August 8, 2011
Seventh Circuit Rules Inmate Sex Change Prevention Act Unconstitutional
A three-judge panel of the Seventh Circuit ruled on Friday in Fields v. Smith that the Wisconsin Sex Change Prevention Act, which bars the use of Wisconsin Department of Correction resources for hormonal therapy or sex reassignment surgery, violates the Eighth Amendment on its face.
The case arose when the Wisconsin DOC refused to provide hormonal therapy to state inmates with Gender Identity Disorder, a psychiatric disorder listed in the DSM-IV-TR. The inmates were diagnosed with GID by Wisconsin DOC doctors and had prescriptions for hormonal therapy. The DOC, however, refused to provide the hormones under the Sex Change Prevention Act.
The court ruled that the state's failure to provide effective treatment for GID, which even the DOC agreed was a serious medical condition, violated the Eighth Amendment. Citing and quoting Estelle v. Gamble ("We therefore conclude that deliberate indifference to serious medical needs of prisoners constitutes the 'unnecessary and wanton infliction of pain,' proscribed by the Eighth Amendment"), the court wrote,
Surely, had the Wisconsin legislature passed a law that DOC inmates with cancer must be treated only with therapy and pain killers, this court would have no trouble concluding that the law was unconstitutional. Refusing to provide effective treatment for a serious medical condition serves no valid penological purpose and amounts to torture. . . . Although [the Wisconsin Sex Change Prevention Act] permits DOC to provide plaintiffs with some treatment, the evidence at trial indicated that plaintiffs could not be effectively treated without hormones.
Op. at 11 -12.
The court rejected the defendants' argument that they could limit the discretion of physicians by outlawing a particular medical procedure under Gonzales v. Carhart. The court said that Carhart wasn't helpful to the defendants, because they didn't offer any medical evidence to show that alternative treatments for GID are just as effective as hormonal treatment. The court also rejected the defendants' arguement that its denial of hormonal treatment preserved prisoner security (because those taking the hormones were potentially subject to violence). The court said the defendants simply didn't provide the evidence.
Because the court resolved the case on the Eighth Amendment, it declined to rule on the plaintiffs' Equal Protection claim.
[Image: Giulio Romano, The Prisoners, Wikimedia Commons]
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