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Court Upholds Trans Prisoners’ Right to Treatment

Court Upholds Trans Prisoners’ Right to Treatment


The U.S. 7th Circuit Court of Appeals on Friday upheld a lower court ruling striking down a Wisconsin law that banned tax-payer funded gender reassignment-related treatment for transgender prisoners.

The American Civil Liberties Union, the ACLU of Wisconsin and Lambda Legal together sued the state on behalf of two trans women over a 2005 law passed by the Legislature, the so-called Inmate Sex Change Prevention Act, that prevented prison doctors from prescribing hormone treatment or sex reassignment procedures.

This case was brought on behalf of inmates Kari Sundstrom (41) and Andrea Fields (29). Both had been diagnosed with Gender Identity Disorder (GID) and had received hormone therapy prior to entering prison. Plaintiffs argued that to deny trans inmates hormone treatment for a medically recognized condition could lead to severe mental and, possibly, physical harm, and clearly violated their rights to be treated like other inmates with established medical needs.

An injunction was granted while the case was ongoing so that trans inmates who had  been receiving hormone treatments to maintain a physical congruence with their gender identity might keep receiving those treatments.

Following a full trial, a federal district court in April 2010 struck down the Inmate Sex Change Prevention Act, saying that to deny trans inmates treatment constituted a cruel and unusual punishment given that the medical needs of trans individuals with GID do not disappear upon entering prison and that to treat them, and only them, differently as this legislation did, was a violation of rights.

The U.S. Court of Appeals for the Seventh Circuit last week upheld that ruling, writing “Surely, had the Wisconsin legislature passed a law that DOC inmates with cancer must be treated only with therapy and pain killers, this court would have no trouble concluding that the law was unconstitutional. Refusing to provide effective treatment for a serious medical condition serves no valid penological purpose and amounts to torture.”

“This was a discriminatory law that cruelly singled out transgender people by denying them — and only them — the medical care they need,” said John Knight, senior staff attorney with the ACLU Lesbian, Gay, Bisexual and Transgender Project. “Too often the medical needs of transgender persons are not treated as the serious health issues that they are. We are glad that the appeals court has found that medical professionals, not the Wisconsin legislature, should make medical decisions for inmates.”

“This decision should make it abundantly clear that it is unconstitutional to deny transgender inmates  hormone therapy and sex reassignment surgery absent a medical basis for doing so,”¯ said Larry Dupuis, legal director of the ACLU of Wisconsin.

State attorneys have not yet indicated if they will appeal further in this case but are said to be “reviewing their options.”

More information on this case, Fields v. Smith, can be found on the American Civil Liberties Union case profile page at: or on Lambda Legal case page at:

Related Reading:

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Photo used under the Creative Commons Attribution License with thanks to brainchildvn.

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6:27AM PDT on Aug 12, 2011

Thanks for the article.

4:02PM PDT on Aug 9, 2011

It's a small victory, but every little bit counts. Thanks Steve.

3:11PM PDT on Aug 9, 2011

jails do things like that.... they denied my son his physical therapy, he was told he only had rights to treatment of things that were immediately life threatening. 18 months without his physical therapy made his disability much worse. The nurse refused even his high blood pressure medication until he almost stroked out on them.

10:52AM PDT on Aug 9, 2011

As Britin J. says this is a good small step. Treatment isn't prevented. It would likely require treatment from an outside physician or therapist. I doubt that is a specialty of prison doctors. The court ruled that surgery could not be prevented by the state, not that the state had to pay.

8:44AM PDT on Aug 9, 2011

I would think getting your junk whacked off would be cruel and unusual punishment.

7:22AM PDT on Aug 9, 2011

Hmmm...Mickey, I didn't see a single thing about the government paying for their gender reassignment surgery. All I saw was that they were to be deprived of their hormone therapy, and this lawsuit gives that back. So what was your complaint again?

4:21AM PDT on Aug 9, 2011

They should be able to get their hormone treatment, but the taxpayers should not be forced to pay for their surgery! That is very expensive and even some of us on the outside cannot afford it, so why should they get it for free?

2:43PM PDT on Aug 8, 2011

This is sickening! While all those people are fighting for the rights of criminals all of the rights of the people who are not criminals are being taking away one by one! This is one screwed up and disgusting world we're living in!

2:32PM PDT on Aug 8, 2011

Bravo! Even small victories add up!

2:13PM PDT on Aug 8, 2011

Glad to hear it, a baby step, but a step none the less.

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