A federal district court judge has rejected a request for a preliminary injunction against a new Florida Department of Corrections (FDOC) policy, delivering a setback to transgender inmates in Florida.
The ruling permits the FDOC to deny “gender-affirming” medical care to incarcerated individuals diagnosed with gender dysphoria, effectively forcing transgender women to conform to their male sex assigned at birth.
The FDOC implemented new guidelines for mental health treatment of inmates diagnosed with gender dysphoria, effective September 30, 2024. The policy aims to provide mental health services tailored to the unique needs of these inmates, focusing on alleviating psychological distress and addressing co-occurring mental health conditions.
Key aspects of the policy include:
Therapeutic Approach: Psychotherapy, including individual and group sessions, is prioritized to help inmates manage distress, adjust to incarceration, and develop coping strategies.
Evaluation: Inmates undergo comprehensive psychodiagnostic and psychiatric assessments to confirm the diagnosis and identify other mental health needs.
The policy prohibits the use of state funds for cross-sex hormone therapy unless required by the U.S. Constitution or a court order. Exceptions are subject to strict criteria:
Clinical Justification: Treatment must show clear medical necessity, supported by peer-reviewed research and approved by a multidisciplinary team.
Informed Consent: Inmates must be fully informed of the risks, irreversible effects, and alternatives to hormone therapy before starting treatment.
Monitoring: The necessity of continued hormone therapy is reviewed every 90 to 180 days.
If an inmate’s gender dysphoria diagnosis is deemed no longer clinically valid, hormone therapy will be tapered off over nine weeks, with continued mental health support during and after the transition.
In October 2024, the ACLU and the ACLU of Florida filed an emergency lawsuit on behalf of Reiyn Keohane, a transgender woman incarcerated since 2016 who had been receiving gender-affirming care under the prior FDOC policy. The lawsuit argued the new policy violates the Eighth Amendment right to medically necessary care.
Despite these claims, the court denied the preliminary injunction, allowing the FDOC to enforce the new policy.
“Florida officials are waging a baseless campaign to dehumanize and degrade incarcerated people like our client,” said Li Nowlin-Sohl, senior staff attorney at the ACLU’s LGBTQ+ HIV Project. “Allowing this policy to move forward threatens the basic human rights of transgender people in the state’s custody, and the court’s order today affords the state’s policy more credulity than it deserves when the clear intent of the state is to ban this health care outright.”
The ACLU and its Florida chapter plan to continue challenging the policy in court.
