Sitting together in the bright living room of their family home in Surrey, Caroline and Peter Litman complete each other’s sentences, as can happen after 28 years of marriage.
“We’re not the best informed,” says Peter, 57, who wears a small ‘trans ally’ pin on his T-shirt.
“We make mistakes and don’t always use the right words,” says Caroline, 56.
“But what we hope we can do to help the trans community is humanize the debate. This is just an ordinary family; a cohesive, loving family torn apart,” Peter continues.
“Not because Alice was transgender,” says his wife, “but because of the reaction to her being transgender.”
Their youngest daughter, Alice Litman, was 20 years old and living in Brighton with a close friend when she died on May 26, 2022. Her parents believe their daughter’s struggle to access timely mental health and gender-affirming care has contributed significantly to her development. dead.
A coroner will release her written conclusions into Alice’s death next week, and she has already presented the evidence before her suggesting that transgender health care is “underfunded and inadequately funded for the level of needs faced by the society we live in today.” life” exists.
Reading Caroline’s witness statement to the inquest, at which the family was supported by the Good Law Project, her anger and frustration burst from the pages as she describes the repeated minimization and dismissal she encountered. “It was a huge struggle to get her taken seriously,” she says now.
It was a “complete surprise” for Peter and Caroline when their youngest child – dancer, rugby player, who wanted to be like “that cool scientist (Einstein)” when she grew up – told them she was questioning her gender identity.
The family was aware that something was bothering the 16-year-old: she was becoming increasingly anxious and her school attendance was declining.
Caroline remembers asking her, “Are you in trouble, has anyone asked you to do something illegal, are you being bullied?” But I didn’t ask her if she was transgender. It’s something I’m a little ashamed of.”
Caroline herself worked as an NHS psychiatrist for twelve years. She left the profession more than a decade ago, partly because, without any irony, she now admits, she was demoralized by the ‘plaster’ of her job.
It was a background, she openly admits, that had given her a special perspective on gender dysphoria as a psychiatric disorder. “We learned stories of people who wanted to cut off body parts because they didn’t feel like they belonged, and that these people were deluded and psychotic.”
Her immediate fear was what Alice might want to operate on; Peter worried that she would lose her fertility. “But who knows what choices she would have made if she had had the right treatment at the right time?” he says. “There is an obsession in our society with what is between your legs.”
Instead, they found themselves advocating relentlessly for their increasingly depressed and isolated daughter, who found her experience of being ‘in the wrong body’ tortuous as puberty progressed, with no immediate prospect of specialist care or the hormonal intervention she wanted so much.
The waiting list for the youth service at the NHS Gender Identity Development Service in Tavistock was 24 months when Alice joined in 2019, a year after first discussing her gender identity with a GP. Although the controversial service has since closed and an independent review recommended the creation of regional hubs, there were still 7,560 under-18s on the waiting list in May.
After Alice’s referral, she began to go through a social transition, and the family hosted a tea party to celebrate Alice joining the family: Caroline remembers her beaming and skipping around the kitchen. But soon her hopelessness about the looming wait for treatment returned.
Alice was transferred to Tavistock’s adult gender identity clinic when she turned 18, but was still awaiting an initial assessment when she died. The adult service has a waiting list of more than 13,000, the inquest heard, with an estimated waiting time of five years.
Desperate, the family sought private treatment, but Alice was unhappy with the prescription she received.
They say their experience with child and adolescent mental health care has been equally difficult. Caroline remembers leaving early meetings “feeling that the diagnosis was bad parenting.”
There was the GP who suggested Alice play more football, and the nurse who blamed her low mood on ‘lifestyle choices’.
Alice attempted suicide twice in 2019. Three months after the second attempt, she was “suddenly removed from care,” says Caroline, and was completely discharged from the mental health system after turning 18.
Regardless of the outcome of the inquest, the family – Alice had two older siblings, Kate, 26, and Harvey, 25 – want to add their voice to the call for systemic change.
“The gender identity clinic needs a complete overhaul,” says Caroline, “but no amount of money or specialists will be able to shorten a waiting list of that length. Without proper planning, they can’t just keep doing more of the same. The only realistic way we see to quickly reduce the waiting list is through primary care.”
GPs need good guidelines, says Peter, to help them support and, if necessary, prescribe hormone treatments for transgender patients. “That’s what most developed countries do and what most transgender people want.”
Surrounded by framed photos of grinning siblings, the couple is painfully aware of the toxic public discourse that has developed around transgender issues.
“She told us she didn’t deserve to live,” says Caroline. “She didn’t specifically say it’s because people hate me, but that must have been on her mind.”
She attended Pride in London in 2019, but had no desire to become an activist, her father says. “She just wanted to be left alone so she could live the life she wanted.”
The couple stay away from social media, but Kate – who posts online about the family’s burgeoning campaign – has described being ‘inundated with hateful comments’ during the inquest.
“You are afraid of what people want to say about your daughter’s death,” says Caroline. “You don’t have to point out my shortcomings as a mother. I feel guilty every day that I couldn’t save her.”
Despite her struggles, Alice maintained close relationships with her school friends. “They are the sweetest couple,” Caroline says warmly, “and they helped us get to know her a little better.”
Alice enjoyed playing the fantasy role-playing game Dungeons and Dragons. “We heard her get so emotional about it upstairs: screaming and yelling and getting angry,” Caroline remembers.
But her laughter stops. “I’m sad now because we weren’t really interested and I wish I had paid a little more attention.”
Speaking of their daughter, they are constantly judging each other’s sadness. “You listened to her,” Peter whispers to his wife, placing a hand on her knee.
“We had a very close relationship,” he adds. “We were able to express very well how much we loved each other. I deeply regret it, but we are confident that Alice knew she was loved.”