After a five-year legal battle, the United States District Court recently ruled that transgender people incarcerated in Connecticut prisons have a right to receive gender-affirming health care.
Veronica-May Clark originally filed the case in 2019, and the American Civil Liberties Union filed her case in 2021. Clark, who has been in custody since 2007, says that after the discovery that you have gender dysphoria – a medical diagnosis for someone with the disorder. that can happen when their true gender does not match their physical appearance and/or the sex they were assigned at birth – his treatment from the Department of Corrections was inconsistent.
“At the end of the day, he just wants health care,” Elana Bildner, Clark’s attorney with the CT ACLU, told The Connecticut Mirror. “He wants health care to be stable, adequate, and appropriate [and] so that he can count on the fact that he will get this health care that he needs for a long time.”
As a result of the DOC’s delay in processing his claims, he says his symptoms worsened, and he seriously injured himself and was hospitalized.
Unheard requests for attention
In July 2009, Clark was sentenced to life, 75 years, in a Connecticut prison for beating his estranged boyfriend to death with a pipe.
According to Bildner, Clark “had lived publicly as a woman” all her life but had never tried to get temporary care. At his sentencing, Clark chose to identify as a cisgender man for his own safety in prison.
Seven years later, in April 2016, Clark sought treatment, including hormone therapy and gender confirmation surgery, and stated that she believed she had gender dysphoria. A month later, a DOC health care provider diagnosed Clark with gender dysphoria, but she was not offered gender-affirming treatment, according to the lawsuit.
Clark began to self-harm in an attempt to self-medicate. According to the memorandum and witness testimony, Clark tried to cut himself in his cell.
After the incident, a DOC psychologist evaluated Clark and confirmed that he had gender dysphoria and that he was under a “higher mental state.” Clark also submitted a request for treatment consistent with this disease.
According to Bildner, the DOC had an “informal policy” that “if you went into prison and received respite care, you wouldn’t get it in prison.”
“He was fighting something he couldn’t see,” Bildner said. “The DOC said ‘Yes, you do.’ [have gender dysphoria]then he refused to take care of her for a while because of this unwritten policy.”
In the months after her hospitalization, Clark continued to request hormone therapy and gender-confirming surgery. He described his situation as “intolerable” and the DOC’s treatment as “cruel and unusual.”
[RELATED: CT: ‘Safe haven’ for transgender youth? For some, not safe enough]
Later, in September 2017, Clark saw an endocrinologist at the University of Connecticut Health. Her doctor prescribed her a low dose of spironolactone and estradiol: two drugs used in hormone therapy. The doctor requested a follow-up in three months with Clark to track his progress and increase his dosage to a therapeutic level.
Clark did not see a doctor again until August 2019.
The case
The inconsistent surveillance, despite his pleas, led Clark to sue the DOC for violating his Eighth Amendment right to be free from cruel and unusual punishment and his Eleventh Amendment right. four equal protection laws in April 2019, according to the complaint.
The Connecticut ACLU joined his group in 2021.
Bildner said the trial took place in two stages. The first, presided over by retired Justice Vanessa Bryant, was intended to “convince the court that if prisons are to provide health care, gender-affirming care is of health. Therefore, prisons must provide equal care. ”
On September 15, 2023, the United States District Court granted summary judgment in favor of Clark. The court concluded that DOC staff were “intentionally insensitive to Mrs. Clark’s serious medical needs.”
After that initial decision, the case entered its “second trial phase,” according to Bildner. This second phase took place throughout July 2024.
“[In] in the trial phase, the DOC was trying to convince the judge [to] ‘forget about what happened in the past,’ because now they were over it and there was no need for the court to intervene.”
The DOC presented evidence that since the September 2023 sentencing, they have been making every effort to provide Clark with the treatment he requested.
However, Judge Victor Bolden was not convinced and finally issued an injunction on July 26 to ensure that Clark’s legal rights remain upheld.
“Although the DOC has continued to provide gender-affirming drug treatment to Ms. Clark in recent months, such efforts have not cured the Eighth’s ongoing violation,” Bolden wrote. . “And, the Court has determined that the order is necessary to ensure that Ms. Clark receives appropriate medical care for her gender dysphoria and does not suffer irreparable harm.”
The order requires ongoing reports of Clark’s care status to his attorneys and the court.
The Department of Corrections’ Office of Community Corrections Affairs said it was reviewing the decision and could not comment.
“That said, DOC strives to provide health care to all under our care,” DOC Public Affairs Officer Andrius Banevicius said.
Example example
Good instruction goes beyond getting gender-affirming health care for just Clark, Bildner said.
The case was the first of its kind in the Second Circuit, which includes Connecticut, New York and Vermont.
“I really think it answers the question of the responsibility of the prison system to different people to provide health care for them that is multifaceted and independent,” Bildner said.
Often, inmates must defend this health care through a lawsuit, according to Bildner. He said that prisons that provide equal care often can still be “inconsistent or inadequate” like Clark’s.
The hope for the ACLU legal team is that the Connecticut DOC continues this recognition and no more inmates resort to legal action in an effort to get this type of care.
“He’s relieved and thankful,” Bildner said of Clark after Justice Bolden’s ruling. “This life support for him saves lives. Getting the hormone injection, he said in court, felt like a complete life saver for him. And knowing that he can go through the transition is all he’s ever wanted.”
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