The US Court of Appeals for the Fourth Circuit [official website] on Monday reinstated a lawsuit [opinion, PDF] by a Virginia prison inmate seeking gender reassignment surgery. The court ruled that Ophelia Azriel De'lonta, an inmate suffering from gender identity disorder (GID) [NIH backgrounder], has sufficiently stated a claim that the Virginia Department of Correction (VDOC) [official website] may have been deliberately indifferent to her serious medical need by refusing to evaluate her for surgery. Previously, the Fourth Circuit held [opinion] that the VDOC had wrongfully prevented De'lonta from receiving any GID treatment in violation of the Eighth Amendment [LII backgrounder]. In Monday's ruling, the court clarified its holding:
We hold only that De'lonta's Eighth Amendment claim is sufficiently plausible to survive screening pursuant to 28 USC § 1915A. We do not decide today the merits of De'lonta's claim. Nor, for that matter, do we mean to suggest what remedy De'lonta would be entitled to should she prevail. In our view, the answers to those questions have no bearing on whether De'lonta has stated a claim that Appellees have been deliberately indifferent to her serious medical need by refusing to evaluate her for surgery, consistent with the [Benjamin] Standards of Care.Following De'lonta's first suit, the VDOC provided De'lonta with GID treatment consisting of regular psychological counseling and hormone therapy. De'lonta has also been permitted to dress and live like a woman to the full extent permitted by the VDOC. However, she has not been allowed to seek evaluation for gender reassignment surgery. The case has been remanded for further proceedings consistent with the court's findings.
Although an increasing number of prisons recognize GID as a compelling medical ailment that requires treatment, sometimes to the extent of gender reassignment surgery, the issue is still contentious. In September the US District Court for the District of Massachusetts [official website] ruled [JURIST report] that an inmate serving life without parole must be granted gender reassignment surgery as it is the only possible treatment for her GID. In March the US Supreme Court [official website] declined to rule [JURIST report] on a similar case, letting stand a lower court decision that found hormone therapy for transgender inmates to be medically necessary. The standing decision from the Seventh Circuit was analyzed [JURIST comment] by JURIST contributor John Knight [professional profile], who suggested that laws and regulations against transgender therapy are "blatantly discriminatory" due to "popular biases being put ahead of medical research, singling out a small group of inmates, and blocking medical treatments necessary only for them."