How can a young person starve alone while on the radar of social and health services? David Fisher investigates a Kiwi teenager’s slide towards a lonely death amidst struggles with anorexia, identity and family estrangement.
Warning: This story may be distressing to some readers.
Ateen who starved alone in emergency accommodation had multiple encounters with professionals who could have saved him in the days before his death.
Alex, 17, described being so weak he fell over in a Presbyterian Support Youth Services’ office - and was then driven back to a motel unit by another social worker where he was found dead in the days that followed.
Alex shared his final days in online messages and video calls with two female friends - Emma, 30, from New Zealand and Laura Berkowitz, 54, from the United States - both separately connected with him online. Both had battled anorexia and wanted to help young people with the same condition.
Alex was found dead on January 16, 2023. His weight had fallen from 47kg to 30kg in just five months - the period of time in which he had been living away from friends and family in emergency accommodation.
Alex shared his journey from health to death in detail online. He had carefully hidden his true identity and location over years of posting with friends on message boards and Discord servers.
In the real world, the Herald has found Alex was isolated at the point of his death and actively avoiding - and lying to - medical professionals who might have identified an eating disorder out of control.
Alex was estranged from his parents after leaving the family home 10 months earlier following what he called “hundreds” of arguments, many over his transition to a male gender identity.
His parents have spoken publicly about their devastation at the loss of their child.
Alex’s last day out appears to have been on January 12, 2023, when he caught a bus to meet his “youth coach” at Presbyterian Support.
Emma provided the Herald with messages sent by Alex over five months including one at 10.34am that day, saying he had “managed to make it to the bus stop” and was planning to stand on the bus in case he was too weak to get up from sitting.
Emma said he rang two hours later and recounted in detail collapsing in front of social workers.
Then, in an online message to a group of which she was part, he wrote: “Everyone at Youth Office noticed weight loss, apparently. One said that they would call the doctor for an appointment within the week, if I hadn’t already, when I fell to my knees, couldn’t get up.”
Alex wrote his youth coach had also noticed the dramatic loss but “didn’t seem too suspicious that I wanted to stand (the) whole time”.
He said one youth worker took him home so he wouldn’t have to bus, and “she saw I had to lift each leg as I got out”.
Emma told the Herald: “I was horrified that he had been taken home, and left alone. I firmly stated [to Alex] he would not be alive in another week, and begged him to phone an ambulance.
“He refused to tell me his location as he was adamant he did not want anyone to intervene.”
It was an account he repeated in conversation with Berkowitz, who lives in the United States. She told the Herald: “I begged him to call an ambulance. I did not know his first name, his last name or where he was. All I could do was beg him.”
Alex wrote to a support forum: “I plan to perhaps have a nice shower, tell the motel owner I don’t need sheet changing this week, calmly sit in my bed ... lose as much weight as possible, and embrace death with open arms. Just let the f****** angels take me ... I have nothing to live for anymore.”
He was visited by another worker later that day, writing to the forum at 2.59pm: “So my Housing First worker just came to see me. She was worried too.
“Kinda said same thing to her, I want a couple of weeks to myself, no contact, just ‘resting from extreme burnout’. She said she’d see about a phone call arrangement as an exception [to a personal visit].”
In the few days left to Alex, Emma and Berkowitz - unaware of each other - desperately tried to pin down where in New Zealand he was.
Emma hunted for clues through thousands of archived messages. She narrowed the search to four towns and then one by matching references in posts to what she could see on Google Maps.
On January 16, she called a motel that had been mentioned in news stories about emergency housing.
“I phoned the motel at 10:16am on January 16th asking for someone to go and check on Alex, and that he would be in desperate need of medical attention. The receptionist was kind and sounded thankful.”
She called back two days later, hopeful the silence meant Alex had been rushed to hospital. Instead, “the owner told me she had found him dead following my phone call”.
