The ACLU of Florida is suing the state’s Department of Corrections over a new anti-transgender policy that will restrict trans prisoners’ access to gender-affirming medical care as well as their ability to express their gender identity.
According to a report from The Marshall Project and theTampa Bay Times, a federal judge in Tallahassee held a preliminary hearing in the case on December 9. The ACLU of Florida has asked the judge to block enforcement of the policy, calling it an unconstitutional ban on gender-affirming care. A ruling is expected in the weeks ahead.
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Under the new policy, Florida prisons will only provide inmates diagnosed with gender dysphoria with therapy. Trans inmates will not have access to gender-affirming hormone therapy except “in rare instances” when it is deemed “necessary to comply with the U.S. Constitution or a court decision.”
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“Unaddressed psychiatric issues and unaddressed childhood trauma could lead to a misdiagnosis of gender dysphoria,” the policy claims. Gender-affirming hormone therapy, it continues, “may be requested by persons experiencing short-termed delusions or beliefs which may later be changed and reversed.”
Daniel Tilley, lead attorney from the ACLU of Florida, compared the policy’s therapy requirements to so-called “conversion therapy.”
In court documents, Danny Martinez, the state prison system’s medical director, said he based the department’s new policies on a 2022 report commissioned by Florida’s Agency for Health Care Administration (AHCA). The report focused primarily on the effects of gender-affirming care on children and its findings contradicted the overwhelming consensus of all major medical organizations, which hold that gender-affirming healthcare is necessary and frequently lifesaving for transgender individuals suffering from gender dysphoria.
The 2022 report resulted in the state banning healthcare providers from billing the state’s Medicaid program for gender-affirming care. But in June 2023, a federal judge struck down the Florida Medicaid ban, finding that the AHCA report was “a biased effort to justify a predetermined outcome, not a fair analysis of the evidence,” and its conclusion was “not supported by the evidence and was contrary to generally accepted medical standards.”
The Florida Department of Corrections’ new policy was announced in September during meetings in which incarcerated transgender women were told that trans inmates would be “reevaluated” to determine whether they would still be allowed access to gender-affirming healthcare and other accommodations that they were already receiving. According to the Tampa Bay Times, inmates said they were not told how prison officials would determine whether they would still be allowed access to care. While so far no inmates reported being taken off hormone therapy, more than a dozen incarcerated trans women told the paper they had already been forced to cut their hair short.
In court filings and interviews, incarcerated trans women in Florida prisons also reported being subjected to breast examinations to determine whether or not they would still be allowed access to bras.
“It felt like I was being treated less than human,” Josie Takach, a trans inmate at a Florida men’s facility, said of the examination. Takach said her undergarments, now considered contraband, were confiscated. “I feel like I’m 12 years old again, sneaking around wearing a bra.”
Sara Maatsch, who is also incarcerated in a Florida men’s prison, said that her gender dysphoria diagnosis was now considered a serious psychiatric illness. She was told she would have to be moved to a more restrictive facility with fewer work and programming opportunities to continue receiving treatment.
Mariko Sundwall told The Marshall Project that after spending 10 days in solitary confinement for refusing to cut her hair, a prison barber buzzed her hair short while she was handcuffed.
“I’m very sad and depressed. I feel like they’re taking away my identity,” Jada Edwards, another trans inmate, said of the buzz cut she was forced to receive.
As The Marshall Project notes, previous court decisions have held that prisons in the U.S. are required under the Constitution to provide gender-affirming care as needed.
University of California San Francisco psychiatrist Dan Karasic, who helped develop international standards for treatment of transgender people, told The Marshal Project that Florida’s new anti-trans prison policies were “a fig leaf on [the state’s] efforts to ban gender-affirming care.”
“They are really trying to skirt the law, as determined by multiple courts, that gender-affirming medical and surgical care must be provided when medically necessary,” Karasic said.
The battle over Florida’s anti-trans prison policies follows the 2024 presidential campaign, which saw Donald Trump’s campaign target Democratic nominee Kamala Harris with ads claiming the Vice President “supports taxpayer-funded sex changes for prisoners.”
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