What happens when a young trans woman is failed by her doctors? For Synestra De Courcy, it seems the answer is a downward spiral of prostitution, depression and drugs – ultimately leading to her death at just 23.

A coroner gave her official verdict of what killed Synestra last week. But for Amanda De Courcy, her mom, the final hours of her beautiful little girl’s life are only half the answer.

Speaking to Gay Star News, she has today shares the story of how Synestra was repeatedly denied the treatment she needed from Britain’s National Health Service.

Their family home is in Stevenage, a commuter town in the east of England, where Synestra grew up as a high-achieving student.

At 15 she started openly wearing make-up and dressing in a way she described as androgynous. She wasn’t bullied for this – in fact the other students saw her ‘pushing boundaries’ and voted her ‘head boy’.

She began to live full-time as a woman from autumn 2011, aged 19.

She moved to London to study cosmetic science at the University of Arts, living with friends and enjoyed life both as a fun, party animal and, according to Amanda and her friends, as a ‘quiet soul’.

In 2012, Synestra paid to see Dr Michael Perring, a psychotherapist and expert at dealing with transgender patients. Dr Perring diagnosed Synestra as a ‘well adjusted self medicating transgender person’.

He provided guidelines to help her National Health Service doctor give her the medication and blood tests she would need. This should have given her free healthcare, paid for by the state.

But the doctor’s practice denied they had got Perring’s letter. Synestra handed them a copy in person but they were still reluctant to deal with her.

The agreed to carry out the blood tests but not to prescribe the medicines. After a while they struck her off their list of patients and told her to go to a whole other city to find a new General Practitioner.

Eventually a local trans support worker and her father, John, intervened and the doctor agreed to take Synestra back. Even after this, they demanded Synestra take more tests rather than sending her to a specialist Gender Identity Clinic straight away.

For Synestra, the delays and blockages while she had to live in the wrong body were too much.

She turned to prostitution so she could afford to buy the hormones online that her doctor refused to give her. Sometimes she was spending £500 ($746 €690) a month on drugs that should have been more-or-less free on the NHS.

This seems to have been the start of a downward spiral for her.

She went in to hospital for an operation and came back from four days away to find she had been robbed of £10,000 ($14,920 €13,790), plus Louis Vuitton boots, worth about £1,800 ($2,686 €2,480). The money had been set aside for her next major operation.

She was raped on more than one occasion. One time she was in a nightclub when she disappeared. She was found a little later in one of the loos with no memory of what had happened. It appears she had been slipped a date rape drug and CCTV showed four men followed her into the loos.

She was very reluctant to go to the police, because she felt this is just ‘what happens’ to trans people.

Despite this, her life was on an ‘upward trajectory’ in her last few months.

In early 2015, she voluntarily entered a program to treat her depression and her drug addiction, and was doing well. She remained a diligent student, committed to finishing her course and getting degree.

She was planning to move in with her boyfriend, Jonathan Palmer, and they were making plans for the future.

Speaking at the inquest, he said: ‘Synestra was one of the most beautiful people I have ever met. She was warm, highly intelligent, an enigma.

‘She was the one I wanted to spend the rest of my life with.’

The weekend she died began with a family meal at her parents with her boyfriend joining her. Her parents say she was happier than she had been for a long time.

That Saturday night the pair went to trans night, Wayout Club, in London before heading on to a house party. Eventually Synestra said she was tired and went into the bedroom to lie down.

Around 7pm, one of the other people in the house noticed Synestra appeared not to be breathing. An ambulance was called and Jonathan and their friends fought to revive her – but at 7.18pm on Sunday 26 July she was declared dead.

An autopsy found traces of mephedrone (‘meow meow’) and cocaine in her urine – both drugs that can cause a heart attack when used at any level.

Two witnesses at the inquest on 11 December described how Synestra had been using club drug GBL in the hours before her death although this wasn’t found in her system. Jonathan reports she used GBL as a ‘coping mechanism’.

Ironically the fact she had been trying to get off drugs may have contributed to the tragic outcome off that night, according to the coroner at her inquest. She told the court that as you wean your way off drugs, your tolerance decreases very rapidly and a dose you could once handle can suddenly prove fatal.

The coroner, Ms Hassell, at Poplar Coroners’ Court returned a verdict of drug-related death. She said: ‘It seems to me all the evidence points in the same direction.’

Two pieces of news arrived too late for Synestra – her doctor had finally decided to give her the medicines she should have been receiving since 2012 and the hospital was finally moving forward with her gender surgery. Would it have made any difference if she had known that before her last night?

Her family have another question too? Would medical professionals treat any other category of patient with such disdain? Would any other patient have needed, as Synestra did, to fight every inch of her journey – or take three years to work through the system?

Amanda told us: ‘There was a lack of understanding which was ultimately a death sentence to her.’

She is determined to help other kids avoid what her daughter went through so is working to help school age children with gender issues.

It’s work Synestra would surely endorse – despite her challenges, she shared her story and tried to help others, particularly through Facebook and YouTube. Here’s one video of her talking about surgery.

Synestra is not forgotten.