A young man who died alone
Alex faced challenges for years, according to his messages and his parents’ account. His parents reported Alex was subjected to sexual abuse at primary school, had obsessive compulsive disorder and was diagnosed as autistic - albeit high functioning - aged 15.
Alex had also alleged more sexual assault by a health worker in early adolescence.
In messages, he describes being diagnosed with anorexia nervosa in 2017 after being hospitalised aged 11. Later, on the recommendation of doctors, Alex was put under a compulsory treatment order.
Emma and Berkowitz’ own experiences fighting eating disorders led them to try to help Alex after August, 2022, when he moved alone into emergency accommodation.
Emma provided a statement to police after his death, saying: “His thoughts and behaviours were typical of severe anorexia, and ... he was deeply entrenched and trapped in his thinking.
“He was adamant he did not want anyone to intervene and ... worked hard to keep his eating disorder hidden.”
He was, she wrote, “very isolated”.
Alex and his online world
The Herald tracked Alex’s online life through interviews with some who knew him and messaging back to 2019 and found it was in stark contrast to his real-world existence.
In the town in which Alex lived, he had few friends. Online, though, he was bright, chatty and engaging.
He shared everything except who and where he was.
Along with a recovery-focused eating disorder group, Alex was an active member of two Discord servers, free social group chat platforms, one of which he created and hosted.
Alex’s journey into adolescence can be tracked through those servers from the days when he and younger members swapped Minecraft imagery and memes through to later years when memes began to test boundaries with off-colour online teen humour.
As they grew up together, the friends explored new music frontiers, shared frustrations, swapped examples of school work and made clumsy, curious references to drugs and sex.
Along the way, some hinted at the prospect of revealing their real-world identities to each other. In Alex’s server, which the Herald has chosen not to identify, there was greater reticence - perhaps because Alex shared so little.
It was a safe place for Alex to talk about gender.
“I’m AFAB (assigned female at birth) but I don’t feel comfortable, maybe I’m non-binary?” Berkowitz recalls Alex saying.
“Alex said he did not feel at all like a girl and he never had: ‘I feel more masculine than I do non-binary.’”
In 2022 he wrote: “I feel absolutely like a guy through and through, no question.”
Alex identified as male in messages and posts seen by the Herald across five different sources.
In the messages he consistently presented himself as male for more than a year before he died and identified as non-binary for an extended period before that.
“I do not go by my birth name any more as hearing/seeing it makes me very uncomfortable” he wrote in one.
“I am trans and don’t really associate that name with myself at all anymore.”
He wrote about how hard it was to bridge the gap between how he looked and how he felt: “Then I look in the mirror and it’s literally like ‘what the f*** am I look(ing) at’ lol.”
Gender was not a common theme. It was another element of life in the server Alex hosted, nestled among so many other slices of life from the personal to world-changing: the emergence of Covid-19, the death of Queen Elizabeth and the invasion of Ukraine.
On that topic, Alex told the others “I’m gonna go talk to Dad about this, see what he says”.
He continued that, while the pair clashed, “he’s pretty much the only person that reads up (on) politics in this house and is well-versed on the subject. So I will take notes and report back.”
That was February 24, 2022. Alex was in his last month at home and would be dead in a year.
‘You know your mum loves you’
Alex’s messages convey a complex and deeply strained relationship with his parents.
They faced a challenging set of issues - the sexual abuse at primary school, the eating disorder and hospitalisations, compulsory treatment orders and a diagnosis of autism.
Alex’s parents came to parenting late and had both migrated to New Zealand.
Online, Alex described having tight boundaries, particularly around devices. He would complain of YouTube - and other sites - being blocked. He knew his parents were worried about pro-anorexia websites.
He talked about disguising the websites he was visiting, mainly to keep in contact with his Discord friends.
Tension at home heightened over gender issues: “I begged [Mum] not to tell Dad but what was the first thing she did? Rushed off and gushed to Dad about her ‘delusional daughter’ ...
“The situation only escalated to the point where months later I had to move out.”
