Court Rejects Wisconsin Bid to Ban Transgender Inmate Treatments

The U.S. Supreme Court refused to consider reinstating a Wisconsin law that banned hormone treatments or sex-change surgeries for transgender prison inmates.

The justices today rejected the state’s appeal of a ruling that the 2006 Wisconsin law, by withholding treatments that prison doctors deem medically necessary, violated the Eighth Amendment prohibition against cruel and unusual punishments.

Three Wisconsin inmates who are male-to-female transsexuals filed suit after prison doctors, who had diagnosed them as having gender identity disorder, stopped providing hormone treatments because of the law.

“Refusing to provide effective treatment for a serious medical condition serves no valid penological purpose and amounts to torture,” the Chicago-based 7th U.S. Circuit Court of Appeals ruled. “Just as the legislature cannot outlaw all effective cancer treatments for prison inmates, it cannot outlaw the only effective treatment for a serious condition” such as gender identity disorder.

Wisconsin Attorney General J.B. Van Hollen, in the state’s high court appeal, said gender identity disorder is a “psychological condition” and the legislature was within its authority to say treatment should be limited to “psychotherapy, antipsychotics and antidepressants.”

The Eighth Amendment “does not prohibit prison officials, prison medical personnel and, most certainly, a state legislature, from denying a small, controversial subset of the wide variety of treatment available for a particular diagnosis,” the state said in its appeal.

Medically Necessary

Lawyers for the inmates said doctors in the Wisconsin prison system were the ones who diagnosed the inmates and prescribed the hormone treatments as medically necessary.

“There was no evidence controverting the testimony of numerous witnesses that, for some people” with severe gender identity disorder, “psychotherapy or psychotropic medication alone” is “simply not effective,” lawyers for the American Civil Liberties Union and the Lambda Legal Defense and Education Fund said, representing the inmates.

The appeals court ruling cited evidence presented at trial that for some people hormone treatment is the most effective way to prevent severe anxiety, depression, attempted suicides or self-mutilation. The court said “severe complications,” including high blood pressure and neurological problems, may arise when patients are taken off hormone treatments.

While the case centered on hormone treatments, the Wisconsin law that was found unconstitutional also prohibits the use of state funds for sex-change surgery.

The case is Smith v. Fields, 11-561.

To contact the reporter on this story: Bob Drummond in Washington at

To contact the editor responsible for this story: Steven Komarow at

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