Idaho Trans Prisoners Get Gender-Affirming Care Ban Blocked

A federal judge in Idaho preliminarily blocked state officials and health-care providers from taking away transgender prisoners’ access to gender-affirming care before a trial on whether doing so violates their constitutional rights.

Chief Judge David C. Nye, of the US District Court for the District of Idaho, on Tuesday certified a class of trans prisoners who are receiving or will receive hormone therapy for gender dysphoria and prohibited state officials from enforcing a July 1 law that prohibits using state money to pay for the care. The named plaintiffs raised serious questions going to the merits of whether denying these treatments violates prisoners’ Eighth Amendment rights, Nye said.

This case raises yet another issue in the politically charged debate over LGBTQ+ rights. The US Supreme Court will hear arguments this term on whether a law that restricts treatments for trans youths violates the 14th Amendment’s equal protection clause. This case focuses on whether such care is medically necessary for incarcerated people, so different constitutional standards are involved.

Cole Robinson is a transgender woman who is incarcerated in an Idaho correctional facility. She and another prisoner challenged the ban on state payments for gender-affirming care, saying it will substantially impact their Eighth Amendment rights.

The amendment protects people from cruel and unusual punishment, including a right to adequate medical care. A prisoner alleging a violation must prove that an official acted with deliberate indifference to their serious medical needs, either by choosing a medically unacceptable treatment or by exhibiting conscious disregard to an excessive risk posed to the prisoner’s health, the court said.

Under Ninth Circuit precedent, laws regulating medical treatment are subject to a highly deferential standard of review if they have only an “incidental” impact on prisoners’ rights, the court said. Lawmakers only need to clearly state their purpose and rely on credible medical evidence in enacting a provision for it to be valid, it said.

Idaho lawmakers clearly stated the law’s purpose, but there’s little information about the medical evidence they relied on, Nye said. It’s therefore uncertain if the law’s effect will be incidental or substantial, he said.

It’s “entirely possible that the prohibition of a particular type of treatment for a particular medical condition constitutes deliberate indifference,” but the court needs more evidence to determine if hormone therapy is medically necessary to treat the prisoners’ gender dysphoria, Nye said.

Nye went on to find that the prisoners likely would be irreparably harmed if forced to stop hormone therapy, and that balance of hardships and the public interest favored avoiding a constitutional violation at this point.

The American Civil Liberties Union Foundation and the ACLU of Idaho Foundation represents the prisoners. The Idaho Attorney General’s Office represents the state officials. Bradley Arant Boult Cummings LLP and Duke Evett PLLC represent prison health-care providers Centurion Health.

The case is Robinson v. Labrador, D. Idaho, No. 24-cv-306, 9/3/24.