Alice Litman inquest: Trans woman's mental health support 'half-hearted'

Alice Litman had waited nearly three years to discuss transitioning

A trans woman's transfer from children's to adults' mental health services was "non-existent", a coroner has concluded.

Alice Litman, from Brighton, waited almost three years for gender-affirming healthcare, her inquest in Hove heard.

She took her own life at the age of 20 while on a clinic's waiting list.

Coroner Sarah Clarke said she would be highlighting concerns including delays in gender affirmation healthcare and a lack of clarity for clinicians.

Ms Clarke said she would be writing a preventions of future deaths report, raising the following concerns:

• The knowledge and training for those in the mental health setting for managing and offering care to those in the transgender community

• The delays in access to gender affirming healthcare

• The lack of provision of mental health care for those waiting for gender affirming treatment

• The lack of clarity for clinicians who are in place to support young transgender individuals in primary care

• The lack of clarity for clinicians who are in place to support young transgender individuals in the mental health setting.

In a statement, Alice's family said: "It is our hope that these unprecedented reports will help to achieve urgent change.

"We can never bring Alice back, but we will keep campaigning to ensure that all trans people are able to live in dignity and receive the healthcare they need and deserve.

"The trans healthcare system is not fit for purpose. Trans people should not have to wait years to access essential care through inaccessible specialist services."

• If you are experiencing emotional stress, help and support is available via the BBC Action Line here.

Alice was referred to the NHS Gender Identity Development Service in 2019, but was still waiting for an initial assessment when she died on 22 May 2022.

She had been waiting 1,023 days for her first appointment with the Tavistock and Portman Gender Identity Clinic, "which contributed to a decline in her mental health", the coroner said.

Alice's family supported her decision to live as a woman

Alice had been referred to Child and Adolescent Mental Health Services (CAMHS) in 2019, following a suicide attempt.

In March 2020, after she turned 18, she was discharged from mental health services altogether, her inquest was told.

'Half-hearted' support

The coroner concluded: "At the time she was not considered to meet the threshold for adult mental health services and Ms Litman never sought further assistance from the community mental health services."

Alice went on to attempt suicide again later that year.

Ms Clarke said in her conclusion: "Alice's 'transition' from children's mental health services in to adult mental health services was non-existent.

"It seems to me that shortly after Alice turned 18, she was offered a 'coping strategies' course in a quite frankly half-hearted final offer of some kind of support."

The coroner had previously said services for transgender people were "underfunded and insufficiently resourced".

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