Extent of waiting lists for gender affirming healthcare ‘an act of aggression’

Alice Litman (Family Handout/PA)
Alice Litman (Family Handout/PA)

The family of a trans young woman who died while waiting for NHS gender affirming treatment have said the extent of waiting lists is an “act of aggression”.

The family of Alice Litman, 20, who died while waiting 1,023 days for treatment, have spoken out following a three-day inquest into their daughter’s death.

The inquest was heard at Sussex County Cricket Ground in Hove, with coroner Sarah Clarke adjourning her conclusion until two weeks’ time while she considers a prevention of future deaths report.

Speaking on Wednesday, Ms Litman’s family said they hoped their daughter’s inquest would be a wake-up call into the state of transgender care.

Ms Litman’s mother Caroline Litman said: “We believe the rulings we’re going to hear more formally in two weeks’ time are going to have very positive outcomes to facilitate important and much-needed change throughout the NHS and systems involved in the care of trans people.

“In particular we’re absolutely delighted the extent of the wait list has finally been acknowledged and unchallenged by the gender identity clinic, that someone referred on their 18th birthday tomorrow would not be given NHS support for gender affirming care until they approached their 40th birthday.”

Peter Litman, Ms Litman’s father, also said on the extent of waiting lists: “I think it’s quite deliberate. When you know something’s there and you do nothing about it, it’s not a neutral act.

“It’s kind of an act of aggression really, I think it’s very, very sad.”

Dr Litman added: “Transgender people are coming out to dry. Alice was a smart, intelligent person, she could see no-one was taking care of her and no-one cared.

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

“What does that tell you about a 20-year wait list, what does that tell you about how important you are?”

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, which ran child mental health services, WellBN, Ms Litman’s GP at the time of her death and online transgender clinic, GenderGP.

After hearing the evidence, coroner Ms Clarke 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.”

She added: “It’s extremely important we recognise how important these issues are not just here in Brighton and Hove but everywhere.”

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 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 Wednesday 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 and GP WellBN told the inquest there was no denial of lifesaving emergency treatment but accepted there was a delay.

A spokesperson for WellBN said: “We would like to pass our heartfelt condolences to Alice’s family at this very sad and difficult time as they have to relive the tragic circumstances of Alice’s death.

“We remain committed to providing the best possible care for our trans and non-binary patients and invite them to contact us directly if they wish to do so.”

A spokesperson for the Tavistock and Portman NHS Foundation Trust said: “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.”

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