\n<\/p>\n
Students hold flags at a protest in Texas.<\/span>Brett Coomer\/Houston Chronicle via AP, File<\/span><\/p>\n<\/div>\n Six days after <\/span>President Donald Trump\u2019s inauguration in January, Alishea Kingdom went to a medical appointment at the federal prison in New Jersey where she\u2019s incarcerated. It was time for her to take the hormonal medication she\u2019d been prescribed years before to treat her gender dysphoria. But prison staffers would no longer give her the medicine\u2014or the bras, underwear, and other feminine items she\u2019d gotten used to wearing. Without her hormone therapy, Kingdom started having panic attacks, struggled to sleep, and experienced suicidal thoughts.<\/p>\n Kingdom is one of about 2,000 transgender people in federal prisons who have lost access to medical care or may soon lose access to it because of the Trump administration\u2019s new policies. Now she\u2019s part of a class-action lawsuit<\/a> filed last week against the president and his team. On Monday, her attorneys at the ACLU asked a federal judge in DC for a preliminary injunction <\/strong>that would allow trans people in federal prisons to continue receiving hormone therapy or other prescribed medical care as the litigation unfolds. \u00a0<\/p>\n \u201cDenying people needed medical care is going to be unbelievably devastating.\u201d<\/p>\n<\/blockquote>\n<\/figure>\n The lawsuit follows other recent suits against the Trump administration by a smaller group of trans women prisoners; those other case are ongoing and primarily seek to stop the women from being transferred to men\u2019s prisons. Trump\u2019s policies are \u201cpart of a broader agenda of hatred for trans people and attempts to erase them from society,\u201d says Corene Kendrick, deputy director of the ACLU\u2019s National Prison Project, which is representing Kingdom in the class-action litigation.<\/p>\n \u201cDenying people needed medical care is going to be unbelievably devastating,\u201d adds Shannon Minter, legal director of the National Center for Lesbian Rights, who is involved with the other cases.<\/p>\n On his first day<\/span> in office, Trump signed an executive order that declared war<\/a> on trans people across the country, as my colleague Madison Pauly put it\u2014instructing the federal government not to acknowledge their existence or protect them under anti-discrimination laws. Trans people make up about 1 percent of the incarcerated population in federal prisons. Trump ordered the Justice Department to keep trans women, whom he described as \u201cmales,\u201d out of women\u2019s detention facilities.<\/p>\n The executive order also prohibited federal officials from spending money on health care to treat gender dysphoria, the potentially life-threatening psychological distress that arises when a person\u2019s gender identity differs from the sex they were assigned at birth. Under the Biden administration and during Trump\u2019s first term, doctors in the federal prison system regularly prescribed hormone therapy and sometimes approved surgeries to treat the condition, in keeping with recommendations from the American Medical Association and other major medical associations. <\/strong>Most trans women still stayed in men\u2019s prisons prior to Trump\u2019s inauguration, but more than a dozen of them were approved to live in women\u2019s prisons, where they were less likely to be sexually assaulted.<\/p>\n After Trump\u2019s executive order, incarcerated trans people described \u201cchaos and mistreatment\u201d as federal prison staffers rushed to implement the new rules, according to Susan Beaty, an attorney in California who represents some of them. Different prisons have implemented the orders differently\u2014a result of the broader disorganization and confusion at the Bureau of Prisons, which is also reeling from the departure<\/a> of its director and other top managers.<\/p>\n Beaty\u2019s clients at a federal prison in Texas said trans women were put into segregation and warned that they would soon be transferred to men\u2019s facilities. In February, federal judges temporarily blocked<\/a> the administration from moving 17 trans women who\u2019d sued from various prisons around the country, but those orders didn\u2019t protect the other incarcerated trans women who hadn\u2019t. This month officials sent at least a couple of them to men\u2019s prisons, according to Minter of the National Center for Lesbian Rights. He notes that the Prison Rape Elimination Act views trans women as particularly vulnerable to rape in men\u2019s prisons: \u201cBecause of this new Trump policy, more people will be sexually assaulted,\u201d he says.<\/p>\n Trump\u2019s transfer orders affect a small portion of federally incarcerated trans people, but the ban on gender-affirming health care would change the lives of the vast majority. In late January, after Trump issued his executive order, the Bureau of Prisons announced that it was disbanding the Transgender Executive Council, the agency\u2019s official decision-making body on all issues affecting the trans incarcerated population, including their medical care. <\/p>\n Then in late February, the agency issued memos that prohibited trans prisoners from buying \u201citems that align with transgender ideology,\u201d such as chest binders and hair removal devices, or obtaining undergarments that matched with their gender identity. Prison officials were ordered to refer to prisoners with pronouns corresponding with their sex assigned at birth, and male guards started patting down trans women. Books about LGBT identity were removed from prison library shelves. And the memos banned the use of federal funds for any medical procedure, treatment, or drug that would \u201cconform an inmate\u2019s appearance to that of the opposite sex,\u201d including hormone therapy.