Transgender services are underfunded, coroner tells Alice Litman inquiry

Alice Litman and her mum smiling, with snow visible on the ground behind them

An inquest investigating the death of trans woman Alice Litman has been told that healthcare services for transgender people are “underfunded and insufficiently resourced.”

Coroner Sarah Clarke is one of many people speaking at a court hearing in Sussex County Cricket Ground this week, to determine what could have been done to save 20-year-old Alice Litman, who took her own life on 22 May 2022 while on a transgender clinic waiting list.

At the hearing on Wednesday (20 September), Clarke said that she was writing to various NHS bodies like the Surrey Borders Partnership Mental Health Trust and Tavistock Gender Identity Clinic to recommend ways of preventing future deaths, and would report back in two weeks’ time with her findings.

Mrs Clarke said that she would also deliver further recommendations about the transition between child and adult mental health services, the care offered to transgender people by mental health trusts, the long wait lists for gender-affirming care, and the level of care offered to people who are waiting on those lists.

Alice Litman with short blonde hair, wearing sunglasses, black dungarees and a pink t-shirt, smiling as the sun shines on her
A coroner spoke at the inquest into Alice Litman’s death. (The Litman family)

Until then, she was able to tell the court: “It seems to me that all of these services are underfunded and insufficiently resourced for the level of need that the society we live in now presents.”

Alice was referred to the NHS Gender Identity Development Service in 2019, but was still waiting for her initial assessment when she died in May 2022. In total, Alice had been waiting for 1,023 days for her first appointment with the Tavistock and Portman Gender Identity Clinic.

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In 2019, Alice was also referred to CAHMS following a suicide attempt.

Despite another attempt later that year, Litman was discharged entirely from CAHMS in 2020, her mother told the court on Monday (18 September).

Alice’s mother, Dr Caroline Litman, also spoke at Wednesday’s hearing, thanking Coroner Clarke for her contribution.

“We are pleased with the statement [the coroner] has made about the prevention of future deaths report, because it’s easy to forget that we’re here because our daughter died and we believe that she needn’t have,” said Dr Litman, per BBC News.

Alice as a baby. Her father holds her hands as he helps her take her first steps on a green lawm
Alice’s father helps her take her first steps. (The Litman family)

“All we can do now is fight for other trans people to be protected.

“We’re absolutely delighted that the extent of the wait list has finally been acknowledged.”

She added: “My daughter was failed by the NHS and I don’t want other parents to lose their daughter, and for other children to lose their sister, the way that our family has done.”

In response to Mrs Clarke’s comments, a spokeswoman for the Tavistock Gender Identity Clinic said, per the BBC: “We were deeply saddened to learn of the death of a patient who was waiting to be seen at our gender identity clinic, and offer our condolences to her loved ones. It would not be appropriate to comment while the inquest is ongoing.”

She said the clinic would issue a further statement after receiving the report from the coroner.

Suicide is preventable. Readers who are affected by the issues raised in this story are encouraged to contact Samaritans on 116 123 (www.samaritans.org), or Mind on 0300 123 3393 (www.mind.org.uk). ​Readers in the US are encouraged to contact the National Suicide Prevention Line on 1-800-273-8255.

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