A coroner said that transgender and mental health services were “underfunded and insufficiently resourced” as she adjourned an inquest in Hove this afternoon (Wednesday 20 September).
Assistant coroner Sarah Clarke is also considering whether to make a report to prevent future deaths when the inquest into the death of a young trans woman resumes in two weeks’ time.
The coroner has spent the past three days hearing about the circumstances that led up to the death of Alice Litman, 20, of Albion Hill, Brighton.
Alice, who had moved to Brighton from Surrey less than a year before, died in a fall from the cliffs at Roedean in May last year and was found by a cyclist on the undercliff path.
Brighton and Hove Coroner’s Court was told that she had been struggling with her mental health and the long wait for gender-affirming treatment.
She was born male but, in 2018, when she was 16, confided in her sister Kate that she felt as though she was a woman, her mother Caroline Litman told the inquest.
She went to see a doctor about her feeling and later started living as a woman and changed her named by deed poll to Alice.
The inquest, at the Sussex County Cricket Ground, in Eaton Road, Hove, was told that gender identity clinic patients who were currently receiving their first appointments had been waiting for five years.
Alice had been waiting for almost three years before she died and, her mother said, flet that there was “no end in sight”.
The coroner heard evidence not just from Alice’s family but also from professional experts before announcing that she would give a narrative conclusion in a fortnight.
The coroner told the court: “It’s a very important inquest. I felt as though I got to know Alice very well. I have learned a lot also from this inquest and some of the issues raised.
“Some of the issues that have been raised are very important in today’s society (and) it’s extremely important we recognise how important these issues are not just here in Brighton and Hove but everywhere.”
The coroner said that she had heard from Alice’s family, the Surrey and Borders Partnership NHS Foundation Trust, the Tavistock Gender Identity Clinic, the WellBN doctors’ surgery, in Hove, and GenderGP, the online transgender clinic.
She said: “It seems to me, all these services are underfunded and insufficiently resourced for the level of need the society we live in now presents and the level of support that services in our society are now expected to offer.”
The coroner said that her findings would be in the form of a narrative verdict which covered Alice’s suicide attempt in June 2019, the first of two attempts to take her life when she was just 17.
The findings would also cover the start of Alice’s transition, in August 2019, and her discharge from the care of Surrey and Borders’ Community Mental Health Recovery Service in March 2020 – a month after she turned 18.
She had made a second suicide attempt not long before and her level of need had not changed, Alice’s mother Dr Litman said.
She told the inquest on Monday: “Nothing had changed apart from that Alice was turning 18 and yet all mental health support was withdrawn.”
The threshold for adult care was higher, the inquest was told. And the coroner said today that her conclusion would look at “the impact that that had on her mental health and her transition”.
It would also deal with “Alice’s wait for hormone treatment (and) her inability to access hormone treatment that, in my view, should be available”.
The coroner added: “My duty to make a report to prevent future deaths is triggered.”
But before deciding whether to make a report and, if so, what it should say, she would consider
- how the transition is managed between children’s and adults’ mental health care
- the knowledge required and training offered to those caring for transgender patients
- the long waiting times to access gender-affirming healthcare
- the lack of provision of mental health care for those waiting for gender-affirming health care
The coroner said that her duty to make a report to prevent future deaths was not triggered in relation to WellBN, the doctors’ surgery in Hove where Alice registered a month before her death.
Sophie Walker, the barrister who represented the Litman family at the inquest, told the inquest today: “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.”
