SALT LAKE CITY — The Utah Department of Corrections came under fire Tuesday for discriminating against a transgender inmate who the U.S. Department of Justice says was driven to harm herself after she was repeatedly denied hormone therapy in violation of the Americans with Disabilities Act.
A federal investigation found that the state corrections department imposed “unnecessary barriers” to prevent the incarcerated trans woman from receiving treatment for intense gender dysphoria. According to the Justice Department report, the woman’s psychological distress, which doctors attributed to a discrepancy between her birth sex and her gender identity, worsened significantly when she was locked up in a men’s prison.
After nearly two years of fighting for access to hormones and other gender-affirming modifications, she performed a dangerous self-surgery to cut off her own testicles.
Now the DOJ is demanding immediate policy changes and anti-discrimination training for all correctional officers in Utah to protect other inmates from future harm. The government agency will also have to pay compensation to the trans detainee, who was not named in the report. The dollar amount had not yet been determined as of Tuesday.
Brian Redd, executive director of the Utah Department of Corrections, pushed back against the discrimination allegations and said he was disappointed with investigators’ approach. He did not indicate whether the agency would comply with the DOJ’s demands.
“We have been working to address this complex issue and were caught off guard by today’s public announcement from the Department of Justice,” Redd said in a statement. “We have also taken steps individually and as a state to meet the needs of inmates while maintaining the highest safety standards.”
Gender dysphoria falls within the ADA’s definition of disability, meaning correctional institutions cannot deny medically appropriate care to people with the condition, according to a 2022 federal court ruling.
“All people with disabilities, including those incarcerated, are protected by the ADA and have the right to reasonable accommodation and equal access to medical care, and that fundamental right extends to people with gender dysphoria,” said Kristen Clarke, DOJ Assistant Attorney General. Division of Civil Rights.
The department’s investigation found that Utah corrections officials unnecessarily delayed the woman’s hormone treatment even as her mental health deteriorated. She had to jump through procedural hoops not necessary for other medical conditions and get approval from a committee that DOJ chief Rebecca Bond said included members with a clear bias against transgender people.
Describing the commission as the “gatekeeper” of health care, Bond criticized the state corrections department in a letter Tuesday for including both medical and non-medical staff, even though the commission’s only role is to process requests for medical care.
When they finally cleared the inmate for hormone therapy more than 15 months after her original request, federal investigators found that they had failed to take basic steps to ensure the treatment was administered safely.
While using estrogen can help trans women develop certain desired physical characteristics, such as breasts, it also increases their risk of developing a potentially life-threatening blood clot in the legs or lungs. Experts from the Endocrine Society, which represents specialists who treat hormone disorders, say such treatments require close medical supervision.
Utah prisons assign incarcerated people to male or female housing based solely on their gender at union, which the DOJ says is determined by a visual examination of the inmate’s genitals. The woman made repeated requests to be housed individually or with other women, but all of those requests were denied, the investigation found.
Federal investigators say the prison failed to make reasonable accommodations to ensure her safety while surrounded by male inmates and staff. The state agency also prevented her from purchasing bras, makeup and women’s underwear at the commissary and required male corrections staff to be searched even as she began developing breasts.
“By not giving me this opportunity to live my life as a woman, who I believe I am and have lived for many years,” she wrote in her ADA complaint, “prison is causing me so much mental stress. ”