On October 11, 2023, Disability Rights Washington (DRW) filed a complaint and settlement agreement in federal court to resolve allegations that the Washington Department of Corrections (DOC) is violating the U.S. Constitution, the Americans with Disabilities Act (ADA), and the Rehabilitation Act in its treatment of incarcerated people with disabilities who are transgender. The court entered a consent decree ordering DOC to comply with the agreement on October 17.

The complaint alleges that DOC violated the 8th Amendment to the U.S. Constitution by failing to provide timely medical and mental health care to transgender patients and subjecting them to harmful and unnecessary cross-gender strip and pat-down searches. The complaint also alleges that DOC violated the ADA and Rehabilitation Act by discriminating against transgender patients with disabilities in the provision of gender-affirming medical and mental health care and failing to modify policies, practices, and procedures to accommodate such patients.

As part of the agreement, DOC will provide gender-affirming healthcare and services that are consistent with the Washington Health Care Authority’s Transhealth Program for people living in the community. The Washington Department of Corrections has agreed to ensure that any person with an active prescription for hormone replacement therapy in the community will continue receiving their prescription in prison and that transgender individuals seeking hormone replacement therapy in prison for the first time will generally be eligible to receive such medication upon request absent major medical contra-indications.

Patients with gender dysphoria will also be promptly evaluated for gender-affirming surgeries and procedures by a community expert in gender-affirming care and patients will have access to gender-affirming mental health care. The Department also agreed to retain a medical specialist in gender-affirming care, gender-affirming mental health specialists at each major prison, community consultants for gender-affirming medical and mental health care, and several care navigators and administrators to implement the program.

In addition, DOC will take affirmative steps to provide gender-affirming clothing and property to transgender people in prison in a timely manner, develop and implement policies to ensure that transgender people may shower and change clothing separately and out of view from other individuals, and cease the practice of subjecting transgender people to harmful and unnecessary cross-gender strip and pat-down searches.

DRW worked closely with many currently and formerly incarcerated transgender people with disabilities to learn about the issues facing our constituents and the best ways for DOC to resolve them. The resulting complaint and settlement agreement, which is one of the most comprehensive settlements about the treatment of transgender people in prison, will help ensure that DOC lives up to its obligation to provide medical and mental health care to transgender patients, protect them from wanton cross-gender strip and pat-down searches, and accommodate patients’ disabilities as required by the ADA and Rehabilitation Act. The agreement requires DOC to produce quarterly data and anticipates that DRW will monitor DOC’s compliance.

This case is also important in the context of DRW’s longstanding work to ensure people in prison have access to necessary specialized healthcare. For over ten years, DRW has tried to convince DOC to provide healthcare for serious medical needs as required by the constitution. This case is one step toward achieving that reality.

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