Trans inmate wins right to gender-affirming surgery despite state law banning it

Yesterday, an Indiana judge found that the Indiana Department of Corrections (IDOC) was violating the law in failing to provide a trans woman inmate with gender-affirming surgery. They have been ordered to provide her surgery as soon as possible.

The case, Cordellioné v. Commissioner, Indiana Department of Corrections, concerned the IDOC’s denial of Autumn Cordellioné’s request for a gender-affirming surgery due to Indiana’s 2023 law, H.B. 1569, which restricts public funds from being provided for gender-affirming surgeries, including in prison. This bill went into effect in July and is still in place for all transgender individuals.

Related:

Trans prisoners in Idaho can get hormone therapy again after major win in federal court

A state law banned gender-affirming care in prisons and elsewhere. A judge shut that down.

Judge Richard Young of the U.S. District Court in the Southern District of Indiana, however, mandated that Cordellioné specifically receive such care, concluding that it was an Eighth Amendment violation for being “cruel and unusual punishment” by denying essential health care and a Fourteenth Amendment violation by denying equal protection under the law on the basis of sex.

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“The court finds, however, that the widespread medical consensus is that gender-affirming surgery is a medically necessary form of care for some individuals with gender dysphoria…it is appropriate for the court to order at this point that this surgery be provided to her at the earliest opportunity. This relief is narrowly drawn, extends no further than necessary to correct the violation of Ms. Cordellioné’s constitutional rights, and is the least intrusive means available and necessary to correct this ongoing violation. There is no evidence that this preliminary injunction will have any adverse impact on either public safety or the operation of the criminal justice system.”

Much of the legal battle in this case concerned whether Cordellioné could demonstrate the safety and effectiveness of gender-affirming care, while the IDOC aimed to call it into question. 

The IDOC cited individuals like Dr. Stephen Levine, a psychiatrist who often campaigns against gender-affirming care and for restrictions on trans people. Levine, among other statements, tried to discredit the World Professional Association for Transgender Health’s (WPATH) Standards of Care for transgender people as being biased and not relying on evidence.

The judge did not agree and accepted the WPATH Standards of Care.

“Given the widespread acceptance of WPATH’s Standards of Care by other professional medical bodies as well as the National Commission of Correctional Health Care, the court finds that the Standards of Care are credible and reliable and will rely on them in reaching its conclusions in this matter,” Young wrote.

Much of Levine’s testimony was struck from the record or given “very little weight,” and other experts and evidence given were not deemed sufficient in comparison to the vast amount of evidence that Cordellioné’s side gave in support of the necessity of gender-affirming surgeries.

Cordellioné has been on hormone replacement therapy and initially sought a gender-affirming surgery in 2022. She has attempted suicide while in prison due to being denied essential care and has been the victim of much mental anguish owing to gender dysphoria.

While this case only concerns Cordellioné’s care, it may have the additional impact of being cited in support of future litigation that may overturn such care bans in Indiana or in other states.

ACLU of Indiana Legal Director Ken Falk said of the ruling in a statement, “Today marks a significant victory for transgender individuals in Indiana’s prisons. Denying evidence-based medical care to incarcerated people simply because they are transgender is unconstitutional. We are pleased that the Court agreed.”

LGBTQ Nation reached out to the IDOC for comment and to ask whether they plan to appeal this ruling and was told “the IDOC does not comment on pending litigation.”

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