Judge orders Illinois to improve treatment of transgender people in prisons

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A federal judge has ordered the Illinois Department of Corrections to make changes to its procedures for transgender prisoners.

On Tuesday, a U.S. district court judge ordered the Illinois Department of Corrections to act quickly to improve transgender prisoners' access to transition-related care and prison facilities corresponding to their gender.

Judge Nancy Rosenstengel of the U.S. District Court for the Southern District of Illinois ruled in the case of Monroe v. Jeffreys, filed on behalf of a class of plaintiffs by the American Civil Liberties Union of Illinois, that prisons in the state must immediately provide transgender inmates with the ability to take a shower privately, give them gender-affirming commissary items such as clothing and hygiene products consistent with their gender, and finalize training for corrections staff on issues affecting transgender prisoners, among other changes.

The lawsuit was filed in 2018 on behalf of five transgender prisoners who represent a class of about 130 people, according to the ACLU. The class is defined as prisoners in Illinois facilities who have sought evaluation and treatment for gender dysphoria.

In 2019, Judge Rosenstengel ordered the state to change the health care services provided to inmates with gender dysphoria to align with standards of care established by the World Professional Association for Transgender Health. Amid discoveries that the ordered changes were not being implemented, the Illinois Department of Corrections asked for summary judgment to avoid trial in the case, a motion the court denied in February 2021.

Transgender prisoners gave testimony at the trial on the prison conditions. Sora Kuykendall, a transgender woman, said that she would cry and shake when strip-searched by a man and has refused to see her mother since 2019 because doing so would mean more strip searches by male guards.

In her ruling on Aug. 9, Rosenstengel wrote:

The Court previously found that Defendants were displaying deliberate indifference to Plaintiffs' serious medical needs related to their gender dysphoria. While IDOC argues that its new Administrative Directives and the changes underway have changed that, there are still serious violations of Plaintiffs' constitutional rights happening every day. Specifically, there are ongoing delays in treatment that constitute deliberate indifference because those delays have injured members of the class and unnecessarily prolonged their suffering in some cases.

She ordered that, within 120 days of the order, the department must get a contract with a doctor who can provide gender-affirming surgery and "implement additional and ongoing training for all correctional staff on transgender issues and awareness, including the harm caused by misgendering and harassment."

The department also has 120 days to evaluate prisoners for transfer to the facility of their gender and review their requests for transition-related surgeries.

John Knight, senior staff attorney for the ACLU, said the court's ruling will have positive effects for all inmates seeking better health care and housing.

Knight said that Monroe v. Jeffreys is the first class action lawsuit filed by prisoners seeking treatment for gender dysphoria, and that Tuesday's court victory is legally meaningful at the national level because the judge made it clear that transgender prisoners deserve prompt access to gender-affirming medical care, without delays for nonmedical reasons.

"She was particularly put off by the fact that there were religiously motivated providers who were trying to talk my clients out of getting hormone therapy. She was very explicit about the scope of the Eighth Amendment and its protection against cruel and unusual punishment," Knight said. 

He added, "This case is as far along as any, and the ruling is as broad as I've ever heard of, so I think it is historic in that sense."

It's unclear whether there will be changes made soon to federal guidance related to transgender prisoners.

President Joe Biden spoke about prison conditions for transgender people during his campaign, and included a section on LGBTQ people in the criminal justice system on his campaign website. In October, he told Philadelphia Gay News that he would reinstate Obama administration guidance for adherence to the Prison Rape Elimination Act, or PREA, with regard to housing and health care for transgender prisoners.

Knight said he has not yet seen any changes made from the Trump administration's policies on conditions for transgender inmates. He said that as far as he knows, no Federal Bureau of Prisons facility has ever provided gender-affirming surgery. The first transgender prisoner to receive transition-related surgery funded by a state was Shiloh Heavenly Quine in California in 2017.

In April, the U.S. Department of Justice filed a statement of interest in a lawsuit involving a transgender woman prisoner, Ashley Diamond, against the Georgia Department of Corrections. The Department of Justice said it is unconstitutional to deny housing corresponding to Diamond's gender and not to provide her with proper medical treatment for gender dysphoria.

Published with permission of The American Independent Foundation.