After a transgender woman in the custody of the Georgia Department of Corrections was denied medically necessary treatment and sexually assaulted by other inmates at a men’s prison, the SPLC filed a federal lawsuit demanding prison officials provide safe placement for the prisoner and medically necessary care, including hormone therapy. The suit also sought an end to prison policies that deny transgender inmates such medical treatment.
Prison officials denied 36-year-old Ashley Diamond the female hormones that she had been receiving for 17 years. The lawsuit describes how denying this medically necessary care resulted in grave physical and mental harm to Diamond, including mental anguish and bodily harm, in violation of the Eighth Amendment’s ban on cruel and unusual punishment.
Diamond endured repeated sexual assaults by prisoners, but prison officials ignored pleas to ensure her safety, according to the lawsuit. Despite her nonviolent offense, Diamond has been housed in a series of prisons for male felons considered to be the most violent and dangerous in state custody. Transgender inmates can be housed safely and without fear of sexual assault when prisons follow the law, including the Prison Rape Elimination Act of 2000.
The professional mental health community has recognized standards of care for individuals, like Diamond, who suffer from gender dysphoria. The National Commission on Correctional Health Care and the National Institute of Corrections recognize these standards, which for some individuals include hormone therapy as a medical necessity.
Diamond endured a painful physical transformation after her hormone therapy was terminated by corrections staff. Her facial hair started growing and her body reverted to a masculine state. She even attempted suicide and self-castration.
The Georgia Department of Corrections blatantly disregarded her health and mental state, insisting that she simply adapt. When she entered Valdosta State Prison, officials told her that they didn’t have the means to protect transgender prisoners. Staff instructed her to “guard your booty” and be prepared to fight, according to the lawsuit. Officials placed Diamond in solitary confinement for “pretending to be a woman.” She also was placed in solitary for 10 days after meeting with SPLC attorneys.
Some prison officials ridiculed Diamond. The lawsuit describes how a Valdosta State Prison official referred to Diamond as a “he-she-thing” in front of inmates and personnel. Staffers were encouraged to ridicule Diamond for her gender expression and to instruct her to act and appear male. When Diamond filed a complaint about this treatment, it was rejected by prison officials on the grounds that Diamond was “clearly a man, not a woman.”
In February 2016, a settlement with the Georgia Department of Corrections was reached. The lawsuit has triggered significant reforms in the treatment of transgender prisoners in Georgia and nationwide.
The U.S. Department of Justice issued a seminal statement in support of the SPLC’s case, declaring that gender dysphoria is a condition requiring medical treatment like any other disease. This means that corrections departments across the country have a constitutional obligation to provide medically necessary care, including hormone therapy, to transgender prisoners.
In addition, the Georgia Department of Corrections rescinded its “freeze frame” policy that prevented many transgender inmates from receiving the treatment they need. Because of the case, dozens of transgender inmates across the state are now receiving hormone therapy for the first time since entering custody. Georgia prison officials also adopted a sexual assault prevention policy that is more closely aligned with federal standards, and they are training prison staffers throughout the state on the health and safety needs of transgender inmates.