Trans woman took her own life while waiting to access NHS gender services

A Black trans woman took her own life after waiting more than two and a half years for access to NHS gender services, a coroner has ruled. 

Armanih Lewis-Daniel, 24, died from fatal injuries in Hatch Grove, Romford on 17 March 2021, an inquest at Walthamstow Coroner’s Court found. 

At the time of her death, Lewis-Daniel had been on the waiting list for an autism assessment for almost two years and for an appointment at a gender identity clinic for more than two and a half years. 

According to Dr Duncan Harding – an expert instructed by coroner Nadia Persaud – delays in her autism assessment and accessing treatment for gender dysphoria “intensified Lewis-Daniel’s distress”. It was also noted that in the months prior to her death Lewis-Daniel told a probation officer it was having a “negative effect” on her wellbeing. 

During the hearing, Persaud said long NHS waiting lists for access to gender identity services “could intensify distress arising from gender dysphoria” and “there is little local support available to patients who are waiting for assessment and treatment by gender identity clinics”. 

The coroner said, as quoted by The Standard: “There was a lack of clarity as to who is responsible for the wellbeing of the patient during the waiting period, for any distress caused by the gender dysphoria. 

“Local mental health services have very little specialist knowledge as to how best to support a person suffering from gender identity dysphoria.

“There was a lack of clarity as to who is responsible for the wellbeing of the patient during the waiting period, for any distress caused by the gender dysphoria.” 

Coroner Persaud added there is concern that various NHS services are “not working optimally to support those during the lengthy waiting periods”. 

‘Kind-hearted, protective and fiercely loving’

The inquest heard Lewis-Daniel had a “constellation of mental health difficulties”, including anxiety, depression and emotionally unstable personality disorder alongside her gender dysphoria. 

From January 2021, Lewis-Daniel’s mental health took a nosedive and she had contact with staff members from different departments at the North East London NHS Foundation Trust (NELFT) four times in the two months leading to her death. 

Red flags were raised to her probation officer following a “tumultuous” appearance in court on the morning of 8 March 2021. 

In his evidence to the coroner, Harding stated Lewis-Daniel’s death could have been avoided had she been referred back to an appropriate mental health team on any one of the occasions before her death. 

“In the months leading up to her death, Amarnih’s mental state declined, and she came into contact with the police, criminal justice system and mental health professionals,” Persaud said. “On the 17 March 2021 … Amarnih was still awaiting care from the Gender Identity Clinic when she passed away.”

Angela Lewis-Campbell, Lewis-Daniel’s mother, said her daughter was a “kind-hearted, protective and fiercely loving” person. 

“She knew what it was like to be bullied, and, because of this, she did everything within her power to ensure that others did not have to feel the way she did,” her mother said. 

Lewis-Campbell described how Lewis-Daniel dealt with the difficulties she faced as like “walking along the branch of a tree”, saying her daughter “felt strong and stable until at some point she simply could not take it anymore and she snapped”.

Lewis-Campbell is extremely critical of the police, saying racism and transphobia characterised the force’s interactions with her daughter.

“The police are trying to get away with this because they know they made mistakes,” she said.

Suicide is preventable. Readers who are affected by the issues raised in this story are encouraged to contact Samaritans on 116 123 (www.samaritans.org), or Mind on 0300 123 3393 (www.mind.org.uk). ​Readers in the US are encouraged to contact the National Suicide Prevention Line on 1-800-273-8255.