Utah corrections officials discriminated against transgender inmate, feds say in lawsuit

The U.S. Department of Justice is suing Utah after corrections officials delayed treatment for an incarcerated transgender woman diagnosed with gender dysphoria, causing her to perform a “dangerous self-surgery” resulting in hospitalization.

In a complaint filed Tuesday in Utah District Court, the DOJ claims state officials failed to enforce Title II of the American with Disabilities Act, or ADA, which prevents state and local governments from discriminating against people with disabilities by restricting their access to programs and services. The lawsuit names the state of Utah, the Utah Department of Corrections and the Utah Department of Health and Human Services. 

The inmate, who is not named in the complaint, made several requests under the ADA — those requests, and subsequent appeals, were denied, according to court records.

Utah “unlawfully discriminated against the Complainant on the basis of her disability, gender dysphoria, by denying her equal access to healthcare services and failing to reasonably modify policies, practices, or procedures where necessary to avoid discrimination,” the complaint reads. 

In addition, corrections officials “imposed unnecessary eligibility criteria” when evaluating gender dysphoria that aren’t required for other health conditions, the lawsuit reads. 

The complaint also accuses corrections officials of denying the inmate’s request to purchase female clothing and other personal items at the commissary. 

The lawsuit comes on the heels of a DOJ investigation last month that determined the Utah Department of Corrections “unnecessarily delayed and restricted” that same inmate’s access to medical care for her gender dysphoria. It also found that some members of the department’s gender dysphoria committee, charged with making medical decisions, held an “overt bias against the individuals seeking care.” 

The department declined to comment on Tuesday’s complaint — but in a March statement, Utah Department of Corrections Executive Director Brian Redd said officials were “working to address this complex issue.” The department was “blindsided” by the DOJ’s public announcement of the investigation’s findings, Redd said. 

“We have also taken steps on our own, and as a state, to address the needs of inmates while maintaining the highest safety standards,” he said. “We fundamentally disagree with the DOJ on key issues, and are disappointed with their approach.” 

The Utah Department of Health and Human Services also declined to comment on the active litigation.

Gender dysphoria is a medical condition, defined by the DOJ as an “incongruence between the sex an individual is assigned at birth and their gender identity.” In 2022, a federal court ruling granted people with gender dysphoria protection under the ADA and last June, the U.S. Supreme Court let the ruling stand.

“Left untreated, individuals with gender dysphoria can experience significant adverse health outcomes, including increased risk for suicide and surgical self-mutilation,” the lawsuit states. 

That’s at least in part what happened, according to the complaint — in May 2023, over a year after her initial request for treatment, the inmate “performed dangerous self-surgery and removed her own testicles, resulting in hospitalization and additional surgery.”

The woman was incarcerated in July 2021. Shortly after, medical records identified her “gender identity disorder issues” and noted that she was seeking hormone therapy, according to the complaint. Nine months and several requests for treatment later, the inmate met with a psychologist who diagnosed her with gender dysphoria and deemed her eligible for hormone therapy, the DOJ argues. 

The lawsuit alleges the department didn’t provide the inmate with hormone therapy until January 2023, about 17 months after the initial treatment request and six months after the diagnosis. 

The inmate’s “access to care for her gender dysphoria was contingent on a biased and unnecessarily prolonged approval process,” the lawsuit reads, claiming she made several “detailed” requests under the ADA for “reasonable modifications” while making requests directly to health care staff. 

“Virtually all” of the ADA requests were denied, as were the subsequent grievances and grievance appeals filed by the inmate, court documents read. 

“People with gender dysphoria, including those held in jails and prisons, are protected by the Americans with Disabilities Act and are entitled to equal access to medical care just like anyone else with a disability … those rights are not given up at the jailhouse door,” Assistant Attorney General Kristen Clarke of the DOJ’s Civil Rights Division said in a statement. 

In the complaint, the DOJ directs the state’s department of corrections to take several measures. They include providing “nondiscriminatory health care services” and paying “compensatory damages” to the inmate, while adopting policies allowing “individuals with gender dysphoria an equal opportunity to participate in and benefit from” programs and services. It also directed the department to train its employees on the requirements of the ADA.

Correction: A previous version has been modified to correct the name of the transgender woman’s medical diagnosis