The U.S. Bureau of Prisons must provide transgender inmates with hormone therapy and social accommodations such as gender-appropriate clothing while a lawsuit over the issue proceeds, a federal judge ruled on Tuesday.
The ruling, by Judge Royce C. Lamberth of the U.S. District Court for the District of Columbia, also certified a class-action lawsuit filed on behalf of more than 1,000 inmates who have been diagnosed with gender dysphoria. The lawsuit claims the Trump administration’s policy denying gender-related treatment to prisoners violates their Eighth Amendment right to medical care and the Administrative Procedure Act, which prohibits “arbitrary and capricious” actions by federal agencies.
In his order, Judge Lamberth said it was not necessary to address the constitutional issue at this stage of the case because the plaintiffs were likely to prevail on Administrative Procedure Act grounds. Under the act, he wrote, the Bureau of Prisons “may not arbitrarily deprive inmates of medications or other lifestyle accommodations that its own medical staff have deemed to be medically appropriate without considering the implications of that decision.”
Judge Lamberth was appointed by President Ronald Reagan.
The ruling temporarily blocks a policy that stemmed from an executive order, issued by President Trump the day he took office, that no federal funds be spent for medical treatments “for the purpose of conforming an inmate’s appearance to that of the opposite sex.”
That order, part of a broader push to eliminate protections for transgender people in the United States, suggested that recognizing the legitimacy of gender identities that do not match a person’s biological sex “has a corrosive impact” on the “entire American system.”
One plaintiff in the suit, Alishea Kingdom, a transgender woman who had been receiving hormone therapy since 2016, was denied hormone injections under the new policy, though she later began receiving them again, according to court documents. Two other plaintiffs, both transgender men, were told that their hormone therapies would not be renewed. Each was denied access to undergarments or hygiene products that corresponded with their gender identity. About 600 inmates with gender dysphoria are receiving hormone treatments, according to the Bureau of Prisons.
The judge’s order does not require the bureau to provide gender-related surgeries. The number of inmates requesting such operations is minuscule, and only two such surgeries are known to have been performed on inmates.
Gender dysphoria can “produce severe side effects ranging from depression and anxiety to suicidal ideation and self-harm if inadequately treated,” the judge wrote, adding that the Bureau of Prisons “does not dispute this medical reality.”
He wrote that it was not necessary to take into account debates over the efficacy of hormone therapies in his decision to issue a preliminary injunction against the policy.
“To conclude that the defendants have failed to meet the procedural strictures of the APA,” Judge Lamberth wrote, referring to the Administrative Procedure Act, “is not to take any position on the underlying merits of the BOP’s substantive policy decisions or the goals motivating the Executive Order.”
Amy Harmon covers how shifting conceptions of gender affect everyday life in the United States.
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