The Utah Department of Corrections violated the Americans with Disabilities Act (ADA) when it failed to provide a transgender woman with her hormone therapy, the Justice Department said Tuesday.
The state corrections department discriminated against the woman, who is not named in court documents, by denying her equal access to health care services, imposing “unnecessary barriers” to treatment for gender dysphoria and failing to grant her requests for reasonable accommodations, including allowing her to purchase female clothing and makeup at the commissary, a federal investigation found.
Utah’s corrections department also “unnecessarily delayed” the woman’s treatment for her gender dysphoria, a condition with which she had “for many years” before entering the department’s custody in 2021, according to the Department of Justice’s (DOJ) findings.
The woman’s psychological distress worsened while she was incarcerated in a men’s prison, federal investigators said, and a health care provider contracted by the state corrections department formally diagnosed her with gender dysphoria — a state of severe distress that stems from a mismatch between a person’s gender identity and sex assigned at birth.
Unlike other requests for medical care, which are typically directed to the state corrections department’s medical staff, a request for treatment for gender dysphoria is sent to the department’s gender dysphoria committee, which federal investigators described as the “gatekeeper” of care.
The committee during the woman’s incarceration included members who demonstrated “overt bias” against transgender individuals seeking care and expressed reluctance to prescribe treatment for gender dysphoria, including hormone therapy, the Justice Department said.
“Complainant’s access to medically necessary care for her disability was unnecessarily delayed due to [the Utah Corrections Department’s] biased and prolonged approval process,” DOJ Disability Rights Chief Rebecca Bond wrote Tuesday in a letter to Brian Redd, executive director of Utah’s corrections department.
It took the department more than 15 months to prescribe the woman hormones, Bond said, despite her repeated follow-up requests and grievances.
When the state corrections department ultimately allowed the woman to begin treatment, it failed to administer her hormones safely and appropriately, federal investigators found. Her physician, for instance, did not conduct routine laboratory testing to make sure the medication did not interfere with her other prescriptions, or to confirm that her dose levels were effective.
The department denied additional requests by the woman to purchase gender-affirming clothing at the commissary and be assigned female housing. ADA requests filed to the department went unanswered or were rejected, federal investigators said.
“By not allowing me this opportunity to live my life as a woman, who I believe I am and have lived life for many years, the prison is causing me such mental stress,” the woman wrote in her ADA complaint.
Gender dysphoria is covered by the ADA, a federal court ruled in 2022. The Supreme Court let that ruling stand in June.
“A prison controls most aspects of an incarcerated person’s life, including their access to health care and many aspects of their ability to live consistently with their gender identity. Here, based on bias and indifference to her serious health needs, [the Utah Department of Corrections] failed to provide Complainant with equal access to its health care services,” Bond wrote in Tuesday’s letter to Redd.
The state correction department’s “failures had severe consequences,” Bond said. In May, after nearly two years in custody without access to adequate gender-affirming health care, the woman performed a dangerous self-surgery to remove her own testicles.
DOJ on Tuesday called for Utah’s corrections department to implement corrective measures to protect other transgender inmates from harm. The state corrections department will also be required to pay damages to the woman, though a dollar amount has not yet been set.
In an emailed statement, Redd, the department’s executive director, said the department was “blindsided” by the Justice Department’s announcement.
“We have been working to address this complex issue,” he said. “We fundamentally disagree with the DOJ on key issues, and are disappointed with their approach.”