<\/p>\n Study after study<\/span> has shown<\/a> that hormone therapy and other gender-affirming treatments can be life-saving, decreasing depression, anxiety, and suicidal thoughts. \u201cWithdrawing gender-affirming health care from or denying such care to individuals for whom it is medically indicated puts them at risk of significant harm to their health,\u201d attorneys at the ACLU wrote in the complaint. Some effects of hormone therapy are reversible, which means incarcerated trans men could lose some of their masculine features and trans women could lose some of their feminine ones without the drugs. Suddenly stopping the medication can also lead to headaches, hot flashes, and spikes in blood pressure, as well as depression, fatigue, anorexia, and muscle and joint pain. \u201cWe\u2019ve heard from health care officials in prisons who are concerned,\u201d Kendrick says.<\/p>\n \u201cFor patients for whom gender-affirming medical care is indicated, no alternative treatments have been demonstrated to be effective,\u201d Dr. Dan Karasic, a psychiatrist who has treated patients with gender dysphoria for three decades and has consulted for state agencies and the United Nations on transgender care, told the court. Cathy Thompson, a psychologist who worked with the federal prison system for 23 years and advised it on best practices for trans prisoners before retiring in 2023, added that federal prisons lack enough clinicians to safely handle the suicide risk that would result from taking trans people off their medications. \u201cI have grave concerns,\u201d she wrote.<\/p>\n At Fairton Federal Correctional Institution, the men\u2019s prison in New Jersey where Kingdom is incarcerated, the halting of medical care has been abrupt. Kingdom lost her hormone therapy in January and could no longer be evaluated by the Transgender Executive Council for surgery. She is 34 and has presented as female since she was a teenager. As her body adjusts to the drop in estrogen, she is experiencing extreme distress and frequently considers using scissors to castrate herself, according to the lawsuit. \u201cAfter more than a month without care, my gender dysphoria has become incapacitating,\u201d she wrote in a declaration to the court. \u201cI frequently find myself thinking, I would rather not live than be forced to live as a man.\u201d<\/p>\n \u201cI frequently find myself thinking, I would rather not live than be forced to live as a man.\u201d<\/p>\n<\/blockquote>\n<\/figure>\n Solo Nichols, a trans man at FCI Tallahassee in Florida, also joined the class-action suit. Prior to Trump\u2019s inauguration, he\u2019d been preparing to undergo a double mastectomy to masculinize his chest, having worn chest binders since he was about 15. His hormone therapy is also threatened under Trump. In February, he and some other trans men at the prison were given half their regular dose of testosterone, which led to lethargy and mood swings for Nichols. The side effects from the reduced dosage, he told a court, meant it felt \u201clike the other transgender men and I were walking around like zombies.\u201d Later, according to the lawsuit, prison staffers told him he could resume his entire dose \u201cas long as the restraining order lasts,\u201d referring to the court orders from the other lawsuits.<\/p>\n In Minnesota, staffers at FCI Waseca recently told plaintiff Jas Kapule that he could not receive any hormone treatments once his testosterone prescription ran out, and that he could no longer use a chest binder. He fears the return of his menstrual cycle, which caused him severe distress before his transition. \u201cWhen my period ended due to the hormone therapy, I felt like I had turned over a whole new leaf and finally began feeling comfortable in my body,\u201d he told the court.<\/p>\n The ACLU argues that ending medically necessary treatment for gender dysphoria in prisons violates the Eighth Amendment, the Fifth Amendment, and the Administrative Procedure Act, which governs how federal agencies enforce regulations. On Monday, attorneys for the group requested a preliminary injunction to block the implementation of Trump\u2019s executive orders and ensure that trans prisoners can keep receiving their medical care. The goal is to \u201cpreserve the status quo,\u201d Kendrick says, noting that hormone therapy and surgery are prescribed only after significant consultation by prison medical staff and after many layers of review. <\/p>\n The Trump administration has suggested that trans people in federal prisons pose a threat to cisgender women there, and that these new policies are intended to keep women safe. But as Kendrick points out, incarcerated women face a much higher chance of being attacked by male correctional officers than by trans women. An entire federal prison in California recently closed<\/a>, she notes, after multiple male staffers were found guilty of routinely sexually abusing women<\/a> in their care. (At least one of attorney Beaty\u2019s trans clients was also abused by staff there.) Trump\u2019s vilification of trans prisoners? \u201cIt\u2019s propaganda,\u201d Minter says. \u201cThey are the ones who are extremely vulnerable.\u201d<\/p>\n As the litigation continues, incarcerated trans people are living in fear. \u201cI am scared that I will be forcibly detransitioned and taken back to a very bad place, mentally,\u201d Kapule wrote to the court.<\/p>\n \u201cThere\u2019s so much harm happening right now to many different groups of people and to trans people generally,\u201d Minter adds, \u201cbut there\u2019s something uniquely horrific about the situation of incarcerated transgender people\u2014because they\u2019re trapped.\u201d<\/p>\n<\/p><\/div>\n\n
\n