Alice Litman faced ‘unbearable’ trans healthcare wait before death, coroner finds
Long waiting lists for gender-affirming care contributed to a decline in Alice Litman’s mental health, a coroner has concluded as the inquest into the death of the trans 20-year-old drew to a close.
Coroner Sarah Clarke delivered her full written findings and conclusion at Woodvale Coroner’s Court in Brighton & Hove on Friday (13 October) after an inquest into Litman’s death opened on 18 September.
Alice Litman died in May 2022, with her family previously stating they believe the long wait she had to endure to access gender-affirming care played a part in her death.
Litman had been referred to an NHS gender clinic in August 2019, and had been waiting more than 1,000 days for an initial assessment.
The inquest, which took place from 18 to 20 September, examined delays she faced in accessing gender-affirming care, specifically from London’s Tavistock Gender Identity Clinic, as well as her transition from child to adult mental health services.
While Litman’s family did not speak at the inquest’s conclusion on Friday, they had previously claimed that she had “described the years-long wait and the inadequacy of her care as leaving her feeling hopeless and helpless, without an end in sight”.
Clarke added in her conclusion that Litman’s family had described her as “bold and brave, warm and kind” and that her friends described her as “such a well-loved and accepted individual”.
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In 2019, Alice Litman was referred to Child and Adolescent Mental Health Services (CAHMS) following a suicide attempt. Despite another attempt later that year, Litman was discharged entirely from CAHMS in 2020.
The inquest found that after being discharged from CAHMS, Litman was referred to adult mental health services, but “did not meet the threshold for receiving support from adult care”.
Litman’s mother, Dr Caroline Litman, who worked as a psychiatrist for the NHS for 12 years, has previously described her daughter as being “failed” by mental health services.
“I believe my daughter could have lived a happy healthy life had she not been failed by the healthcare system that should have supported her,” Dr Litman wrote in a letter, seen by the BBC.
Clarke explained at the inquest’s conclusion that she will be writing to various NHS bodies, including the Surrey Borders Partnership Mental Health Trust and Tavistock Gender Identity Clinic, to recommend ways of preventing future deaths, adding that she takes the report “very seriously”.
Clarke said she would also deliver further recommendations about the transition between child and adult mental health services, the care offered to trans 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.
She told the court on Friday that the 20-year-old had described the wait to receive gender-affirming care as “unbearable”, but added that she did not consider that Alice was “unable” to access gender-affirming care on the NHS.
An FOI (freedom of information) request in August found that trans people at a gender clinic in Yorkshire could face a 35-year waiting list for treatment.
Litman’s parents previously described the waiting lists for gender-affirming care in the UK as “torture”.
Speaking to Channel 4 News, Dr Caroline Litman said: “It’s torture to be left on the wait list, to be left hanging [on] for so long with no end in sight and no power and no control over your destiny.”
Peter Litman said of the long wait: “It’s kind of an act of aggression. If you know something’s there and you do nothing about it, it’s not a neutral act. It’s quite deliberate.”
When the inquest began in September, the Tavistock and Portman NHS Foundation Trust, where the clinic is based, told PinkNews it was “deeply saddened” by her death, but it was “not appropriate to comment while the inquest is ongoing”.
PinkNews has contacted the Tavistock and Portman NHS Foundation Trust for comment.
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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