Taliyah Murphy received a letter in early 2018 about a soon-to-be-filed class action lawsuit on behalf of transgender women like her who were housed in men’s prisons in Colorado. It gave her hope.
Murphy and other transgender women in Colorado had faced years of sexual harassment and often violence from staff members and other inmates. They were denied requests for safer housing options and medical treatment, including surgery, for gender dysphoria, the psychological distress some transgender people experience because of a mismatch between the gender they were assigned at birth and their gender identity, according to the lawsuit.
“We were targeted for victimization, whether it was sexual assault, blackmail, you name it,” said Murphy, who was released in 2020. Most of the time, he added, “The guards just looked the other way.”
A landmark legal settlement called a consent decree, expected to be finalized in early March, will create two new voluntary housing units for incarcerated transgender women, making Colorado the first state to offer a separate unit, according to lawyers in the case. A federal law states that such units are prohibited unless ordered by a court. The plan outlined in the agreement, which received preliminary approval last fall, would require the Colorado Department of Corrections to pay a $2.15 million settlement to the trans women affected. update its protocols and staff training; improve medical and mental health care; limit cross-gender searches by correctional officers; and require corrections staff to use proper names and pronouns for transgender female inmates.
A state judge held a hearing on the consent decree on Jan. 4 and is expected to finalize it by early March after granting an extension to allow more incarcerated women to be notified of the settlement. About 400 currently or formerly incarcerated transgender women are eligible beneficiaries.
Housing assignments in US prisons are based almost exclusively on a person’s anatomy, despite federal law outlining that the safety concerns of transgender people must be taken into account when determining placement. This is because they are far more likely than non-transgender prisoners to be sexually or physically assaulted while in prison.
“It’s like putting targets on their backs,” said Paula Greisen, the civil rights attorney who filed the class action in 2019 along with the California-based Transgender Law Center.
The US Department of Justice found in 2014 that incarcerated transgender people are far more likely to be sexually assaulted behind bars by staff and other inmates, with 35% of trans inmates surveyed reporting being assaulted the previous 12 months. A 2007 study of transgender women in California prisons found that 59% reported being sexually assaulted while incarcerated, a rate 13 times higher than for others housed in prisons.
The Colorado case comes amid a growing number of lawsuits across the country aimed at improving access to gender-affirming care and safety for incarcerated transgender people. In a landmark 1994 case, the US Supreme Court ruled that prison officials’ “deliberate indifference” to an inmate’s safety concerns violates the Eighth Amendment’s “cruel and unusual punishments” clause. Since then, incarcerated transgender people have won legal cases against prison administrators in Washington, Georgia, California and Idaho.
And while some states, including Colorado, have written policies on gender-affirming care and surgery, the barriers to accessing care are often insurmountable — an issue the consent decree hopes to address. California became the first state to enact policies on gender-affirming medical care in prisons, providing gender-affirmation surgery starting in 2017. In 2019, a three-judge panel ruled that the state of Idaho had to perform a surgery they previously had the officials refused. A Colorado inmate has undergone gender confirmation surgery, according to a Department of Corrections spokesperson.
The Constitution requires jails and prisons to provide the same standard of care that is available in the community, said Matthew Murphy, an assistant professor of medicine and behavioral sciences at Brown University and a physician who oversees gender-affirming clinical care for the Department of Corrections. of Rhode Island Sciences. . (Matthew and Taliyah are not related.)
“With Medicaid and private insurance increasingly covering gender-affirming care,” she said, “there is a growing precedent.”
There were 148 transgender women housed in Colorado prisons in December, according to a Department of Corrections spokesperson, with nine transgender women housed in women’s facilities. Before 2018, trans women were housed exclusively with men. The class action applies only to trans women and does not include trans men, non-binary people, or intersex people.
The lawsuit was filed after a young transgender woman who was previously housed with girls in a juvenile facility was transferred to an adult prison, where she was brutally raped. Her numerous requests to be housed with other women, citing safety concerns, had been denied. After taking on the woman’s case, Greisen quickly ran into many more trans women who had experienced similar violence. She contacted the Colorado attorney general’s office and the governor’s office, but little changed, prompting her to file the class-action lawsuit.
“The Department of Corrections in every state — it’s like trying to turn the Titanic. There’s so much red tape,” Greisen said. “You often have to sue to get their attention.”
The World Professional Association for Transgender Health, the leading professional organization that sets standards for the medical care of people with gender dysphoria, recommends an “informed consent model” that allows patients to pursue gender-affirming care, including surgery, without needing to undergo extensive psychological counseling.
But Colorado’s prison system, like many across the country, falls short of those standards. Current department of corrections policies require transgender women to obtain multiple letters of recommendation from physicians and mental health providers to be considered for transition-related surgery. Often, prisons offer gender-affirming care “on paper,” but lack qualified providers, making care impossible, according to Matthew Murphy.
This was the case for Taliyah Murphy, who underwent gender confirmation surgery twice during her incarceration. Murphy went to prison in 2009 after a conviction stemming from a fight with her abusive boyfriend, according to the lawsuit. Her sentence was reduced in 2013, he said.
In 2019, she finally received a recommendation for surgery to treat her gender dysphoria from a corrections psychiatrist. But she was told her other doctors didn’t have the necessary training to evaluate her, according to the lawsuit, which halted the process. She received surgical treatment only after her release in 2020, he said.
Left untreated, gender dysphoria can lead to depression, anxiety, thoughts of self-harm and suicide – all of which already disproportionately affect transgender people due to the discrimination, stigma and other social stressors they face. “These things are generally resolved, or at least ameliorated, by undergoing gender-affirming clinical care — whether it’s medical, procedural or surgical,” said Matthew Murphy.
But prison systems are dragging their feet in providing treatment, she said, and a national shortage of gender-affirming care providers and surgeons is making matters worse.
“And so, people are then forced to go to court,” he said.
The consent decree will create two new voluntary housing options for transgender women incarcerated in Colorado to better meet their specific needs and improve their safety.
A voluntary 100-bed transgender unit, which is already under development, will be located at the men’s penitentiary. For those approved to move to the women’s prison, they will spend a few months in the 44-bed integration unit described in the consent decree.
That adjustment time will be critical both for cisgender women already housed in women’s prisons and for trans women who are likely to leave traumatic situations in men’s prisons, said Shawn Meerkamper, senior staff attorney at the Transgender Law Center, which worked for the case. .
“We’ve seen in other places when people just fall into a really new environment, it can be a sink or swim situation,” Meerkamper added.
Eligibility for the units will be decided on a case-by-case basis by a committee, including medical and psychiatric experts trained in gender-affirmation care, as well as correctional officers, according to the settlement. However, regardless of placement, the Colorado Department of Corrections would still be required by law to provide transgender women with adequate mental and physical health care.
“Trans women shouldn’t be forced to go to the trans unit or a women’s prison if that’s not what they want,” Meerkamber said. “And they can’t be fined or penalized for refusing to go.”
In response to the lawsuit, the Department of Corrections has hired an independent medical expert from Denver Health, as well as a gender-affirmation care specialist, to help oversee requests for housing assignments and surgical advice.
Taliyah Murphy hopes the new housing and improved access to gender-affirming care will allow incarcerated trans women to focus less on safety and survival and more on rehabilitation and planning for their lives outside prison walls.
“We want them to leave better than they came and get the care they need,” said Murphy, who is now a small business owner in Colorado Springs and pursuing a degree in finance and accounting. “That’s all it is.”
|
This article was reprinted by khn.orga national newsroom that produces in-depth health journalism and is one of KFF’s core operating programs – the independent source for health policy research, polling and journalism.
|
