Supreme Court lets stand ruling that sides with transgender inmates

Ms. Schmelzer also asked the court to examine whether the Seventh Circuit overstepped its authority in affirming an injunction invalidating the state’s ban on sex-change surgery for prison inmates.

“The court of appeals upheld the injunction as to a procedure that no one had requested, let alone shown was medically necessary to prevent a significant risk of serious harm,” Schmelzer wrote. “It is undisputed that none of the plaintiffs were deemed in need of surgery or even requested it.”

The Wisconsin Attorney General’s Office said the appeals court erred by analyzing the case as if gender identity disorder was a potentially fatal physical medical condition, like cancer, rather than a psychological condition.

“Inmates with GID do not have any physical ailment – their bodies are healthy,” Schmelzer wrote. “The condition is a psychological condition and psychological treatments such as psychotherapy, antipsychotics and antidepressants are appropriate and work to reduce the risk of self-harm.”

The Eighth Amendment does not entitle inmates to specific treatments or the best care possible, Wisconsin officials argue, and courts should defer to the judgment of prison officials.

“A state law should be upheld under the Eighth Amendment as long as it allows for the availability of alternate treatments that, although not curative, work to manage the symptoms of a condition and diminish the risk of harm to a reasonable level,” Schmelzer said.

John Knight of the American Civil Liberties Union in Chicago said the Eighth Amendment prohibits deliberate indifference to a serious medical need.

Denial of treatment for severe GID “causes or creates a serious risk of depression, anxiety, suicidal ideation, suicide attempts, and self-mutilation or autocastration for transsexual people,” he wrote in his brief.

“Psychotherapy or psychotropic medication alone, without hormone therapy treatment (and in some cases, sex reassignment surgery), is simply not effective,” Mr. Knight said.

“For those who need it, sex reassignment surgery can be life-saving,” he wrote.

“The Seventh Circuit properly ruled that a state statute that prohibits prison doctors from providing what they deem to be medically necessary treatment for a serious medical condition violates the Eighth Amendment,” Knight said.

“Decisions about the proper course of medical treatment should be made by prison medical staff on an individualized basis” rather than with blanket bans on certain procedures and treatments, he said.

The case is Smith v. Fields (11-561).

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