Fed Prisons Change ‘Freeze Frame’ Trans Medical Policy


The Federal Bureau of Prisons (BOP), as a result of an inmate’s lawsuit, has ended its so-called “freeze frame” policy in which treatment for any person with gender identity disorder (GID) is maintained only at the level provided when the prisoner entered the federal prison system.

This restriction has meant that trans people with a GID diagnosis who had not undergone medical treatment prior to being incarcerated could not then have treatment for their medically recognized condition while serving their sentence.

This was the case for Vanessa Adams, a BOP inmate at FMC Butner in North Carolina. Ms. Adams, who has gender identity disorder, sued BOP in order to receive appropriate treatment for her medically recognized condition. She was forced to do this even though it was in fact BOP doctors that diagnosed her, told her what treatments were available, and characterized her condition as serious.

BOP has now changed its policy to allow for appropriate treatment of GID that does not stop at the level previously held prior to incarceration. This change was noted via two memoranda, dated May 31, 2011, and June 15, 2010, from BOP’s Medical Director to all BOP’s chief executive officers. The May 2011 memorandum ends:

In summary, inmates in the custody of the Bureau with a possible diagnosis of GID will receive a current individualized assessment and evaluation. Treatment options will not be precluded solely due to level of services received, or lack of services, prior to incarceration.

This information has has reportedly been given to all prisoners who have been diagnosed with GID, as well as to medical staff.

More on the case from the Gay & Lesbian Advocates & Defenders (GLAD) press release:

“BOP’s freeze frame policy trapped transgender prisoners in despair, leading often to depression, suicide attempts, and in many cases, serious self-harm, as was the case with Vanessa,” said Jennifer L. Levi, Transgender Rights Project Director for Gay & Lesbian Advocates & Defenders (GLAD).


When the suit was filed on February 24, 2009, Ms. Adams was at a federal prison in Florida. There she was being denied medically necessary hormone therapy and prevented from otherwise expressing a female gender identity because she had not received this treatment prior to her incarceration. In a June 7, 2010 ruling, Federal District Court Judge Joseph L. Tauro rejected BOP’s argument that Ms. Adams’ claim was moot because BOP had finally started Ms. Adams on hormone therapy.

Citing BOP’s consistently callous conduct toward Ms. Adams, the fact that BOP could stop her treatment at any time, and that BOP did not disavow its policy, Judge Tauro sent the case to mediation. With today’s settlement, the parties jointly agreed to end the case.

Cassandra Capobianco of Florida Institutional Legal Services said, “It is critical not only for Vanessa’s health and safety but for the good of other prisoners that BOP’s policy has been changed.”

“We applaud the BOP for getting rid of an unfair policy that has denied medically necessary care to many people. We hope that other state and county prison systems will follow BOP’s lead and eliminate discriminatory policies that are based on bias rather than medical need,” said Jody Marksamer, a staff attorney at the National Center for Lesbian Rights.

In addition to GLAD, Ms Adams was represented by Florida Institutional Legal Services (FILS), the National Center for Lesbian Rights (NCLR), Bingham McCutchen LLP, and Allyson Kurker.

Lawmakers in some states have moved to try and prevent trans inmates from accessing treatment for their medically recognized condition, most recently Michigan Representative Thomas Hooker who in August introduced a bill that would ban gender reassignment surgery for prisoners, and possibly all gender reassignment surgeries funded through tax payer assistance programs. You can read more on that here.

Related Reading:

Netherlands Trans Law Violates Human Rights

CA Senate Passes Gender Identity Protections

GLAAD Slams Chelsea Lately’s Anti-Trans Chaz Bono Jokes

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


Beth M.
Beth M6 years ago

Good news.

Rita White
Rita White6 years ago

good post

Mary L.
Mary L6 years ago

Sharon A, Ginger S,

Work to get the Tea Party out and the orignal Access to Health bill passed. Stop the insurance companies from paying their way out of having to give up a small part of their annual billions in profits.

Universal health care, including dental, will be the saving of many lives, Rand Paul be damned.

Leslea Herber
Leslea Herber6 years ago

To continue.

