A backlog of letters

After much procrastination I have finally got my act together and recorded my first independent Instagram reel. And it turns out it wasn't that difficult to edit it myself after all.

In it I explain that since the UK Supreme Court ruling on 16th April I vowed to write weekly, or twice weekly, to Wes Streeting and Keir Starmer. I have failed. But I have written to both multiple times, both before and after the ruling, and those I can find within the chaotic workings of my laptop are set out in chronological order below. They are not really intended for anyone to read in one sitting, but they are recorded here, as a log of my efforts.

The first time I emailed Starmer's office I got a stock reply that went out to everyone who wrote to complain about the SC judgement. Further emails and an initial snail mail letter I wrote subsequently, were ignored. Streeting's office was worse, failing to acknowledge any email or letter beyond an automated receipt.

So, the sixth time of writing to Streeting at the DHSC I did something different, I cc'd the letter to Starmer with a covering letter. This mixed things up. Today, a crisp envelope with 10 Downing Street embossed across the flap, arrived in the post.

I have to admit, the letter was kind, and personal. It didn't use any of the stock phrases that we've become so used to from this Labour government, no claims that they are treating trans people with compassion, respect and dignity, when we know they are not. For that I am grateful.

So what did it say? It offered condolences in a sincere and compassionate way. It assured me that my "championing of the transgender community is extremely valued". It said my comments about the importance of gender affirming care had been "carefully noted". It said the Prime minister appreciated my offer to share my experiences. But it fell short of accepting that offer.

What did it actually say that was of any material benefit to trans people? Nothing. It did however say the letter would be sent back to the DHSC for them to address the matters I raise.

Perhaps Streeting will be moved to finally reply to me, to acknowledge my existence and the existence of Alice and dozen's of other young people like her, when the letter is pushed in front of him by an embarrassed advisor. An advisor who has to admit, yes, they have seen the letter before, but they didn't notice the PM was cc'd in, or they did, but didn't think he'd take any notice either. Maybe I am being wildly overoptimistic and he will continue to ignore me. In a way I hope he does, because it will just highlight his arrogance and lack of empathy.

In the meantime I will keep on writing and If I get a reply I'll let you know. But even if I do, we'll all know Streeting only reached out because his boss told him to.

As letters of condolence go, this is one of the better ones. The head of the direct communications unit knows how to write a letter.

The Letters

First email to Streeting 28th October 2024

(Warning, this email contains very brief but specific detail about how Alice died).

Dear Mr Streeting

I am writing to you in your capacity as Secretary of State for Health and Social care. I am Caroline Litman, the mother of Alice Litman a transgender woman who died by suicide on 26th May 2022, aged just twenty. At the time of her death she had been on the waitlist to be seen at a gender identity clinic for 1023 days. If she were still alive today she would still be waiting, more than five years after her original referral.

At her inquest, the coroner ruled Alice's death was preventable and issued a Prevention of Future Deaths notice to: NHS England, the RCGP, The Tavistock and Portman NHS Foundation Trust and Surrey and Borders Partnership NHS Foundation Trust, in order that they might address the failings she identified in Alice's care.

You can access the report here: https://www.judiciary.uk/prevention-of-future-death-reports/alice-litman-prevention-of-future-deaths-report/ 

Upon the election of a Labour government, large sectors of the trans community and their allies were hopeful the treatment of trans people would improve. Unfortunately this has proven not to be the case. As a qualified doctor and an ex-NHS psychiatrist, the failure of this Labour government to understand the impact of the current state of trans healthcare, and the way trans people are being used by far-right organisations to undermine the rights, not just of all of those in the LGBTQ+ community, but of women too, fills me with dismay.

I am moved to write to you today, to ask for a meeting to discuss my concerns about Cass, the puberty blocker ban and the complete failure of the NHS in England to provide timely life-changing care to trans people.

My request is prompted by reading that you met last week with four nurses from Darlington to discuss their concerns about a trans colleague. As you must know, their petition was organised by Citizen Go, a far-right organisation opposed to trans existence, as well as being against same sex marriage and abortion. 

It appals me to see a gay Labour health minister, apparently happy to embrace a gender critical ideology that is quite happy to throw gay people and women of child-bearing age, under the bus, in their efforts to demonise and demean trans people.

It's time you listened to trans people and their families. We are not monsters. Alice was not a monster, she was my child and she died. She jumped off a cliff. She had been assaulted and name called in real life and on-line too many times. She had experienced the health service turn her away, discharge her and put her on a waiting list for non-existent appointments for too long. She broke. She was not drunk or high. She was not depressed. She was hopeless.

The current ant-trans rhetoric plastered over our print media and on-line, asserts that people like me and my daughter are paedophiles, perverts and groomers. It must stop. It is exactly the same moral panic that spread through the 1980s about gay people under Margaret Thatcher. How can you, as a gay Labour politician sit silently and not comment on this obvious parallel? How can you act as if you agree?

