A woman with chronic pain who wears a blue 'Please offer me a seat' badge today calls on her fellow Londoners to 'look up' and be aware of those who struggle on the Tube with hidden illnesses.
Dr Alex Lee, who graduated with a PhD from UCL in March 2017, said anecdotally '90 per cent' of commuters fail to get up and offer her a seat, despite her badge.
Dr Lee wears the badge around London, and she says it has given her the confidence to ask other passengers for a seat on the Tube.
However she said it is "rare" that commuters offer their seat without her having to ask, as she does not visibly appear to be disabled.
The Look Up campaign, joined by TfL last month, asks people travelling on public transport to look up to see if someone is in greater need of their seat.
Dr Lee has worn a blue badge - for people with invisible impairments - since November 2016, when she was invited to take part in an initial 20-day trial by TfL.
She told the Standard using the badge day-to-day has been "life-changing".
"It gives me the confidence to ask for a seat when I want one," she said. "I don't look disabled and so before the badge I didn't feel like I would be able to ask for a seat - even when I did need one."
Dr Lee has a genetic condition called Hypermobile Ehlers-Danlos syndrome - a connective tissue disorder that means she is too "stretchy", she explains.
It means her joints are loose and do not stay in place very well, causing chronic pain, dizziness and fatigue.
"If I stand for longer than 10 minutes my feet go numb," she says. "I am usually in pain all the time.
"It's not always the same thing, but there will normally be something that hurts."
Travelling on the Underground prior to the launch of the blue badge was "horrible", she said.
"I avoided rush hour as much as I could because I knew that I wouldn't get a seat.
"If I did I would arrive at my destination in pain and have to wake my feet back up again.
"I would have to stand concentrating on remaining upright and telling myself it would be okay - hoping that there would be a seat at the next stop."
In April 2017, TfL officially launched the free 'Please offer me a seat' badge to help people with invisible impairments (ranging from hidden disabilities, conditions or illness) following a successful trial in autumn 2016.
Currently 81,000 badges have been issued to disabled customers and those with invisible conditions.
"It means that the pain is a lot more manageable and I'm a lot less tired when I reach my destination," Dr Lee said.
The academic strongly praises the scheme, and promoted the badge as part of TfL's 'Priority Seating Week' in April this year.
But she said that she still has to ask for a seat on the majority of her Tube journeys.
Dr Lee said people often look down at books or phones during their commute, rather than looking up to see if someone needs their seat.
She said: "It's really rare that someone would offer me a seat or stand up for me without me having to ask.
"I would say maybe 10 or 15 per cent of the time. Usually at least 90 per cent of the time I have to ask.
"But people rarely do it by themselves, which is why I think the Look Up campaign is so important.
"This campaign has got loads of momentum at the moment and it's meaning that people are looking up."
Our customer @CorryShawComedy is disabled & lives with chronic pain.— Transport for London (@TfL) July 18, 2018
She needs a seat when travelling but struggles as people don't look up to see this. She asked us & @MayorofLondon to back her campaign.
Now we have. #LookUp to see if someone needs your seat more pic.twitter.com/WYNVPYKH9N
She said she is "thrilled" to see the campaign so widely acknowledged.
TfL joined the Look Up campaign in July, launching station and train driver announcements that ask 'please look up to see if anyone needs your seat more than you do'.
Alongside this, there are further measures to raise awareness such as promotional posters in station halls, messages on digital advertisements and social media activity.
This supports TfL’s existing Travel Kind campaign, which encourages customers to be considerate of one another when using public transport.
Mark Evers, TfL’s Chief Customer Officer for London Underground said: “Being able to get a seat on public transport can make a real difference to people who are less able to stand and we’re pleased to get behind the Look Up campaign to support our work to make services more comfortable for people with accessibility needs.
"Asking passengers to look up while travelling is a simple way to ask customers to be considerate of their fellow passengers and raise awareness of the needs of people with visible and hidden disabilities.”