Another trans woman has been forced to secure a court judgement saying she can’t be denied gender affirming hormone therapy after state prison authorities refused her this medical treatment. So what is it about this basic human right that the American prison service doesn’t get?
The inmate in question, Whitney Lee, is currently housed at the Mansfield Correctional Institution in Ohio–a facility for men even though Lee has been living as a woman since she was 18. She is serving a three-year sentence for forgery and theft. Lee had been using hormone treatment since 1999 (which you must first be medically approved for) until February of 2012 when, abruptly, the prison psychologist said that Lee failed to meet the criteria for the treatment and so the prison could lawfully stop treating her.
The case went before the federal courts, with Lee’s lawyers testifying that she suffered from being deprived her hormone therapy, feeling immense stress as well as seeing the emergence of male characteristics like hair growth and a loss of breast tissue. She was eventually placed on suicide watch. As a result of the serious nature of this complaint, a temporary injunction was issued by the courts saying that the state must resume treatment until the matter was settled.
The state maintained that this deprivation of treatment against Lee’s rights was overblown and that, even if the state was to concede that the diagnosis by the prison psychologist was incorrect, it would at most add up to medical malpractice.
However, Judge Algenon Marbley ruled on Friday, May 2, that the denial of medical treatment violated Lee’s constitutional rights and that the state must continue Lee’s treatments.
Most notably, the judge cites the prison’s own regulations. While the prison service is not under any duty to allow a prisoner to start hormone therapy, the prison service has to adjudicate fairly whether hormone therapy that was started before going into the prison system should continue, giving full consideration to what stopping that treatment might mean for the individual. The state failed to do so in Lee’s case, the judge said.
This isn’t the first such case of trans people facing dehumanizing treatment at the hands of state prison services. Last month we brought you the story of one teenager who, despite never having been charged, was moved from a young adult facility in Connecticut to an adult one, and at the time was in danger of being housed with male prisoners despite her identifying as and presenting as female.
Other states have also tried to deny trans people their right to continue medical treatment for their gender dysphoria, including Oregon which, in addition to an ongoing and lengthy case, appears to be routinely denying trans people hormone therapy and the right to other gender affirmation treatment. Other courts though have said much the same as the District Courts in Whitney Lee’s case: that to deny transgender people access to their treatment is tantamount to denying others medications to treat a range of medical problems, from psychiatric illnesses to physical ailments. It’s cruel, and it is unconstitutional. So, why does it continue?
The problem, chiefly, seems to be there is still a lack of understanding, or a deliberate failure to understand, that for many trans people gender affirming treatment is a medical necessity. Without this treatment, transgender people face their body betraying them with features that do not comport with their gender. As a result, they may feel depressed and even suicidal. To compound this, they may become targets for other prison inmates.
What, then, can we do to change this? Legislation of the kind that explicitly states that no prison service can withhold gender affirming treatment that was started prior to entering the prison is needed, but there appears little appetite among lawmakers for this kind of action.
The prison service also must catch up with medical science which puts a dim view on the prison service’s sorting prisoners arbitrarily by anatomical or birth sex and failing to account for their gender identities which, as science has shown, is not simply tethered to our sex organs. Putting trans prisoners in the wrong facilities means that the prisoners face years in what is essentially solitary confinement, removed from the rest of the prison population for their own safety. Solitary confinement has been shown to be damaging, especially over the long term.
We can of course summarize this much more neatly: we should be treating trans prisoners as human beings. We do not strip other prisoners entirely of their identities, nor do we allow prison authorities to inflict psychological and physical harm, and yet that is precisely what is being done to trans people in our prisons.