By Derek Gilna
A lawsuit filed by a transgender federal prisoner in Massachusetts has resulted
in the Bureau of Prisons (BOP) making appropriate medical care available “to
[prisoners] who believe they are the wrong gender,” according to a May 31, 2011
memo issued to all BOP wardens. Previous BOP policy limited treatment of
transgender prisoners to medical care that maintained them “at the level of
[gender] change which existed when they were incarcerated.”
The prisoner who filed suit, Vanessa Adams, whose legal name is Nicholas Adams,
had been diagnosed with Gender Identity Disorder (GID) in 2005 by medical
professionals at the U.S. Medical Center for Federal Prisoners (USMCFP) in
Adams sought declaratory and injunctive relief under 28 U.S.C. §§ 2201 and
Her lawsuit noted that GID is a “recognized diagnosable and treatable medical
condition listed in the American Psychiatric Association’s Manual of Mental
Disorders (DSM-IV-TR).” Medically appropriate GID treatment options include
providing patients with 1) hormones of the desired gender; 2) the “real life
experience,” i.e. living full-time as the new gender; and 3) surgery to change
the patient’s sex characteristics – often collectively referred to as “triadic
According to her complaint, Adams “believed she was assigned the wrong gender,”
which caused her “much emotional turmoil.” Those feelings intensified during
her incarceration; she amputated her penis and attempted to castrate herself.
Adams’ lawsuit alleged that the BOP’s medical protocol for transgenderprisoners violated the Eighth Amendment because it inflicted cruel and unusual
punishment by failing to provide necessary care for a serious medical
The new BOP guidelines mean that treatment plans for transgender prisoners “may
include elements or services that were, or were not, provided prior to
incarceration, including, but not limited to: those elements of real life experience
consistent with the prison environment, hormone therapy and counseling.”
Additionally, transgender prisoners will be informed of the policy change and
BOP doctors will receive training to recognize and treat GID.
BOP spokesman Ed Ross said 48 federal prisoners had been diagnosed with GID.
Jennifer Levi, director of the Transgender Rights Project at Gay and Lesbian
Advocates and Defenders (GLAD), noted that prison officials have typically been
hostile to transgender prisoners and additional legal action may be needed to
ensure the BOP’s new policy is put into practice. “This should have a very
significant effect on the lives of transgender [prisoners],” she said. “It
means people will be receiving appropriate medical care.”
While the BOP guidelines do not mention sex reassignment surgery as a treatment
option, it may still be available. “There is no reason why an incarcerated
person should be excluded from receiving surgery if it turned out to be
medically necessary for that individual,” Levi stated.
In addition to the policy changes, the BOP agreed to provide specific medical
treatment for Adams and pay her attorney fees and costs. The amount of fees and
costs was not disclosed, and PLN has filed a Freedom of Information Act (FOIA)
request seeking that information. Adams was represented by Florida
Institutional Legal Services, GLAD, the law firms of Bingham McCutche LLP and
Kurker Law Group LLC, and the National Center for Lesbian Rights. See: Adams v.
Federal Bureau of Prisons, U.S.D.C. (D. Mass.), Case No. 1:09-cv-10272-JLT.
Additional source: Associated Press