Please show the trans community that you are willing to meet with the people who are most effected by the policies you are putting in place. Not just four gender-critical nurses, but the mother of a trans child who died, in part due to NHS failings that you as Secretary of State for Health, help perpetuate. Surely meeting with a mother whose life has been turned upside down by her daughter's suicide, in the face of what I see as systemic NHS failures towards trans people, is as at least as important as meeting with four women who are triggered by anxieties about encountering transgender bodies.

Yours sincerely

Dr Caroline Litman

Second email to Streeting 12th December 2024 (The day of the permanent puberty blocker ban).

Dear Mr Streeting

I am he mother of Alice Litman. I have asked for a meeting before, in your capacity of secretary of state for health and you ignored me.

Now I have evidence that Professor Appleby's DHSC report is a sham perhaps you will reconsider?

I look forward to hearing from you

Caroline Litman

Then six minutes later I emailed him again.

Dear Mr Streeting

It has caused me immense distress that you cited Professor Appleby's DHSC report  to claim there is no added risk to the mental health of young trans people from your proposed puberty blocker ban.

Now, as a result of my battle to find answers about my dead child's data,  we know the report is unreliable. Will you reconsider your claims and apologise to parliament for misleading them?

Yours sincerely

Caroline Litman

A fourth email to Streeting, 5th February 2025.

Excuse the repetition, but I have to assume he is reading as if hearing from me for the very first time.

Dear Mr Streeting,

I am writing to you once more in your capacity as Secretary of State for Health and Social care. I am Caroline Litman, the mother of Alice Litman a transgender woman who died by suicide on 26th May 2022, aged just twenty. I am also an ex-NHS psychiatrist. At the time of her death Alice had been on the waitlist to be seen at a gender identity clinic for 1023 days. If she were still alive today she would still be waiting, five and a half years after her original referral and with years more to wait.

At her inquest, the coroner ruled Alice's death was preventable and issued a Prevention of Future Deaths notice to: NHS England, the RCGP, The Tavistock and Portman NHS Foundation Trust and Surrey and Borders Partnership NHS Foundation Trust, in order that they might address the failings she identified in Alice's care.

You can access the report here: https://www.judiciary.uk/prevention-of-future-death-reports/alice-litman-prevention-of-future-deaths-report/ 

I am writing about your decision to make the puberty blocker ban permanent for trans youth (but not cis youth).

In parliament on the day the permanent ban came into effect, you cited Professor Louis Appleby's DHSC review into suicides at the Tavistock gender clinic, to dismiss backbencher questions about the detrimental effects the ban would have on the mental health of trans youth.

https://www.gov.uk/government/publications/review-of-suicides-and-gender-dysphoria-at-the-tavistock-and-portman-nhs-foundation-trust

Ever since that report was published I have made a series of FOI requests to the DHSC, NHS England and The Tavistock and Portman NHS Foundation NHS Trust, to establish whether data about my daughter's death was made available to Prof. Appleby, for his review.

Imagine my distress, when on the very day you announce in parliament that you will extend the puberty blocker ban indefinitely, I discover my child's suicide was not counted by Professor Appleby in his report. Alice's suicide is probably the most high profile trans suicide this decade. If her death on the waitlist was not counted, how many others were missed? I believe my discovery renders Professor Appleby's report meaningless, and if you to continue to use it to justify, what appears to be an ideologically driven ban, (this) will be irresponsible, at best.

Then just a few days ago, I am made aware of a video where you describe meeting with parents from Bayswater Support Group, a transphobic parents group which has been exposed for promoting conversion therapy and abuse of minors in order to de-transition them. More than that, you not only met with them, you expressed empathy for their parental trauma. 

Can you imagine my trauma, as the mother of a trans child who died whilst languishing on an NHS waitlist for years with no end in sight, to learn this, when my request for a meeting with you, was not even considered worthy of a reply?

Since the Health and Social Care Act 2012, one of the pillars of NHS good practise has been the importance of the voice of the patient. 

https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/138262/B3.-Factsheet-Greater-voice-for-patients-300512.pdf

 “If the fundamental purpose of the Government’s proposed changes to the NHS – putting the patient first – is to be made a reality, the system that emerges must be grounded in systematic patient involvement to the extent that shared decision making is the norm.” NHS Future Forum Patient Involvement and Public Accountability Report (June 2011)

When are you going to start applying this mantra to trans healthcare and listen to trans people and supportive families (who are the vast majority of families), rather than appearing to only listen to anti-trans organisations like Sex Matters and LGB Alliance, and only those parents who bully and disown their children?

Sex Matters and LGB Alliance have no authority to speak on trans matters. Their only agenda is to diminish trans people and strip them of their rights and dignity. Yet you have chosen to centre their voices over the BMA, RCPsych and RCGP who I have learnt all opposed the permanent ban on puberty blockers.

Are you are you aware that on 4/12/1961 Enoch Powell, Conservative health minister, announced the oral contraceptive pill will be available on the NHS for the first time. A Labour opposition MP asked: “is it left to the doctor to decide whether the pill shall be prescribed both for married & single women?” Powell replied: “it is always for the doctor to decide in each case what are the medical requirements”. This should be sounding deafening alarm bells to Labour. Are you happy to be more right wing than Enoch Powell, when it comes to matters of health care?

https://blog.nationalarchives.gov.uk/just-a-pill-60-years-of-the-contraceptive-pill-on-the-nhs/

In addition, just last week I discovered that Finasteride, the medication a private clinic gave my daughter, because her GP refused to administer the gold standard treatment, a puberty blocker, has a warning on its product information sheet for increased suicidal ideation. 

