LGBTQI Advocates Urge 11 Circuit to Uphold Lower Court Ruling to Provide Medical Care to Transgender Woman in Florida Prison

11 Organizations File Friend-of-the Court Brief Highlighting Voices of Incarcerated Transgender People

January 10, 2019, Tallahassee
— Late yesterday, 11 LGBTQI advocacy and legal services organizations filed a friend-of-the-court brief in the United States Court of Appeals for the Eleventh Circuit urging the court to uphold the district court ruling in a case brought by The American Civil Liberties Union (ACLU), the ACLU of Florida, and global law firm DLA Piper LLP on behalf of Reiyn Keohane, a transgender woman incarcerated in a Miami prison who was denied medically necessary care by the Florida Department of Corrections (DOC). 

Last August, the U.S. District Court for the Northern District of Florida ruled that it was medically necessary for the DOC to continue Ms. Keohane’s hormone therapy and to provide her the ability to socially transition in prison, in that she must be permitted access to the same clothing and grooming standards as other incarcerated women.

In the friend-of-the-court brief filed, LGBTQI advocates argue that the Eleventh Circuit should affirm the lower court ruling that the Florida Department of Corrections “freeze-frame policy” that denied Ms. Keohane’s medically necessary treatment violates the Eighth Amendment of the U.S. Constitution’s prohibition on cruel and unusual punishment. The brief explains that being able to live in accord with one’s gender identity is medically necessary for transgender people, as recognized by many other courts and by the medical community, including the American Medical Association and World Professional Association for Transgender Health. The brief elevates the voices and experiences of transgender men like Ky Peterson and transgender women like Ashley Diamond, Jessica Hicklin, and Zahara Green, all of whom suffered because they were denied the ability to socially transition in prison. The brief also notes that the Federal Bureau of Prisons and at least 20 state Departments of Corrections’ policies recognize social transition as medically necessary treatment for gender dysphoria.

The friend-of-the-court brief includes: Lambda Legal, Center for Constitutional Rights, Black and Pink, Florida Institutional Legal Services Project of Florida Legal Services, Freedom Overground Corp., GLBTQ Legal Advocates & Defenders, The National Center for Lesbian Rights, The National Center for Transgender Equality, Southern Poverty Law Center, TRANScending Barriers, and The Transgender Law Center. 


“Lambda Legal has received dozens of calls this year from incarcerated transgender people who have been denied treatment for their gender dysphoria in prison and we hear firsthand how distressing it can be for them without this medically necessary care,” said Richard Saenz, Counsel for Amici, Lambda Legal Senior Attorney and Criminal Justice Strategist. “Our client, Jessica Hicklin, was saved from pain and anguish when a Missouri district court ruled that it was cruel and unusual punishment for Missouri prison officials to deny vital health care to her. We are hopeful that the Eleventh Circuit will also see these discriminatory policies as deliberate indifference to incarcerated transgender people’s serious medical needs and affirm the district court’s ruling.”

Said Center for Constitutional Rights Attorney Chinyere Ezie, “The Center for Constitutional Rights has a long history of advocacy with the LGBTQI community, and we remain committed to fighting against LGBTQI persecution in all of its forms. We are proud to elevate the voices and stories of the transgender community behind bars, and will fight alongside them until state officials stop the cruel and usual practice of denying them medically necessary care.”                 

“People who are incarcerated depend on the government to provide medically needed care, which cannot be denied simply because a person is transgender,” said Amy Whelan, a senior staff attorney for the National Center for Lesbian Rights. “There is no place for bias or discrimination against any group in our nation’s prisons.”  

“Our Constitution requires that prisons provide adequate medical care to everyone they house, including the thousands of transgender and nonconforming persons our criminal justice system disproportionately incarcerates,” said David Dinielli, deputy legal director for Amici, Southern Poverty Law Center. “Adequate care for these individuals often requires that they be permitted to present themselves in a manner that conforms to their gender identity. But the stories of our clients and of many others, as retold in this brief, prove that prisons often punish transgender and nonconforming people for the very conduct that medical professionals have confirmed is necessary for their survival. These unconstitutional practices, it seems, are cruel, but not unusual.”

“It is inhumane to deny medically necessary care to transgender people who are incarcerated,” said Jennifer Levi, Transgender Rights Projector of GLBTQ Legal Advocates & Defenders (GLAD). “The consensus position of the medical community recognizes gender transition-related care to be essential in appropriate cases. There is no basis for denying such care just because someone is transgender. Allowing prison systems to disregard inmates’ essential medical needs demeans all of us as a society and violates core constitutional principles."

Read the brief on our case page here.

The Center for Constitutional Rights works with communities under threat to fight for justice and liberation through litigation, advocacy, and strategic communications. Since 1966, the Center for Constitutional Rights has taken on oppressive systems of power, including structural racism, gender oppression, economic inequity, and governmental overreach. Learn more at


Last modified 

January 10, 2019