health.
  • I believe that it is no longer safe for me, a Minority Ethnic, Transgender, Queer, Jewish doctor to practice medicine in the UK because your training and safeguards have fallen short of that which doctors and the public should expect from an organisation with such an important regulatory role.
  • I represent a disproportionately small number of transgender doctors practicing in the UK, and I do not believe that the GMC has the Transgender community’s best interest at heart.
  • I therefore believe the GMC cannot be trusted to safeguard the public’s best interest, especially when it comes to those who are oppressed.

History of complaint

In May 2022, you received several complaints from DG, a member of the public. Even though the complainant states in her first email that she is aware that I am transgender/transmasculine, DG refers to my gender in a number of inaccurate and inappropriate ways:

  • “Designated “she/her””.
  • “Assumed name Asher, designated he/him/they”.
  • “Non gendered”
  • “S/he” (multiple times)
  • “Now designating themselves as male”.
  • She and/or her (multiple times)

(At no point did she refer to me by my preferred pronouns; he/him).

In June 2022, you ruled that DG’s concerns would not require you to restrict or remove my registration. You informed both of us that the GMC would not be taking any further action, and the case had been referred to my responsible officer.  DG urged you to reconsider. At this point she accused me of “racist comments toward white people”. 

In November 2022 you informed me of your intention to assess whether the original ruling was materially flawed and would be commencing an investigation under rule 12. You also chose to open a second Rule 12 investigation at the same time, regarding a complaint made by AB in April 2022. From what I can tell, AB did not request this himself. At this time you raised the following concerns:

  1. Allegations of bullying and harassment, including someone you described as a “vulnerable” member of the public, even though he is a cisgender white man who published several of our private messages on twitter and to the GMC, including the description of sexual assault that I had divulged to him on WhatsApp.
  2. An explicit accusation that a comment I made about “thin, white women” was “racist”.
  3. Concerns about how I may treat patients whose opinions about weight loss differ from my own.
  4. Concerns about how I might treat vulnerable members of the public.
  5. Concerns that I might not respect confidentiality.
  6. Concerns about the way I might treat patients due to my “discriminatory views”.

 

In January 2023, I filed a complaint with the GMC because I felt I was being discriminated against because of my gender and sexual orientation, my views about weight, and my views about race.  The GMC responded to this complaint without taking any further action. Around the same time, DG emailed you to express her concerns that my “inappropriate comments about thin, cisgender individuals” brought into question my ability to treat patients without bias.

I have been a doctor since 2003 and have never once received a complaint from a patient that describes bullying, harassment, racism, discrimination, abuse of power or an inability to respect confidentiality. I have had overwhelmingly positive feedback from patients and colleagues alike. I have participated in yearly appraisals, during which no concerns were raised.  I have proven myself to be an exemplary doctor.

I therefore believe that the review into my fitness to practice was solely based on the word of an openly transphobic woman and a series of tweets that she had screenshotted and taken out of context. To make matters worse, the complainant is a mental health professional, founder of a national eating disorder organisation, and belongs to The British Psychological Society.

On the 6th of June 2023, the GMC concluded that the original ruling made a year prior was “materially flawed” and a “fresh decision is necessary in the public interest under Rule 12”. I had to wait a further 5 months to hear from the investigation team. At this stage I had been out of work for almost 2 years due to the ongoing nature of this investigation and the impact it had on my ability to seek employment as well as my mental health.

On the 19th of January 2024, after seeking legal advice on more than one occasion, you informed me that my case could be concluded with a warning, a draft copy of which reads:

‘In 2022, you posted a number of tweets online, two of which referred to people’s gender, colour and sexual orientation in a manner that was:

  1. inappropriate; and/or
  2. offensive; and/or
  3. disparaging; and,
  4. demonstrative of attitudes that were contrary to those required of doctors by Good medical practice.

This conduct does not meet with the standards required of a doctor. It risks bringing the profession into disrepute and it must not be repeated. The required standards are set out in Good medical practice and associated guidance. In this case, paragraph 65 of Good medical practice and paragraph 5 of the guidance, Doctors’ use of social media (2013) are particularly relevant:

Good medical practice (2013)

(65) You must make sure that your conduct justifies your patients’ trust in you and the public’s trust in the profession.

Doctors’ use of social media (2013)

(5) The standards expected of doctors do not change because they are communicating through social media rather than face to face or through other traditional media. However, using social media creates new circumstances in which the established principles apply ..

Whilst this failing in itself is not so serious as to require any restriction on your registration, it is necessary in response to issue this formal warning. This warning will be published on the medical register in line with our publication and disclosure policy, which can be found at www.gmc-uk.org/disclosurepolicy.’

The allegations make no mention of the accusations of bullying and harassment, my inability to treat people with different views about weight than my own, the potential risk I pose to vulnerable members of the public, or concerns about my ability to respect confidentiality. They focus solely on the accusations of racism and discrimination.

The allegations read:

That being registered under the Medical Act 1983 (as amended):

  1. You made posts on social media, in which you said:
    1. ‘Am considering getting a T-shirt made with this little cutie’s face on it which reads: “WARNING: my dog gets anxious around white people (and so do I)” What do you think?’
    2. If you’re a cishet white man that is. I dislike your species as a general rule and you gotta work real damn hard to get into my good books … ‘

or words to that effect.

