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Fourth Circuit Finds No Sex Reassignment Surgery Evaluation States Claim; $13,000 Settlement

Fourth Circuit Finds No Sex Reassignment Surgery Evaluation States Claim; $13,000 Settlement

he Fourth Circuit Court of Appeals held on January 28, 2013 that refusal to evaluate a transgender prisoner for sex reassignment surgery states a valid Eighth Amendment claim. The case later settled after the plaintiff was released on parole.

Virginia state prisoner Ophelia Azriel De’lonta, aka Michael A. Stokes, is a pre-operative male-to-female transsexual who suffers from Gender Identity Disorder (GID). Like other transgendered people, De’lonta feels trapped in a body of the wrong gender and experiences pervasive thoughts and impulses of self-mutilation, including self-castration attempts.

In 1999, De’lonta filed suit against the Virginia Department of Corrections (VDOC), challenging a policy which prevented GID treatment. The district court dismissed the action for failure to state a claim but the Fourth Circuit reversed. See: De’lonta v. Angelone, 330 F.3d 630 (4th Cir. 2003) [PLN, July 2004, p.31].

The VDOC settled with De’lonta in 2004, acknowledging that GID is a serious medical need and agreeing to provide continuing treatment, including regular psychological counseling and hormone therapy. Prison officials also allowed her to dress and live as a woman while incarcerated.

After nearly a decade of counseling and hormone therapy, De’lonta’s GID symptoms persisted. A continuing strong, “imminent” urge to self-castrate, especially following counseling sessions, caused De’lonta physical and emotional suffering. A July 2010 self-castration attempt resulted in her hospitalization.

In September 2010, De’lonta asked to stop counseling and undergo evaluation for sex reassignment surgery pursuant to GID treatment protocols published by the World Professional Association for Transgender Health. Known as the “Benjamin Standards of Care,” they are the generally accepted GID treatment protocols.

VDOC officials directed De’lonta to continue with counseling and did not allow an evaluation by a GID specialist for sex reassignment surgery.

De’lonta filed another federal lawsuit in 2011, alleging that denial of evaluation for sex reassignment surgery constituted deliberate indifference in violation of the Eighth Amendment. On initial screening, however, the district court dismissed the complaint for failure to state a claim.

The Fourth Circuit reversed, concluding “that De’lonta’s complaint sufficiently alleges ... deliberate indifference to her serious medical need, and consequently, that the district court’s dismissal was in error.” The Court of Appeals made clear, however, that it was not deciding the merits of the case; it held only “that De’lonta’s Eighth Amendment claim is sufficiently plausible to survive screening pursuant to 28 U.S.C. § 1915A.” See: De’lonta v. Johnson, 708 F.3d 520 (4th Cir. 2013).

Following remand, in an August 28, 2013 memorandum opinion the district court granted De’lonta’s motion to compel, ordering the VDOC defendants to allow her to be examined and evaluated for sex reassignment surgery by a physician of her choice, at her own expense. The court also took under advisement De’lonta’s motion for a preliminary injunction to require the VDOC to conduct its “own evaluation of her readiness for” sex reassignment surgery.

De’lonta was released on parole in January 2014, and subsequently settled her lawsuit against the VDOC in May 2014 for $13,000. See: De’lonta v. Johnson, U.S.D.C. (W.D. Vir.), Case No. 7:11-cv-00257-JCT-RSB.


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De’lonta v. Johnson

De’lonta v. Johnson