Transgender Inmate Seeks Hormone Therapy After Georgia Authorities Deny Treatment

The U.S. Department of Justice filed a statement of interest last Friday with the U.S. District Court for the Middle District of Georgia regarding a transgender prisoner who filed a case after prison officials refused to let her undergo hormone therapy to remedy her deep sense of dissatisfaction with her own gender, a condition called gender dysphoria.

Prisoner Ashley Diamond, 36, alleged that the Georgia Department of Corrections violated the Eighth Amendment by withholding treatment for her gender dysphoria against the advice and recommendations of her treating clinicians.

She said the corrections department withheld the treatment because of Georgia's "freeze-frame" policy which prohibits assessment and treatment of individuals with gender dysphoria.

"Instead, prisoners may only receive the same level of care they received in the community," according to the document filed by the justice department. "Under GDOC's policy, if an inmate is not identified as transgender and referred for treatment at intake, he or she may receive no treatment at all."

Diamond said she was first diagnosed with gender dysphoria as a teenager about 20 years ago.

Gender dysphoria, the justice department said, is listed in the Diagnostic and Statistical Manual of Mental Disorders, fifth edition, as a major mental illness characterized by a marked incongruence between one's experienced and expressed gender and assigned gender at birth.

She began taking feminizing hormones which helped her develop secondary sex characteristics and helped ease her physical and emotional discomfort.

When she entered the Georgia prison, she was not identified or referred for continuation of her hormone therapy. The treatment was terminated and she was placed in a prison for men.

"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," she added.

When Diamond requested treatment in prison, her gender dysphoria was confirmed by the prison's medical personnel, which recommended that she receive hormone therapy.

Corrections officials denied the request and told Diamond that she was ineligible for treatment based on the department's policy.

The justice department in its filing said, "[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."