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Fifth Circuit Holds Defendants Entitled to Sovereign Immunity For Denial of Sex-Reassignment Surgery to Texas Prisoner

by Matt Clarke

On July 30, 2021, the United States Court of Appeals for the Fifth Circuit vacated orders denying sovereign immunity to some defendants in a lawsuit brought by a transgender Texas prisoner seeking access to sex-reassignment surgery, female commissary items, and a long-hair pass.

Texas Department of Criminal Justice (TDCJ) prisoner David Allen Haverkamp, also known as Bobbie Lee Haverkamp, was diagnosed with gender dysphoria. Dr. Walter Meyer prescribed a 12-month course of hormone therapy and said sex-reassignment surgery was available. Haverkamp requested the surgery. Meyer later said the University of Texas Medical Branch (UTMB), in its provision of medical services to TDCJ prisoners, “is going to have to face the inevitable that gender reassignment surgery is going to happen.” But, near the end of the hormone therapy, Meyer met with him and told him “very plainly that TDCJ would not pay for surgery.”

Haverkamp filed a federal civil rights lawsuit alleging violations of the Equal Protection Clause because biological women prisoners were given medical necessary care that included vaginoplasty and Haverkamp was refused similar, sex-reassignment surgery.

The lawsuit was initially filed against a physician and Dr. Lannette Linthicum, Director of TDCJ’s Health Services Division and a member of the Texas Correctional Managed Healthcare Committee (CMHCC). The CMHCC develops and approves the managed health care plan delineating the level of health care for TDCJ prisoners and ensuring access to needed care. After defense counsel advised the court that, if Haverkamp was seeking surgery, he should have named Dr. Owen Murray from UTMB and, if seeking a policy change or new policy, the principal members of the CMHCC were the appropriate defendants, Haverkamp amended the complaint with the new defendants—Murray and the entire CMHCC.

Some CMHCC members filed motions to dismiss contending Haverkamp’s claims were barred by Eleventh Amendment sovereign immunity, Haverkamp lacked standing because they would not redress his alleged injuries, and there was no plausible equal protection claim. The trial court denied the motions.

On interlocutory appeal, the Fifth Circuit noted that, under Ex Parte Young, 209 U.S. 123 (1908), there is an exception to Eleventh Amendment immunity if the state official sued has “some connection with the enforcement of the [challenged] act.” The mere formulation and promulgation of policies is insufficient for the exception. The court held that Haverkamp had not alleged who overrode Dr. Meyer’s recommendation for surgery, feminine items, and a long-hair pass, or even that there was a dispute between him and higher UTMB officials. It was not plausible, based on the facts pleaded, that the CMHCC had any connection to the enforcement of a policy that resulted in Haverkamp being denied the surgery, items or privileges. Therefore, there was no justification for an exception and defendants were entitled to sovereign immunity. The district court’s orders denying sovereign immunity were vacated and the case remanded for further proceedings. See: Haverkamp v. Linthicum, 6 F.4th 662 (5th Cir. 2021). 

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Related legal case

Haverkamp v. Linthicum