When a prisoner is in prison, they have NO ACCESS to work, in which to pay for any medical care. The American health system sucks to be certain, but it sucks even more when the best you can access is the prison "health" system. The doctors aren't exactly the "top of their class".

You think these folks are REALLY getting decent treatment when MRSA is so prevalent in prisons that it's damn near a certainty of getting it? Or that the risk of daily rape & murder are reasonable concerns to have?

You people have some SERIOUSLY whacked-ass views of reality.

Want things fixed? Get universal health care in America. Stop spewing GOP taglines & clue in that the GOP isn't your ally.

What you folks don't clue in about, astounds those of us outside the USA.

OH & one more hint. A cardiac patient who goes to prison still gets cardiac health care. WHY the hell should a Trans person accept anything less than EQUAL treatment in regard to their health issues? Or does your "ick factor" trump that logic?

Leslea Herber
Leslea Herber6 years ago

A few things to consider. 1) GID is an internationally recognized medical condition that requires quite a few diagnostic tools to be used to diagnose it properly. People like "David" below, wouldn't get past the first couple of psych treatments in all likelihood. If he did do so, then he runs into part 2.

2) GID tends to lead to hormone replacement therapy. Such a "manly man" wouldn't survive HRT. Literally. The brain is either wired to accept & work on either estrogen or Testosterone. Not both. That's a major reason TS women for example (also known as male to female, MTF TS folks) do so crappy in their lives before HRT. As a "manly man", David would literally go insane on female hormones. Side effects for those who are NOT TS, include depression, psychological shock, impotence, permanent erectile problems (aka, Mr happy goes into a permanent coma), sterility and often end up DEAD by their own hand.

Add in the other risks from HRT, which include mood complications, GI distress, liver damage, liver failure, organ failure, DVT (Deep Vein Thrombosis, aka a killer blood clot) and death, and it's really NOT worth it for the moron who thinks that it's all about sex, rather than IDENTITY.

To be continued...

Sharon A.
Sharon A6 years ago

Ginger S., I have to say, I agree with you. It's a damn shame when a prisoner can get this costly treatment and an honest citizen cannot get medical care.

I dont deny that prisoners are human beings and deserve medical care. I only want the same level of care given to our citizens who have NOT commited a crime!! Is that wrong?? Perhaps not "pc" but certainly not wrong. While taking away a woman's right to an abortion seems to be the popular political position today, these same politicians are saying it's ok to perform hundreds of thousands of dollars worth of cosmetic surgery and provide homones to prisoners so they can feel "comfortable"?????????????? What about MY right to be "comfortable"?? What about the unloved, unwanted, sick, poor, homeless, elderly, abused citizens who havent commited any crimes? Where's their health-care??

Once again, not saying that prisoners shouldnt get medical care, but let's be fair....if the gender-confused prisoner gets care, why shouldn't the underpriviledged gender-confused honest citizen receive the same level of care???

David J.
David J6 years ago

Next time I get sent to a federal prison you can bet that I will come down with a really bad case of GID so I can get sent to the women's' prison. Actually, that sounds like so much fun, I may commit a federal crime so I can get incarcerated with a bunch of sex starved women. I know! I'll refuse to get health insurance so Obama should be locking me up post haste.

K s Goh
KS Goh6 years ago

Thanks for the article.

Ginger Strivelli
Ginger Strivelli6 years ago

So we are suppose to pay for very costly operations to chop stuff off and tack stuff on, plus the costly on-going hormone therapy for criminals who think they are 'in the wrong body'?

Amazing...when my disabled kids (Who aren't criminals) can't get decent dentist or disability services on their state insurance, or my mother (also not a criminal) who can't afford any insurance is dying for lack of specialist tests....and I have to pay thru the nose for my insurance that won't cover my bad tooth that needs pulled. (I am also not a criminal.)

Sorry to go all nonPC on y'all but these criminals need some mental health therapy for sure, but they do not need cosmetic surgery or hormones to make them look like what they think they should....even if they paid for it, it is wasteful, if we pay for it, it's 'criminal.'

Joe R.
Joe R6 years ago

All people deserve basic human rights including medical care for people with diagnosed GID. Good move.