Messages reveal Alex didn’t want to take hormones or have gender-affirming surgery until he was in his 20s and possibly not even then.
But he did want masculine clothing, a haircut and a chest binder. Alex said none of these things happened at home.
He wrote: “Hundreds of arguments arose around gender and trans topics and often ended in screaming ... ”.
Berkowitz told Alex to stop arguing his case with his parents.
“You know your mum loves you. You have to stop trying to convince your dad. Talk to people on Discord, stay safe,” she advised.
“But he wouldn’t.”
In late 2022, Alex wrote it had been a year since he’d “come out” as male and his parents had not accepted it.
In March 2022 he called a friend to ask if he could be collected.
With two boxes, aged 16 and three months, Alex left home.
‘They don’t want to see me’
For the five months that followed he lived with a couple who had teenage sons. “I’m in an environment where I’m just treated like all the other guys in the house and it’s good, obviously,” he wrote.
Changing house didn’t change Alex, or his gender dysphoria: “the occasional ‘she’ just really throws me off and when I go out and stuff and get referred to as a ‘lady’ ... I just want to look like a guy so desperately”.
There were high points. His friend’s mum took him shopping for men’s pyjamas and other male clothing. Alex wrote of how fulfilling it was, posting a picture - no face - in his new PJs, telling online friends they were from the menswear section.
There was a trip for a haircut. To a “barber”, he declared.
Alex’s estrangement was difficult.
In text messages between Alex and his parents in May 2022 - a few months after moving out - the family discussed a possible meeting. Alex explained he would be dressed in a masculine way and asked his mother and father not to call him by his birth name or gender.
“When and if things change it would [be] wonderful to hug my daughter. Dad thinks the same. We love you” his mother replied in the text exchange.
Alex forwarded the message to an old school friend, adding: “I just feel so sad ...”
Life at his other friend’s house lasted until the family needed to move away and Alex moved into emergency accommodation.
His messages from August 2022 mark a shift. He said anorexia “was back” - and that he had a specific weight fixed in his mind.
“I know I’m not fat, but I just really wanna be that number,” he wrote. “I just pray I don’t get caught.”
‘We were alienated from our child’
Alex’s parents remember their child as female and, to protect their privacy, use the name Vanessa in public statements. The Herald quotes a statement from Alex’s father as it was written.
“Why did the state fail to sustain her life (and protect her from the obvious consequence of anorexia nervosa) when it was they who had complete and total control of where she lived, how she lived, her educational needs, her financial needs and her ‘identity’ needs?
“In the last nine months of her life, our daughter’s trans-identity/fixation was affirmed by everyone around her: school teachers, social workers, counsellors, MSD, Presbyterian Support, Salvation Army, housing providers, NZ Police, doctors - everyone. Do you see any lack of support for gender affirmation in the last nine months?
“Quite simply, ‘Vanessa’ did not die from a lack of gender affirmation, she died from a lack of the most basic care; to simply check that she was eating.
“CAMHS [Child and Adolescent Mental Health Services] played this role until discontinuing the Indefinite Compulsory Treatment Order shortly after her 16th birthday. Perhaps reaching 16yrs was the only excuse they needed to ‘drop’ her? A matter I expect the Coronial Inquiry will investigate.
“Would you not consider that publishing ... ‘Vanessa’s’ online messages is assisting in a cruel distraction, a misdirection, intended only to discredit our viewpoint? Juxtaposing the ‘caring’ online trans-community against the ‘terrible’ parents.
“Yet, as it became clear that ‘Vanessa’ was dying slowly for weeks in front of her laptop, what did any of her online trans-supporters do about her Anorexia Nervosa/her starving to death?”
A separate statement from both parents - as it was written - said: “First and foremost, we loved ‘Vanessa’. She was our only child and her death has all but destroyed us.
“We acknowledge that there was tension and conflict between ‘Vanessa’ and us.
