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Trans inmates win right to gender-affirming care as judge calls it “a serious medical need”
Photo #8010 December 09 2025, 08:15

A federal judge has blocked a gender-affirming care ban for trans inmates in Georgia that has been in effect for several months. Judge Victoria Calvert agreed with the plaintiffs that the blanket ban violated the Eighth Amendment, which bars cruel and unusual punishment.

“The Court finds that there is no genuine dispute of fact that gender dysphoria is a serious medical need,” Judge Calvert wrote in her opinion. “Plaintiffs, through their experts, have presented evidence that a blanket ban on hormone therapy constitutes grossly inadequate care for gender dysphoria and risks imminent injury.”

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Georgia Senate Bill 185 was signed into law in May by Governor Brian Kemp (R). The bill prohibited state funds and resources from being used to provide gender-affirming care to inmates in Georgia prisons. That included hormone replacement therapy (HRT), as well as “sex reassignment surgeries or any other surgical procedures that are performed for the purpose of altering primary or secondary sexual characteristics,” and even “cosmetic procedures or prosthetics intended to alter the appearance of primary or secondary sexual characteristics.”

The bill took effect in July, and five plaintiffs filed a lawsuit against it in August. In addition to arguing that SB 185 constituted cruel and unusual punishment, the lawsuit also claimed that it violated the Equal Protection Clause. HRT and other gender-affirming care treatments were not banned under the bill for all inmates, only for those who were trans. The bill also prohibited trans inmates from paying for the care themselves while incarcerated.

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“We would never allow a state to decide that people in prison with diabetes should be cut off of insulin just because the state didn’t want to pay for it anymore,” said Celine Zhu, a Staff Attorney for the Center for Constitutional Rights, which is representing the plaintiffs. “So why would we allow Georgia to cut off medically required care for people with a similarly serious diagnosis of gender dysphoria?”

SB 185 was a blanket ban that overruled the opinions of judges, doctors, and the Georgia Department of Corrections, all of whom have previously acknowledged that gender-affirming care is medically necessary for incarcerated trans people.

While the judge’s ruling makes it clear that not every inmate is entitled to gender-affirming care, it puts those decisions back in the hands of medical professionals and the patients rather than having the legislature make medical decisions for trans people.

“The Court requires healthcare decisions for prisoners to be made dispassionately, by physicians, based on individual determinations of medical need, and for reasons beyond the fact that the prisoners are prisoners,” the judge said in her ruling.

Current estimates suggest that there are around 300 out trans people incarcerated in Georgia state prisons.

After the ruling, the Department of Corrections filed a notice of appeal with the 11th Circuit Court of Appeals.

This sort of case has been litigated for over twenty years now. In 2005, Wisconsin introduced a ban on doctors providing trans inmates with gender-affirming care, affecting inmates who had been on hormones since the early 90s. The law was overturned by the 7th Circuit Court of Appeals, and the Supreme Court declined to hear the state’s appeal in 2011.

The decision in the Georgia case comes as the Department of Justice has instructed inspectors to stop reviewing prison standards aimed at preventing sexual assault against transgender, intersex, and gender-nonconforming people.

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