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Gender dysphoria: Should prisons be forced to provide hormone treatment for inmates with this condition?

jailWASHINGTON – People who have gender dysphoria feel strongly that they are not the gender they physically appear to be, and sometimes, people with this condition are sent to prison.

Treatment for this condition may include hormones, which help develop secondary sex characteristics and may help ease physical and emotional discomfort felt with his or her biological sex – but prisons do not always allow or provide this treatment.

Should prisons provide care for gender dysphoria?

The Justice Department says so, in filing a statement of interest this week in a case with an inmate in Georgia:

A transgender prisoner alleges that the Georgia Department of Corrections failed to provide adequate care for her gender dysphoria. The statement of interest from the Justice Department discusses the unconstitutionality of “freeze-frame” policies, such as the policy allegedly used in the Georgia Department of Corrections. These policies unconstitutionally prohibit treatment beyond the type of care the prisoner received in the community prior to incarceration. Through this filing, without taking a position on the merits of the allegations, the United States stated that the Eighth Amendment mandates individualized assessment and care for gender dysphoria.

“By taking action in this case, the Justice Department is reminding departments of corrections that prison officials have the obligation to assess and treat gender dysphoria just as they would any other medical or mental health condition,” said Acting Assistant Attorney General Vanita Gupta of the Civil Rights Division. “Prisoners with gender dysphoria should not be forced to suffer needlessly during their incarceration simply because they were not receiving care, or could not prove they were receiving care, in the community. Freeze-frame policies can have serious consequences to the health and well-being of transgender prisoners, who are among the most vulnerable populations incarcerated in our nation’s prisons and jails.”

Based on the facts as alleged, Ashley Diamond was first diagnosed with gender dysphoria as a teenager, nearly twenty years ago. She began taking feminizing hormones, which helped her develop secondary sex characteristics and helped ease the significant physical and emotional discomfort she felt with her biological sex. Yet, when she entered the Georgia Department of Corrections, she was not identified or referred for continuation of this treatment. Instead, her hormone therapy was terminated and she was placed in a secure prison for men.

When Ms. Diamond requested treatment during her incarceration, she was evaluated by Department medical personnel who confirmed Diamond’s gender dysphoria and recommended reinstatement of hormone therapy and other clinically-indicated treatments. However, department officials continued to deny this treatment, telling Diamond that she was ineligible for treatment pursuant to the department’s policy. Because the department did not properly identify Diamond’s gender dysphoria at intake and refer her for treatment at that time, she was, and continues to be, denied necessary medical care.

The facts alleged in this case indicate that the Department of Corrections relied on its freeze-frame policy to deny Diamond the care recommended by the department’s own physicians, in violation of the Eighth Amendment. As stated by the Justice Department in its filing, “[t]wo things are clear from the record in this case: one, the generally accepted standards for treatment of gender dysphoria require treatment decisions be individualized; and two, Ms. Diamond did not receive individualized care.”

Should prisons provide individualized care for these inmates, or should they simply treat them like any other inmate?

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