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Illinois State Prisons Must Overhaul Medical Care For Transgender Prisoners, Judge Rules

After a hearing at the Southern District of Illinois' U.S. District Court, a judge will determine whether the state of Illinois must begin changing its procedures for medically treating transgender prisoners. July 31, 2019.
Nick Telep | St. Louis Public Radio
After a hearing at the Southern District of Illinois' U.S. District Court, a judge will determine whether the state of Illinois must begin changing its procedures for medically treating transgender prisoners.

A federal judge has ordered Illinois state prisons to immediately overhaul their policies for providing medical care to transgender inmates. 

Currently, according to the ruling, the Illinois Department of Corrections allows unqualified medical professionals to treat transgender patients; it also deprives them of medically necessary medications and accommodations. Prisoners named in the lawsuit testified that these practices jeopardized their health and drove them to harm themselves and attempt suicide. 

The ruling, handed down Thursday, requires the department to update its policies to be consistent with internationally accepted standards of care for medically treating gender dysphoria. 

The ruling, a preliminary injunction, is part of a class action lawsuit brought by five transgender prisoners. The suit alleges that the department’s medical staff denied them adequate treatment for gender dysphoria and violated their constitutional rights. 

American Civil Liberties Union of Illinois attorney Ghirlandi Guidetti said the ruling is a significant victory.

“The judge has recognized an incredible lack of expertise when it comes to treating gender dysphoria in the prison population,” said Guidetti, who is one of the lawyers representing the prisoners. “And that as a result of that, that our clients have suffered incredibly, they continue to suffer.” 

The injunction doesn’t end the debate over whether the department violated inmates’ rights.

The lawsuit is ongoing, and the case does not yet have a trial date. A preliminary injunction is only granted to prevent irreparable harm during a trial and when it’s likely that the parties requesting the injunction could win. 

U.S. District Judge Nancy Rosenstengel wrote that the department’s policies are actively causing harm to prisoners. She described “serious deficiencies” in medical care.

“There is evidence that IDOC denies and delays the diagnosis and treatment of gender dysphoria without a medical basis,” she wrote.

The department declined to comment for this story. 

One woman named in the suit, Sora Kuykendall, said in court that every time the department denied her requests for treatment, her mental health suffered. 

“I feel myself slipping into a deeper depression. I am struggling with constant thoughts of self-harm,” she said.

Medical experts also said in court that the department failed to correctly monitor blood levels for 90% of inmates who were prescribed hormone treatment. That left them them susceptible to complications that can include heart arrhythmias, kidney failure, blindness and death. 

The ruling orders the department to make the following changes:

  • Stop policies that allow a committee of unqualified professionals to make medical decisions regarding gender dysphoria.
  • Start ensuring that qualified medical professionals develop care plans for transgender patients.
  • Stop denying or delaying hormone therapy for non-medical reasons.
  • Start providing hormone therapy on a timely basis and monitor it regularly.
  • Stop depriving prisoners of social transition tools, which include clothing, hygiene products and housing assignments consistent with gender identity.
  • Develop new procedures for treating patients that abide by the World Professional Association for Transgender Health’s Standards of Care.
  • Allow inmates to obtain evaluations for gender dysphoria.
  • Develop a policy to ease social transition, including ceasing cross-gender strip searches.
  • Train staff on issues related to transgender inmates, including the effects of misgendering and harassment.

Rosenstengel’s ruling notes that no department representative attended the hearing. She wrote that the court is concerned that the department is not taking the allegations seriously, so she ordered all of the employees named in the suit to read the full transcript of the hearings before Jan. 6.
The department has until Jan. 22 to provide a plan for how it will change medical care for transgender prisoners. 

Guidetti said that he hopes the department will immediately implement smaller changes, such as providing hormone therapy to prisoners diagnosed with gender dysphoria. Other changes, such as moving transgender prisoners to facilities that match their gender identity, could take longer, he said.

“There are certainly steps that IDOC can take right away, and we hope that they will take that responsibility seriously in light of this order that shows that people are suffering,” Guidetti said.

Read the judge's opinion:


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Kae Petrin covers public transportation and housing as a digital reporter for St. Louis Public Radio.