Prison Officials Escape Suit Over Gender-Affirming Care Denial

Connecticut prison inmates who seek gender transition-related healthcare have no clearly established right to be aided by gender-dysphoria specialists or to receive “specific treatments,” a divided Second Circuit panel said.

The US Court of Appeals for the Second Circuit reversed a district court’s denial of qualified immunity to prison officials who withheld gender-affirming care to inmate Veronica-May Clark, who identifies as a transgender woman. The case was remanded with instructions to grant the officials’ motion for summary judgment in a split decision Monday.

The district court improperly denied qualified immunity to three officials with Connecticut’s Garner Correctional Institution “because “there is no clearly established right to specific gender-dysphoria treatments.” The court also refers to a circuit split that pits the Ninth Circuit, which holds that a prison psychologist was deliberately indifferent for denying an inmate’s requests for sex-reassignment surgery, against several appeals courts. The majority calls the Ninth’s ruling a “stray decision.”

In 2009, Clark was convicted of murder, assault, and burglary with a deadly weapon and is serving a 75-year sentence without the possibility of parole.

Seven years into that sentence, prison clinicians learned that Clark identified as a transgender woman. A health-care provider at Cheshire Correctional Institution diagnosed Clark with gender dysphoria the next month. After an attempted self-castration, prison officials transferred Clark to Garner.

Clark then asked Garner official Gerald Valletta for various gender-dysphoria treatments, including requests for hormone therapy, laser hair removal, and a vaginoplasty. Valletta denied Clark’s requests “based on his understanding that Connecticut prison policy allowed for the continuation, but not the initiation, of hormone therapy for inmates,” the court said.

The district court erred by conducting its qualified-immunity analysis at “too high a level of generality,” said Judge Michael H. Park on on behalf of the majority. “It defined the relevant right as ‘the right to be free from deliberate indifference to serious medical needs.’” Yet such a right “‘is far too general a proposition to control this case.’”

The “proper inquiry here” is whether there is a clearly established right to a specific course of gender-dysphoria treatment, the court said. “The answer is no.”

The record doesn’t support the allegation that Clark was deprived of “informed care,” the court said. But even if that were so, that wouldn’t violate the Constitution, the court said. While the Eighth Amendment requires that “inmates receive adequate food, clothing, shelter, and medical care” and that prison officials take “reasonable measures to abate” a “substantial risk of serious harm,” it’s “well-established” that “mere disagreement” over the proper treatment doesn’t create a constitutional claim.

Judge Beth Robinson, who concurred in part and dissented in part, said that while the defendants aren’t “entitled to qualified immunity under our clearly established law,” the officials engaged in a “wholesale failure to provide relevant medical care, often based on blanket policies that are not anchored in accepted medical standards.”

Judge Richard J. Sullivan joined the majority opinion.

Krieger Lewin LLP, the ACLU Foundation of Connecticut, and Finn Dixon & Herling LLP represent Clark.

The case is Clark v. Valletta, 2d Cir., No. 23-7377, 10/6/25.