Health services involved in transgender woman’s care in Brighton ‘underfunded’, coroner says

Alice Litman Credit: PA Media

An inquest held into the death of a young trans woman has revealed how services involved in her care are all “underfunded and insufficiently resourced”, a coroner has said.

Alice Litman, 20, had been waiting to receive gender affirming healthcare for 1,023 days when she died on May 26 2022 in Brighton, the family said, ahead of her inquest which began on Monday.

An inquest into her death was heard over three days at Sussex County Cricket Ground in Hove.

On the final day, September 20, coroner Sarah Clarke said she would be considering a prevention of future deaths report and would be adjourning the inquest to give a narrative conclusion in two weeks’ time.

Addressing the inquest, Ms Clarke said: “It’s extremely important we recognise how important these issues are not just here in Brighton and Hove but everywhere.”

During the inquest, evidence was heard from The Tavistock and Portman NHS Foundation Trust, which ran gender identity services Ms Litman was referred to, Surrey & Borders Partnership NHS Foundation Trust (Child and Adolescent Mental Health Services), WellBN, Ms Litman’s GP at the time of her death and online transgender clinic, GenderGP.

After hearing the evidence, the coroner said: “It seems to me all the services are underfunded and insufficiently resourced for the level of need the society we live in now presents.”

Issues Ms Clarke will consider include Ms Litman’s previous suicide attempts and transition in 2019, waiting lists and inability to access hormone treatment and the importance of being discharged by children’s mental health services to adult mental health services and the impact it had on her mental health in terms of her transition.

Alice Litman, who had been waiting to receive gender affirming healthcare for 1,023 days when she died Credit: Family Handout/PA

Previously the inquest heard that transgender people are being let down by “extraordinarily long” NHS waiting lists, which are causing a “travesty” of self-harm and suicide.

Ms Litman’s mother, Dr Caroline Litman told the court on Monday she believed her daughter’s death was “preventable with access to the right support”.

The court heard Ms Litman, originally from Surrey, first told her sister she felt she was a woman in September 2018 and went to see a doctor about her gender identity later that year.

It was also heard Ms Litman had been receiving hormone treatment privately at the time of her death.

Sophie Walker, who represented Ms Litman’s family at the inquest, said it was significant Ms Litman was not on testosterone blockers and she became increasingly distressed by that.

On September 20 at the inquest, Ms Walker said: “In effect the system in place to provide healthcare for trans youth does not exist.

“It is not able to be accessed at the time when they need it, or when they need it the most.”

Healthcare providers The Tavistock and Portman NHS Foundation Trust, which ran the gender identity clinic Ms Litman was referred to, and her GP WellBN, told the inquest there was no denial of lifesaving emergency treatment but accepted there was a delay.


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