Trans prisoners in Georgia sue over state’s gender dysphoria treatment ban
Five transgender inmates in Georgia’s state prison alleged the state’s ban on gender-affirming care for prisoners violates the Eighth Amendment, and they’re not receiving adequate care. A leading medical association argued that while not every trans person experiences gender dysphoria — a requirement many states have — a lack of a diagnosis shouldn’t prevent states from offering such care.
Inmates Isis Benjamin, Fantasia Horton, Naeomi Madison, Brynn Wilson and an anonymous John Doe sued Georgia and the state’s contractor for prisoner health care. At issue is the enforcement of a state law that barred access to certain medical treatments for those with gender dysphoria. All of the inmates named are trans and were diagnosed with gender dysphoria and accused the state of violating their civil rights.
The Eighth Amendment’s prohibitions on cruel and unusual punishments extend to medical care for inmates, the Supreme Court of the United States ruled in Estelle v. Gamble.
Gender dysphoria is described as when a person experiences extreme discomfort between their gender identity and biological sex, according to the American Psychiatric Association.
“People in prison deserve health care and we can’t allow our state governments to decide that just a certain group of people — trans people — don’t get health care,” Celine Zhu, justice fellow at the Center for Constitutional Rights, told Straight Arrow News.
The five trans inmates are being jointly represented by the CCR and the Bondurant, Mixson and Elmore law firm in Georgia. They filed a motion for class action status, which stated there are nearly 300 trans individuals held in Georgia’s correctional facilities.
Neither the Georgia Department of Corrections nor the Attorney General’s Office immediately responded to Straight Arrow News’ requests for comment. Centurion didn’t immediately respond to Straight Arrow News’ request for comment.
The legislation Gov. Brian Kemp signed in May prohibited using state funds for treating gender dysphoria in state inmates via cosmetic procedures, surgery and hormone therapy. Treatment for the condition can include speech therapy, hormone therapy, hair removal, sex reassignment surgery and other affirmative actions, the APA said.
The case, similar to others, could test the grounds for what authority state prisons have on incarcerated people’s health care. The group requested the court to mandate the state to resume giving gender-affirming care to all inmates. A hearing is set for Thursday, Aug. 28.
“People will die if this bill isn’t changed, and that’s why we’re seeking immediate relief from the court,” Zhu said.
What does the Eighth Amendment say?
A state’s legal obligation to treat gender dysphoria and transgender inmates can be tricky to litigate on the grounds of deliberate indifference, the American Medical Association wrote in its Journal of Ethics.
SCOTUS ruled that violations of the amendment are qualified if a person shows that care must be medically necessary and failure to provide such is a “deliberate indifference” by prison officials who know that a person is suffering because of no medical treatment.
The journal said patients who are transgender or have gender dysphoria can suffer from extreme distress that includes self-harm and suicidal ideation. Various medical boards and associations have agreed adequate care is necessary to relieve the distress.
Zhu said some of the inmates are either getting half of their prescribed dosages of hormone therapy or being denied the drugs entirely. Some of those same inmates had severe symptoms of gender dysphoria that were remedied under the medication but fear they could return.
The second criteria is harder to prove due to it relying on subjective assessments, the medical association wrote. The five inmates alleged the state exercised this, according to court records, as incarcerated trans people in Georgia were previously given hormone therapy and other treatments before Kemp signed the current bill into law.
“It’s only gonna get worse,” Zhu said, “because a lot of these folks had these really severe symptoms before they started going on treatment.”
States sued for denial of care
Inmates and civil rights organizations have litigated access to gender-affirming care for a number of years.
Three transgender women held in Idaho’s prisons sued Idaho Attorney General Raúl Labrador, other state officials and Centurion Health after the state passed legislation barring transgender inmates from seeking gender-affirming care. Chief U.S. District Court Judge for Idaho David Nye has approved three motions that required the state to resume giving hormone therapy to trans inmates. His order only included people who were eligible for treatment under former policies to maintain the status quo.
Not all judges required states to provide the care. In Florida, U.S. District Court Judge Allen Winsor denied an injunctive relief for Reiyn Keohane, a trans woman incarcerated in the state. According to court records, Winsor wrote Keohane failed to show how Florida violated her rights under the Eighth Amendment.
“The record indicates Keohane receives extensive medical treatment relating to gender dysphoria,” he wrote. “In addition to the hormone treatment currently provided, the Department makes psychotherapy available to those with gender dysphoria. This is not a case in which the Department simply provides no treatment at all.”
Access in federal prisons
Under former President Joe Biden, the Justice Department supported such medical care and filed statements in lawsuits. They argued the Americans with Disabilities Act required prisons to treat a person who has gender dysphoria, which includes sex reassignment surgery.
President Donald Trump issued an executive order during his first month of his second term in office to prohibit gender-affirming care for transgender people in the federal prisons and immigration detention centers. Attorney General Pam Bondi’s DOJ reversed the former administration’s legal position on Friday, April 25, and said the former administration filed the statement based on politics and “junk science.”
Three transgender inmates sued the Trump administration in May over the ban. They’re seeking a class action status, alleging nearly 2,000 trans people are incarcerated in federal prisons. According to the American Civil Liberties Union, a U.S. District Court judge issued an injunction in June, requiring the federal Bureau of Prisons to continue providing such care, despite Trump’s executive order.
“If legislatures like Georgia’s General Assembly tries to do things like this, the community’s not gonna back down,” Zhu said.
Ella Rae Greene, Editor In Chief
