In this decision, a federal district court judge (the trial judge) denied the Federal Bureau of Prison's (FBOP) motion to dismiss the complaint of a transgender prisoner, Vanessa Adams, seeking access to hormone therapy. It is a district court decision focused largely on the issue of mootness, and therefore of limited precedential value particularly outside of Massachusetts. However, the decision is potentially useful to advocates trying to remedy denied or unpredictable access to needed medications, whether for transgender or HIV positive inmates of prisons and jails, in situations where they may eventually or occasionally get access but there is no clear policy ensuring that their access to essential medications will be as regular as medically necessary.
The judge rejected the FBOP's argument that Williams' case against the Federal Bureau of Prisons was made moot by their decision to finally provide Williams with hormone therapy. As the Bureau failed to demonstrate in any way that the deprivation of hormone treatment was not likely to recur, the plaintiff's allegation that the refusal to provide hormonal therapy constituted inhumane treatment under the Eighth Amendment was still a live claim.
When Vanessa Adams entered federal prison, she was classified as male but self-identified as female. In 2005, Adams was diagnosed with Gender Identity Disorder (GID), but was denied hormone therapy even though, as the court notes here, the denial could cause "serious harm including depression, anxiety, self-mutilation and suicide."
Adams did in fact attempt suicide, after which a FBOP psychologist warned that she was at continuing risk for harming herself. Adams' subsequent requests for hormone therapy were denied, and were followed by repeated acts of self-mutilation and ultimately the filing of her civil rights case in January 2009.
On August 14, 2009, following the filing of an emergency motion for an outside expert psychological evaluation by Adams' lawyers, the FBOP finally started hormone treatment for Adams. However, without the FBOP's disavowal of its policy of refusing hormone therapy for transgender prisoners who didn't enter prison already on hormones, the court determined that the issue was not moot and the case could proceed.