Please explain to me how it makes sense to ban a drug (puberty blockers) because of hypothesised unknown side effects, and for that ban to drive trans youth to be prescribed other drugs with known harms. The same goes for SSRI's which are drugs with a host of unpleasant side effects and which have not been tested on children, but are prescribed to them anyway. Make it make sense.

I implore you to give my email the serious attention it deserves and request that you meet with me to understand the harms you are causing trans people and their families.

On 13th March 2025 you will be able to read all about Alice and my families journey in a ground-breaking memoir about raising a trans child in the hostile climate you and your party choose to exacerbate. You may find it an education and can pre-order a copy here. 

https://www.amazon.co.uk/Her-Name-Alice-transgender-experience/dp/0008667934/ref=asc_df_0008667934?tag=bingshoppinga-21&linkCode=df0&hvadid=80883014839391&hvnetw=o&hvqmt=e&hvbmt=be&hvdev=c&hvlocint=&hvlocphy=&hvtargid=pla-4584482480506377&psc=1

I will also be writing to the librarian at the House of Commons with a view to making some copies available to MPs.

I look forward to hearing from you,

Yours faithfully

First snail mail letter to Keir Starmer 12th May 2025

https://www.carolinelitman.com/post/my-letter-writing-campaign-to-keir-starmer-begins

First snail mail letter to Wed Streeting 19th May 2025

Dear Mr Streeting

I need your help in your capacity as Minister for Health and Social Care. I’m the mother of Alice, a transgender woman who died by suicide aged twenty on 26th May 2022. I am also an ex-NHS doctor.

I have just seen that you reviewed Hannah Barnes book, Time To Think with the words: “a brilliant book written in a very thoughtful way about the failures of the Tavistock clinic”.

I too have written a book, Her Name Is Alice, a memoir about my daughter published by Harper Collins. I wonder if you would care to read my book too. For balance.

It too has been called, brilliant and a must read, gripping and important. I would be very pleased to hear what you make of it.

Alice will have been dead for three years on the 26th May. If she were still alive, she would still be waiting for her first NHS gender clinic appointment. She would have been waiting more than a quarter of her life. She was referred in August 2019.

Please let me know if you would like my editor to send you a copy and she will pop one in the post.

Yours sincerely

Second snail mail letter to Wed Streeting 26th May 2025

https://www.carolinelitman.com/post/a-letter-to-wes

Cc'd to Keir Starmer

Second snail mail letter to Keir Starmer 26th May 2025

This is the letter sent to the PM accompanied by a copy of my letter to Streeting

Dear Prime Minister

I’m the mother of Alice, a transgender woman who died by suicide aged twenty. Today is the third anniversary of her death. Instead of sending her a card I am sending you this letter. I have sent the same letter to the Secretary of State for Health and Social Care but he has repeatedly aired me so I am asking you to intervene.

Today I learnt that in Utah, USA, the Republican party’s own research into gender affirming care, commissioned to support their ban on such care, has instead shown gender affirming care reduces suicide risk and improves mental health outcomes in transgender people, with the effect most marked in the under 18 age group. I’ve not seen the study, which was started in 2023, but reports from the US say that it is more comprehensive than Cass and includes more up to date research. Naturally the Republicans are ignoring it. Will you ignore it too?

Today my husband and I drove to Brighton and left flowers where Alice died. We went to the crematorium to clean her headstone. We returned to bed at midday. We sent messages to and received messages from Alice’s friends. Some of them visited Alice’s grave too. Instead of going to the pub with Alice for a pint or glass of wine, they went to her grave and wept.

As an ex-NHS psychiatrist, the knowledge that my government cherry-picks research and enacts healthcare policies, like in Utah, that harm the mental health of trans people, compounds my grief. Your government retraumatises me, my family and Alice’s friends with your ill- advised stance. It’s too late for Alice, but it’s not too late for all the other trans people who need care. But you choose to traumatise them too, rather than help. I lie awake at night wondering if tomorrow I’ll hear another mother now walks my path. For the current situation for trans youth is so dire, more suicides are inevitable. Being a teenager is hard, being trans is harder, being trans and denied care, being othered and denied access to public spaces or fearing attack or perhaps arrest, is harder still. This effects a person’s mental health. You don’t need to be a doctor or read it in a journal to know this must be true.  

Please stop the trauma and start listening: to me, parents of trans youth who support their child’s transition and most importantly trans people themselves. Please let me bring a group of parents and trans people to 10 Downing Street so you can hear from those effected by your laws, rather than the anti-trans campaigners who encouraged you to implement them.

Yours sincerely

Dr Caroline Litman MBBCh

If you've read all of this in one sitting you are a legend.

Go and do something nice and frivolous. Bake a cake. Eat Nutella straight from the jar. Skip. Or head back to bed.

Alice loved doing all these things.