Santiago v. Gage, et al.

While in custody at Stafford Creek Correction Center in Washington state, Ashley Moon Raelynn, a transgender woman, was diagnosed with gender dysphoria. The Washington Department of Correction’s (DOC) policy, that was in effect at the time, required that decisions concerning treatment for gender dysphoria, including hormone therapy, must be approved by the Gender Dysphoria Care Review Committee (“GD-CRC”). In September 2017, her primary care providers sent a request for hormone therapy to the GD-CRC. After the referral, in the remaining months of 2017, Ms. Raelynn experienced serious physical and emotional distress, and on January 5, 2018, Ms. Raelynn attempted to remove her testicles with a razor blade, which required immediate medical and psychological treatment. Ms. Raelynn was still not provided with hormone therapy to treat her gender dysphoria. Ultimately, defendants delayed authorization to start hormone therapy for nearly 19 months after her initial diagnosis, and 14 months after the referral to the GD-CRC. Finally, Ms. Raelynn was provided with hormone therapy in November 2018.

Ms. Raelynn filed suit in the District Court alleging violations of her Eighth Amendment right to be free from cruel and unusual punishment against defendants. Ms. Raelynn relied on the Health Plan and  the World Professional Association for Transgender Health Standards for the Health of Transsexual, Transgender, and Gender-Nonconforming People to establish that defendants’ actions were outside accepted professional standards for her treatment, and that the intentional delay in her treatment caused her harm.

The District Court dismissed her case by granting qualified immunity to all defendants. Our brief argues that qualified immunity does not apply because the constitutional right to medical care, including for gender dysphoria, was clearly established and that the defendants acted with deliberate indifference to her serious medical need by delaying her treatment.

Amici curiae are civil rights and non-profit organizations including the Center for Constitutional Rights, GLBTQ Legal Advocates and Defenders, Lambda Legal Defense and Education Fund, Inc., National Center for Lesbian Rights, National Center for Transgender Equality, Southern Poverty Law Center, Transgender Law Center, and Transgender Legal Defense & Education Fund.