  1. Your actions as referred to in paragraph 1:
    1. were inappropriate and/or offensive;
    2. had the potential to undermine public confidence in the medical profession.

And that by reason of the matters set out above your fitness to practise is impaired because of your misconduct.

Details of complaint

For starters these tweets are taken out of context. The first one refers to my rescue dog Mia, who came to us after three unsuccessful attempts at finding her a home. The first thing I was told about Mia was that she was afraid of men and barks whenever she encounters them. After living with us for a year, Mia is now comfortable around men that remind her of my husband (a Black man) but continues to be wary of men that do not look like him.

The tweet referenced my months-long struggle to be able to walk Mia in public without her being so reactive. It appears you deemed the “and so do I” comment as inappropriate and/or offensive, even though I am a Minority Ethnic person (Jewish/Asian) who has every right to express his fear of the people who have historically oppressed his ancestors for centuries.

The second tweet was part of a thread, which is clear because it makes no sense on its own. Once again, I am talking about cisgender heterosexual men. During your investigation into me, I supplied evidence of the relentless transphobic and homophobic bullying and harassment that I receive both on social media and in real life. I expected you to take this into account when assessing my social media content. I do not think either of these tweets were inappropriate or offensive and I cannot see how they would undermine the public’s trust in the medical profession. It is not clear what you have based these accusations on.

Furthermore, these tweets are two examples of the hundreds I have written about white supremacy/privilege, colonialism, and oppression. Several of them were screenshotted and sent to you by both DG and AB as evidence of my so-called ‘discriminatory comments’, yet you chose to focus on these two without explaining why. What makes these two in particular so offensive and/or inappropriate?

I believe that a commitment to social justice is a requirement of all doctors, and is underpinned by the four main principles of medical ethics. As you are aware, there is an entire section in Good Medical Practice that focuses on probity. If anything, I am improving the public’s confidence in the medical profession by standing up against injustice, oppression, and inequalities in healthcare.

I sent you 60+ pages of statements of support from people who follow me on social media, including one from a fellow GP and one from a registered psychologist. It is clear from this evidence alone that my social media content is in the public interest. Furthermore, the evidence I provided demonstrates that the medical profession is failing a lot of people by refusing to stand up against injustice and, worse still, by perpetrating harm.

Whilst your warning will not affect my ability to hold a licence to practice, it will still prevent me from working because I will continue to be unable to gain a Scottish Performers Number and I will also need to disclose it to future employers. I have already been unable to work as a doctor for almost two years because of your investigation into me. All the while there is a critical shortage of doctors across the country and the NHS is in desperate need of experienced and high calibre GPs like me to meet the ever-growing need.

However, even if you were to decide not to issue me a warning, the last 2 years have had a profound effect on my ability to trust the GMC. That was why I filed a second complaint of discrimination on the 20th of January. On the 23rd of January, I received the following reply:

I am sorry to note from your complaint that you feel you have been discriminated against… Unfortunately, you have not told us why you feel that this is the case. You said that you wished to use your previous complaint as a starting point, however the circumstances of that complaint are different (for example, I cannot see any evidence that you have been misgendered during the current case) and have already been addressed by way of an email, with attached letter, dated 26 January 2023.

As you are aware, the GMC processes and procedures are underpinned by statutory guidance and legislation. All staff must also undergo mandatory Equality, Diversity & Inclusion training and relevant staff are trained in how to identify and be aware of unconscious bias. These factors are aimed at, amongst other things, eliminating any potential discrimination and therefore I am also satisfied that there are adequate safeguards in place to ensure that individuals are not discriminated against on any grounds.

Since you are satisfied that there are adequate safeguards in place to ensure that I have not been discriminated against on any grounds, it is no longer safe for me, a Minority Ethnic, Transgender, Queer, Jewish doctor to practice medicine in the UK. It is clear to me that your training and safeguards have fallen short of that which the public should expect from an organisation with such an important regulatory role.

There is an alarming amount of evidence that Black, Brown, Minority Ethnic, Transgender, and LGBTQIA+ patients do not trust their doctors. Furthermore, there is evidence that the GMC is disproportionately investigating doctors who hold marginalised identities. This suggests to me that you have not worked hard enough to address your implicit bias, and my case is a clear example of this.

As a result of your actions, I believe the GMC cannot be trusted to safeguard the public’s best interest, especially when it comes to those who are oppressed. There is a disproportionately small number of transgender doctors practicing in the UK and you just lost one of them. Since you have repeatedly failed to address the complains I have raised, and you continue to act in a manner that I believe puts both patients and doctors at risk, I believe it is in the public’s best interest for me to make my dealings with the GMC public.

I have done my best to anonymise any evidence I have supplied (aside from that which is public on social media) and want to make it expressly clear that I do not wish for anyone to come to harm as a result of this open letter. My issues are not with the individuals involved, but the structures and systems that are in place to protect and uphold colonialism, oppression and white supremacy at all costs. It is time you did something to address these, and I hope that this letter highlights the many areas in which change is necessary.

Supporting Evidence

Below is a document containing  evidence that supports my letter. You can also download a selection of Statements of Support and/or a sample of the Hate Mail I receive (Please be advised that the latter contains transphobic, homophobic, antisemitic and fatphobic content.)

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