Federal court orders IDOC to improve gender dysphoria treatment


A federal court this week ordered the Illinois Department of Corrections (IDOC) to improve their treatment of transgender prisoners with gender dysphoria.

According to the ACLU of Illinois, U.S. District Court Judge Nancy Rosenstengel issued a rebuke of IDOC’s failure to improve care for this population since it was first ordered to do so in December 2019. In a oral order delivered from the bench upon the conclusion of the trial, Rosenstengel rejected as “nonsense” IDOC’s arguments that the slow process of providing transgender prisoners with appropriate medical care was due to concerns over non-transgender “predators.” Similarly, the court brushed aside claims that the COVID pandemic justified ongoing delays that have caused ongoing harms to trans prisoners.

The judge concluded that she was no longer willing to trust IDOC, saying “I don’t have faith to simply, quote, let the process play out.”

“I acknowledge that COVID understandably caused delays,” she said. “But, COVID does not authorize inadequate medical care and treatment.”

“Our clients have endured years of suffering, waiting for IDOC to simply provide basic health care,” said John Knight, LGBTQ & HIV Project Director at the ACLU of Illinois, who represents the prisoners in this case. “The court recognized that IDOC’s promises of better treatment and the other steps it has taken on the eve of trial have failed to result in any meaningful improvement in the care provided. We must do better to end the human suffering our Illinois prisons are causing transgender Illinoisans by continuing to provide them an abysmal level of care.”

The IDOC has a long history of legal issues and accusations around their treatment of trans prisoners. The department has been sued not just for medical care, but also refusing to move trans women out of men’s prisons and retaliating against trans prisoners who filed lawsuits.

Rosenstengel ordered the following steps be taken by IDOC, among others, according to the ACLU:

  • Members of the class who requested hormone therapy previously must get blood testing within 21 days and start hormone therapy within 14 days thereafter, with follow-up blood work at least every three months until the levels are within an appropriate range;
  • Members of the class who currently receive hormone therapy must be given blood tests to assess proper hormone and other levels that must be monitored within 14 days. Hormone levels must then be adjusted as necessary based on the blood work. This process must be repeated every three months until the levels are within an appropriate range, and all class members receiving hormone therapy shall get blood work done at least once a year;
  • Class members whose hormone levels are within the appropriate range and who have requested evaluation for gender-affirming surgery shall be evaluated for such surgery within 120 days, with class members being evaluated in chronological order of the date of their original request for surgery;
  • Class members shall be allowed to choose the gender of their correctional officer who will conduct the search;
  • Class members who have requested transfer to a facility matching his or her expressed gender shall be evaluated for transfer within 120 days of the date of the order, with class members being evaluated in chronological order of the date of their original request for transfer;
  • Class members shall immediately be provided with access to gender affirming items in the commissary and shall immediately be provided with a list of available gender affirming items;
  • IDOC shall immediately ensure that medical care and mental health treatment of class members shall be conducted only by medical staff and mental health professionals who have taken the WPATH training and are committed to continuing education on issues of transgender health;
  • IDOC shall immediately ensure that transgender prisoners are allowed access to a private shower.

The court also ordered the IDOC to finalize the various projects they claimed at trial were “in the works” within 120 days.

The trial was the culmination of a class action lawsuit filed in January 2018 on behalf of five women – Janiah Monroe, Marilyn Melendez, Lydia Heléna Vision, Sora Kuykendall and Sasha Reed as well as a class of all transgender prisoners in IDOC custody who have requested evaluation or treatment for gender dysphoria.



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