“Children often become very angry with their parents when we have to assert our authority and make decisions we consider to be best for them. She was very angry with us. Doing the right thing by our child was often the very hardest thing.
“To be clear, Vanessa was not ‘lost’ due to her ‘gender identity’. Her anorexia, a long-standing and deeply painful struggle, was the cause of her death. She was 30 kilograms when she died. That is what killed her.
“Parenting is never easy, but when your child is autistic, has anorexia, and is a survivor of childhood sexual abuse, the challenges can feel overwhelming. As parents, we have always done our best, but the complexity of ‘Vanessa’s’ needs and the trauma she carried meant we often had to be the ‘bad guys’ advocating for her best interests when her mental illness was telling her to harm herself.”
“In all but a few sad circumstances, family and parents are best placed to advocate for their children and ensure they get the care they need. We were alienated from our child and then those who drove that alienation left her to die.”
‘Anorexia wins when you die’
Emma met Alex online in September 2022 when he was living on his own. To her, everything about him was alarming, she said. He was locked into a pattern of behaviour “typical of severe anorexia” complicated by autism and obsessive-compulsive disorder.
She said Alex worked to isolate himself from anyone who might interfere with his dangerous behaviour, spending time with online friends who didn’t know who or where he was.
Alex didn’t want to meet a “shrink” from Child and Adolescent Mental Health Services and hoped the appointment would be over Zoom.
When his mother expressed concern and hope he would see his psychiatrist in person, he raged at her interference.
On September 16 he wrote: “I don’t want to get f****** weighed ... She and the rest of CAMHS can die and go to hell. I know that’s harsh but I am FURIOUS right now.”
He bought a set of scales, compulsively weighing himself and everything he ate.
The meeting with the psychiatrist went ahead on September 21. To Alex’s clear delight, it took place over Zoom in a library which - he said - caused privacy issues. He wrote: “We just had to make do with the chat function, lol. She asked me (obviously) about my weight and eating; obviously, I lied my ass off about that.
“She asked me if I felt suicidal or depressed ... and I lied my ass off about that too. But she ... was happy enough to discharge me from her care over to my GP right then and there!”
There would be no face-to-face meetings or weigh-in.
Social agencies tried to engage but were no match for his deception.
Berkowitz, from personal experience, says: “Anorexia wants to keep you alone and be the only voice in your ear. It wins when you die. That is anorexia’s end goal.”
Through September and October, Alex connected with WINZ and Presbyterian Services to organise an emergency benefit but actively avoided seeing his GP in person for the medical certificate he needed for the application.
He visited a police station “as a last resort” and stayed overnight with the friend of a police officer. In another encounter with Police, he said they were worried about his eating and left him with a food parcel.
By December, he was back in another motel.
Alex’s messages show gender emerged in only a few instances with social agencies: he wrote with delight about his youth coach getting WINZ to use the name Alexander.
“Super nice that every time I log into MyMSD now … I hopefully shouldn’t get hit with my deadname.”
Emma says Alex was resolute about his gender identity with her, yet it continued to be a point of tension with his parents.
Alex’s messages reveal how much he grieved the separation from his parents and that he felt he had no one to turn to.
“I kind of shouldn’t [because] of some of the things he’s said and done but ... f***. I miss my Dad … I do. And I miss when we were closer when we were younger."
‘I don’t want to die’
Alex charted his disintegrating resilience and health in a series of online messages recorded by Emma.
She said every aspect of his life was dictated by routine, ritual, measurement and “painstaking precision”. On one occasion, on Christmas Eve, he described to an eating disorder group how it took nearly five hours to weigh and measure his food.
Alex wrote: ”I don’t want to die. I really don’t ... but I can’t just stop. I feel so lost on what to do. I’m so tired right now. Every moment today has been a conscious effort."
On January 12 2023, days before dying, Alex wrote: “I finally managed to get a hold of my mother to tell her I loved her …”.
