The US Court of Appeals for the Seventh Circuit [official website] on Friday upheld [opinion, PDF] a lower court's ruling invalidating the Inmate Sex Change Prevention Act [Act 105 text], which prohibited the Wisconsin Department of Corrections (DOC) [official website] from providing transgender inmates with hormone treatment. The district court invalidated the act because it violated the Eighth Amendment ban on cruel and unusual punishment and the Fourteenth Amendment's Equal Protection Clause. The appeals court rejected the defendants' contention that the state legislature has the power to prohibit certain medical treatments when other medical treatments are available and that the act is justified by a legitimate need to ensure security in state prisons. The appeals court first found that Gender Identity Disorder (GID) is a psychiatric disorder often treated with hormones to relieve psychological distress and that when hormones are withdrawn, severe complications may arise. The court found that the defendants failed to produce evidence to show that other treatment existed to effectively treat GID without hormones. By not providing the inmates with effective treatment, the court found that the DOC violated the Constitution's ban on cruel and unusual punishment, articulated in Estelle v. Gamble [opinion text] by denying effective treatment for a serious medical need. To advance their second argument, the defendants argued that the more feminine male inmates become targets for sexual assault in prisons and therefore hormone therapy incites prison violence. The appeals court rejected this argument on evidence that showed transgender inmates may be targets for violence even without hormones and therefore the act had no legitimate purpose. The appeals court did not consider the Equal Protection challenge since it had concluded that the district court properly held the act violated the Eighth Amendment, both on its face and as it applied to the plaintiffs.
State lawmakers passed the hormone therapy ban when an inmate who had been receiving hormone therapy sued the DOC when it refused to pay [Journal Sentinel report] for a sex-change operation. That inmate is not a part of this suit. The three plaintiffs in the suit are male to female transsexuals who have been diagnosed with GID. US District Judge Charles Clevert issued an injunction last year enjoining DOC officials from stopping the treatment.