The ACLU is declaring victory after a federal court ruled in favor of an inmate initially seeking hormone therapy while incarcerated. The transgender woman is also now allowed to wear female clothes in accordance with her gender identity.
Since 2014, Reiyn Keohane has been in the custody of the Florida Department of Corrections, after pleading guilty to stabbing her Fort Myers roommate.
While she’d been living as a woman for years, she’d started hormone therapy months prior to her state incarceration. But, when she was initially imprisoned, ACLU of Florida Attorney Daniel Tilley says she did not receive hormone therapy and other medically necessary treatment for what’s known as “gender dysphoria.”
So, what is gender dysphoria?
“Typically, someone who identifies as transgender does so because their gender identity does not match the sex they were assigned at birth,” said Tilley. “And, what gender dysphoria can refer to is the distress that comes from that incongruence. So, not all transgender people will have a formal diagnosis of gender dysphoria in that not all transgender people experience clinically significant distress because of the incongruence between their gender identity and the sex they were assigned at birth. But, some folks will experience that distress.”
According to court filings, Keohane—who still has the anatomy of a man—had tried to self-castrate herself. She’d also attempted suicide after she grew depressed over the confiscation of her female undergarments and didn’t like how she looked after she was forced to have short hair.
“In the past, her hair has been forcibly shaved many times by DOC officials,” Tilley added.
In its own response to the initial court filing, Florida Department of Corrections officials said they were just doing what was required under the prison agency’s “male inmate hair length policy.”
Keohane is currently housed at Walton Correctional Institution, an all-male prison. She was initially at Everglades Correctional Institution in Miami—another prison for male inmates.
“Their policy in men’s prisons is that men must keep closed crop hair, and women’s prisons or prisons where they house female inmates, there is no length restriction,” Tilley continued.
So, Tilley says for those reasons, they believe Keohane is entitled to have hormone therapy and access to female clothing, which he adds has been known to help people with her condition.
“There are specific medical interventions that can help alleviate that gender dysphoria, including hormones, including social transition, including various surgeries…there are a variety of ways, including counseling. So, there are a variety of treatments that a person could receive,” he stated. “And, in this case, the judge held that—at least hormone therapy—were medically necessary for our client.”
Soon after the lawsuit was filed, the Florida Department of Corrections did begin providing her the hormones via the prison’s private medical provider. In its court documents, prison officials said that provider Wexford Health Sources would continue to do so as long as its medically necessary.
And, in a recent ruling, U.S. District Judge Mark Walker agreed that treatment was medically necessary for Keohane—adding if the state had refused, it would be unconstitutional and a violation of the Eighth Amendment.
And, Tilley says the federal judge also solidified some things that Tilley and correctional officials had worked out for his client in the past.
“She does have access to the hormone therapy now,” he said. “She also has access to a sports bra, but not the traditional bra that’s provided to other female inmates. And, she has been permitted to grow her hair, or I should say the DOC has been permitted from forcibly cutting her hair, as it has in the past. Now, with the court’s ruling, we’re expecting accommodations will be solidified in that she will be provided the other accommodations that the court discussed in the ruling, including to access to the traditional bra, underwear, and female grooming items.”
In his ruling, Walker also called into question the qualifications of corrections officials or medical staff to make decisions about transgender health or even gender dysphoria.
The judge particularly found fault with the Florida Department of Corrections’ chief medical officer, Dr. Timothy Whalen—who has the final say when it comes to making exceptions to the prison’s medical polices.
Walker stated that social transitioning, longer hair, access to makeup and female garments are ways to treat gender dysphoria. But, Whalen testified that some of those would be a “hard sell” and “non-urgent.”
In a statement, Florida Department of Corrections Spokeswoman Michelle Glady said her agency “provides constitutionally mandated health care to inmates in our custody, to include any treatment deemed medically necessary by a doctor.”
Ultimately, Judge Walker stated the case came down to whether the law and the court recognizes Keohane as a woman. And, he said, “The answer is simple. It does and I do.”
And, Tilley, Keohane’s attorney, says he couldn’t be happier for this client.
“I’m thrilled of what this ruling means for our client and I hope it leads to better care for other transgender inmates in Florida and across the country because I think it’s such a powerful statement of the law and of what is needed for transgender inmates in prisons,” he concluded.
Meanwhile, spokeswoman Michelle Glady says her prison agency is reviewing the judge’s order.
For more news updates, follow Sascha Cordner on Twitter: @SaschaCordner.