Prejudice towards trans youth such as Alice Litman are making us lose sight of people’s humanity

Published by The i paper 25th September, 2023

Twice this month I have been stopped in my tracks by a BBC radio interview with a woman grieving over the loss of a family member due to patient care failures. Both were difficult to hear as incidents of avoidable death were articulated with courage, clarity and honesty. Both exposed systemic problems in the sacred national health service that had fatal consequences. Both cases led coroners to raise concerns at inquests. But while one of the interviews sparked an outpouring of sympathy and instant political action to remedy the faults, the second only exposed the toxicity of our culture wars that piled extra pain on a traumatised family.

The first interview was with the journalist Merope Mills, who spoke with incredible strength about watching her 13-year-old daughter Martha  deteriorate from sepsis in hospital after a bicycle accident. She told BBC Radio 4’s Today programme how complacent and patronising doctors swept aside her concerns and failed to share full details about her child’s condition, hampering the alarmed parents’ ability to obtain better treatment. “When you are in hospital you are totally powerless,” she said. “More agency on the part of patients to challenge the culture will make hospitals safer. Asking for a second opinion should not be a problem.”

It was impossible not to be moved as Mills told of missing her daughter’s laugh so much. “Every day I see something I want to show her just so I could see her smile like that again.” This bereaved mother spoke out to “stop other people from going through this horror”. It was good to see both the Government and Labour react by saying they were committed to introduction of “Martha’s Rule”, giving patients and families the right to request a clinical review if they feel concerns are being ignored. Only time will tell if this initiative works or – like so many previous efforts to improve patient safety and strengthen power of whistleblowers – is engulfed by the sludge of bureaucracy or stifled by medical hierarchies.

The second interview was also on Radio 4 – on The World at One last week – as another woman spoke about the needless loss of her ‘delightful’ 20-year-old sister. Kate Litman recalled the joy at hearing her sibling Alice “giggle and giggle” when listening to bedtime stories as a child. “She was really caring, really kind.” She was also transgender – and took her own life after “losing hope” waiting for both mental health care and for an initial assessment with NHS Gender Identity services, having spent 1,023 days on this waiting list by the time of her death. “There are only so many times someone with poor mental health and poor resilience can be pushed back,” said Litman.

This tragedy exposes two linked fault lines in our health service: a lack of cohesion between children’s and adult mental health provision, which left a suicidal teenager to fall through the gap as she was discharged simply for turning 18, and the surging pressures on underfunded NHS clinics for gender dysphoria. There is, said Litman, a five-year wait for these citizens often desperate for help. A Freedom of Information request by Tortoise media revealed there were 29,692 individuals in England alone waiting in May for their first appointment at an NHS adult gender dysphoria clinic.

Once again, this was a woman speaking through grief in a heartfelt bid to prevent needless deaths. Their mother – an NHS psychiatrist for 12 years – told an inquest this month how the long wait for help was like torture for Alice. “My daughter could have lived a happy healthy life had she not been failed by the healthcare system that should have supported her,” said Caroline Litman. This bereaved mother spoke of being left feeling “shame” that despite her own medical expertise she was unable to “get my daughter past the gatekeepers for both mental health care and gender identity services.”

This story echoed another that I heard recently. Danny France, a transgender teenager from Cambridgeshire, took his life aged 17 after falling into the “black hole” between child and adult services. An inquest last year heard he was trapped on long waiting lists for mental health and gender treatment, resulting in a preventable death according to the coroner. His father was infuriated by the persistent failure to learn lessons from such tragedies. “So many people are dying needlessly because we do not offer the services to help them,” he told me.

Yet what makes Kate Litman’s interview even more shocking was her revelation that the family became caught up in the culture wars being stoked so deliberately by some politicians and commentators. They were distraught to discover that news stories and even family posts on social media about Alice’s death provoked hateful remarks, disparaging comments, even jokes from pathetic keyboard warriors. “I find it so hard to understand, incomprehensible,” she said, pleading with people to see that her sister was “not a predator, wasn’t trying to force her way into women’s spaces” and that transgender people were often just vulnerable young citizens desperate to access health care who have become pawns in other peoples’ battles.

Litman sought to humanise this debate that sees fanatics on both sides thwarting serious discussion of complex issues. Her intervention coincided with the latest release of the National Centre for Social Research’s British Social Attitudes report showing Britain has become far more liberal – except for a sharp rise in prejudice towards transgender people. This sad interview offered grim insight into the poison flowing through our public spaces while rising numbers of people endure deep torment due to inadequate care. It provoked little discussion yet it should make us all pause for thought, regardless of views on this issue. For Britain has become a dark place in which the death of a troubled young person sparks a barrage of abuse and mockery rather than sympathy for her family. So what does this say about our society?

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