US federal prisons must provide hormones sought by transgender inmates

A federal judge ordered the bureau of prisons on June 17 to continue providing hormone medications to transgender inmates, rejecting, at least for now, the Trump administration’s decision to no longer provide such medical treatment for prisoners.

Judge Royce C Lamberth, of the US District Court for the District of Columbia, issued a preliminary injunction, finding that doubts the government has raised about hormone therapy were unlikely to satisfy a legal requirement that federal agencies offer a reasoned explanation for reversing existing policies.

Amid an array of legal fights over the Trump administration’s policies on transgender Americans, the case is rare for focusing broadly on medical treatments for transgender adults, rather than minors.

But the bureau of prisons officials have taken the position that even for adults with gender dysphoria – significant distress linked to a mismatch between a person’s birth sex and gender identity – the benefits of hormone therapy are unclear.

Lawyers for transgender prisoners have said transition-related treatment, which can include cross-sex hormones, social transition and in some cases surgery, is the only approach known to effectively treat gender dysphoria.

The treatment has come under scrutiny for adolescents, but has been accepted as effective for adults for several decades, and is supported by the major medical and mental health organisations in the United States.

About 1,028 federal prisoners have been diagnosed with gender dysphoria, according to the bureau of prisons. Of that group, 628 prisoners receive cross-sex hormone therapy.

The ruling is the second time Lamberth has blocked the dureau from denying transgender prisoners access to hormone medication.

Last June, the judge had agreed with three inmates who sued the prison system, arguing that by adjusting their medical treatment, the bureau had most likely violated the Administrative Procedure Act, a 1946 law that requires federal agencies to justify policy changes.

In April, the government asked Lamberth – who was appointed to the bench by President Ronald Reagan – to dissolve his earlier order, saying that it had satisfied the legal requirement to justify its action.

The inmates, represented by the Transgender Law Centre and the ACLU Foundation, argued that the agency was aware of the risks of withholding hormone therapy because its own doctors had previously deemed it clinically necessary. NYTIMES