Charlotte — A federal judge has issued a decision in Zayre-Brown v. NC Department of Adult Correction (DAC), ruling that the state’s process for evaluating whether gender-affirming surgery is medically necessary for incarcerated individuals is unconstitutional.
The American Civil Liberties Union, ACLU of North Carolina, and Patterson Harkavy LLP filed the lawsuit in 2022 on behalf of Mrs. Kanautica Zayre-Brown, an incarcerated transgender woman whose request for gender-affirming medical care has been repeatedly deferred and denied.
For years, Mrs. Zayre-Brown has been requesting medically necessary treatment consistent with established standards of care. The prison system has refused to provide this treatment, despite its own healthcare providers concluding that Mrs. Zayre-Brown requires surgery to treat the severe distress she experiences because parts of her body remain inconsistent with the woman she knows herself to be.
The DAC empowers a specialized body called the Division Transgender Accommodation Review Committee (DTARC) to evaluate medical requests for incarcerated transgender people. The prison system has a policy that says it permits gender-affirming surgery, but the DTARC has received more than thirty such requests and denied all of them. Dr. Arthur Campbell, a DTARC member and Chief Medical Officer of the DAC, has previously asserted that gender-affirming surgery is never medically necessary to treat gender dysphoria.
The decision, written by U.S. District Court Judge Max O. Cogburn, Jr., confirmed that Dr. Campbell's assessment of Mrs. Zayre-Brown did not provide individualized consideration of her medical needs, and that DTARC’s reliance on someone hostile to gender-affirming surgery constituted a de facto ban on gender-affirming surgery.
“[T]his case is about whether states can permit prison officials’ personal views to determine the medical care available to prisoners,” wrote Judge Cogburn in his decision.
Judge Cogburn ruled that the DAC violated Mrs. Zayre-Brown's rights under the Eighth Amendment by failing to give her request individualized consideration. He ordered that the DAC either provide Mrs. Zayre-Brown with the surgery she has requested or, within 30 days of the order, form a new committee containing at least two medical doctors with gender dysphoria expertise to reevaluate Mrs. Zayre-Brown's request.
“We are pleased that the court has recognized that DAC’s processes are biased against transgender health care and have failed those DAC is legally obligated to care for,” said Jaclyn Maffetore, Senior Staff Attorney for the ACLU of North Carolina. “Mrs. Zayre-Brown has endured years of suffering as a result of inhumane treatment by DAC officials and the discrimination she has faced while in DAC custody. We hope that this decision leads to her receiving the care she needs.
“We also hope that this decision will pave the way for other incarcerated transgender people to receive the care they need without being subject to discrimination and indignity. Gender-affirming care is life-saving care, and we will continue to advocate for all transgender people and those who are incarcerated in North Carolina.”
You can read Judge Cogburn’s decision below.