Coroner’s inquiry to come
Alex died, aged 17, alone and 26 minutes’ drive from the house where his parents live.
The coroner will determine the causes of Alex’s death and the events that led to it. No date has yet been set for the inquest.
Those who spoke to the Herald intend to offer their memories and message archives to the coroner’s office. Emma has already done so.
She told police investigating for the coroner how she thought Alex’s appointment with Presbyterian Support’s youth service on January 12 would save his life.
“I absolutely believed that if he made it to that appointment, he would be taken to hospital.”
She did not expect he would be dropped back at the motel after collapsing in front of social workers.
The inquest will likely also hear from Alex’s school, Health NZ, the Ministry of Education, Oranga Tamariki, the Ministry for Social Development and social NGOs Presbyterian Support and Salvation Army.
People at a number of those agencies say they cannot comment ahead of the coroner’s inquiry but are looking forward to presenting evidence they hope will lead to change.
Presbyterian Support Services co-chief executive Barry Helem said: “The death of a young person is devastating, and we would like to acknowledge the grief being experienced and express our condolences to the parents and all those who were close to this young person.”
Dr Hiran Thabrew has specialist expertise in eating disorders as a child psychiatrist and paediatrician at Starship Children’s Hospital and is a lecturer at the Department of Psychological Medicine at the University of Auckland.
He said demand is increasing for eating disorder care and there is difficulty meeting needs in the regions.
Thabrew said there are increasing numbers of cases of anorexia, autism and those questioning gender in part because of greater openness around gender issues and “more complex ways of living”.
“Young people don’t ever want to get treatment for an eating disorder,” he said.
While gender issues around body image could exacerbate eating disorder tendencies, Thabrew said the issues were not considered linked.
He said eating disorders and gender issues place challenges on families but family - or other adult support - offers the best path to treatment.
The Herald asked Health NZ about the state of services for eating disorders in smaller New Zealand centres. Mental Health and Addictions Service Enhancement director Phil Grady acknowledged increasing demand locally and globally.
He said the strategy plan for eating disorders was being updated, and Health NZ and the Ministry of Health were working to make sure those who needed eating disorder support received it.
The quality and scope of that care was described in a briefing to Mental Health Minister Matt Doocey in October, which said services were “under significant demand pressure”.
It said the regional specialist model - where experts provide expertise to remote areas - offered quality but not always timely support.
It also said services were understaffed and didn’t have data that adequately captured the level of need.
Berkowitz says she tried everything she could to get Alex to seek help in those final days.
“I kept saying, ‘what about your mum’ and he said, ‘she doesn’t want to see me like this, she’ll be heartbroken’ and I said, ‘she’ll be heartbroken if you die’.
Their last video chat was 15 hours long.
“Basically me begging him to call an ambulance. He could barely keep his eyes open.
“He said he would call an ambulance the next day and asked me to stay on video chat with him. I did ... but at some point around 4am, I fell asleep.
“When I woke up he was gone.”
The NZ Herald editorial code of conduct and ethics says a person who changes gender is transgender and should be referred to by the gender identity with which they identify.
Do you need help?
Eating Disorders Association of New Zealand: Ph 0800 2 EDANZ or email info@ed.org.nz
Eating Disorders Carer Support: Email info@edcs.co.nz or https://www.facebook.com/EDCSNZ
For urgent help contact your GP.
• LIFELINE: 0800 543 354 or 09 5222 999 within Auckland (available 24/7)
• YOUTHLINE: 0800 376 633 ,free text 234 or email talk@youthline.co.nz or online chat.
• NEED TO TALK? Free call or text 1737 (available 24/7)
• KIDSLINE: 0800 543 754 (available 24/7)
David Fisher is based in Northland and has worked as a journalist for more than 30 years, winning multiple journalism awards including being twice named Reporter of the Year and being selected as one of a small number of Wolfson Press Fellows to Wolfson College, Cambridge. He joined the Herald in 2004.
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