Incarcerated trans man sues Virginia Department of Corrections over access to gender-affirming care

Lambda Legal has filed a federal lawsuit against the Virginia Department of Corrections (VDOC) on behalf of a transgender man incarcerated at the Fluvanna Correctional Center for Women (FCCW) who has been denied medically necessary and gender-affirming care.

The lawsuit was filed in the U.S. District Court for the Western District of Virginia on behalf of Jason Yoakam, transgender man who was denied a bilateral mastectomy by the VDOC, which claimed the surgery was not medically necessary treatment for gender dysphoria. The VDOC also denied Mr. Yoakam treatment from qualified mental healthcare providers and other reasonable accommodations.

“The only thing I am asking is to be treated fairly and have access to the same standard of healthcare that other incarcerated people receive. It has been traumatizing, isolating, and stigmatizing to be denied health care services to treat the gender dysphoria that VDOC's own providers have diagnosed," said Yoakam.

Yoakam contends that the denial of surgery violates the U.S. Constitution's Eighth Amendment's prohibition on cruel and unusual punishment and argues that denying medical treatment on the basis of his transgender status violates the Equal Protection Clause of the Fourteenth Amendment.

Mr. Yoakam also raises statutory claims under the Americans with Disability Act and under Section 504 of the Rehabilitation Act based on his disability of gender dysphoria, a medical condition that some transgender people experience as significant distress when their gender identity is not congruent with the sex assigned at birth. The lawsuit also brings a claim under Section 1557 of the Affordable Care Act, a nondiscrimination provision in the federal civil rights law that prohibit discrimination in health care setting based on sex.

“Mr. Yoakam is not seeking special treatment, just access to medically necessary health care and reasonable accommodations for his gender dysphoria," said Richard Saenz, Senior Attorney and Criminal Justice and Police Misconduct Strategist at Lambda Legal. “Every incarcerated person has a right to basic health care based on their medical needs –and should not face discrimination because of their sex. We hope that the Court affirms that denial of this safe and medically effective treatment for transgender men like Mr. Yoakam is a clear violation of their constitutional and statutory rights."

Jason Yoakam
Background to the case

Mr. Yoakam suffers from severe gender dysphoria and experiences depression, anxiety, panic attacks, sleep and appetite disturbances, and physical pain related to his chest. In his pre-teen years, Mr. Yoakam began to bind his chest, a practice he continues to do today – which has caused him bleeding, scarring, and pain. His treating endocrinologist and a transgender health specialist at the University of Virginia have deemed chest surgery medically necessary treatment for him.

In August 2017, health care providers at Fluvanna diagnosed Mr. Yoakam with gender dysphoria. As part of his treatment, Mr. Yoakam has received hormone therapy and was provided a binder for his chest. However, the Virginia Department of Corrections denied a bilateral mastectomy, or chest surgery, for Mr. Yoakam on the basis that it was not medically necessary. The lawsuit alleges that VDOC has a de facto policy or practice to deny surgery for gender dysphoria. This denial runs counter to the World Professional Association of Transgender Health (WPATH)'s Standards of Care, under which Mr. Yoakam meets the criteria for surgery – documentation that he has provided to VDOC and yet was denied.

Lambda Legal and Robins Kaplan previously secured a pro bono victory on behalf of Jessica Hicklin, an incarcerated transgender woman, after a federal district court struck down a Missouri Department of Corrections (MDOC) policy as cruel and unusual punishment because it denied vital health care to transgender people. The ruling in that case, Hicklin v. Precythe, was believed to be the first to find that freeze-frame policies are unconstitutional.

Richard Saenz, Senior Attorney and Criminal Justice and Police Misconduct Program Strategist, Sasha Buchert, Senior Attorney, and Greg Nevins, Senior Counsel are handling the case for Lambda Legal, along with Kellie Lerner, Partner, Ellen Levish, Jessica Gutierrez, and Rebecca Zadaka of Robins Kaplan LLP, and local counsel Jeffrey Fogel of the Law Offices of Jeffrey E. Fogel.

Read more about the case here.

Read the brief complaint here.

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