Medical Care for Trans Women in Illinois Prisons Is Cruel and Unusual Punishment

Medical Care for Trans Women in Illinois Prisons Is Cruel and Unusual Punishment

When recent news reports revealed that a number of Illinois Department of Corrections (IDOC) staff maintained a private Facebook group they used to dehumanize, taunt and degrade transgender prisoners and people of color, we were not surprised. For years, we have fought alongside people imprisoned in Illinois to reveal the brutal truth about life in the state’s prisons. The private group’s social media posts — depicting the worst kind of transphobia and racism — reveal the depths of the IDOC’s dysfunction and cruelty. For our transgender clients in Illinois prisons, this cruelty has become a matter of life or death.

The life of one of our clients, Janiah Monroe, is hanging in the balance right now. The IDOC continues to torture her simply for being who she is.

Monroe has been in prison for more than a decade, and for most of that time, Illinois prison officials refused to accept that she is a woman and housed her in men’s prisons. Guards constantly harassed her, physically assaulted her on multiple occasions and failed to protect her from other incarcerated people who targeted her with violence. One male prison guard even raped her. These conditions drove Monroe to attempt suicide several times.

Two weeks ago, she once again attempted to take her own life. IDOC’s years of mistreatment and abuse have led to this moment. The state of Illinois will be responsible for her death if her next attempt is successful.

Compounding IDOC’s continued, bigoted abuse, prison officials have refused to provide Monroe with the basic medical care she needs, even after IDOC officials confirmed her gender dysphoria diagnosis. Out of desperation, she attempted to take matters into her own hands by removing her own genitals in order to stop the flow of testosterone in her body. Only then did prison officials finally agree to provide her with the hormones she needs. Yet they still refused to allow her to wear a bra or makeup, and refused her the grooming items allowed every cisgender woman in Illinois prisons. Nor have they provided other medically necessary care, including the gender-affirming surgery she urgently needs.

In response to a lawsuit Monroe filed, prison officials finally moved her to a women’s prison earlier this year. But even at the women’s prison, her torture has continued. IDOC does not accept her as a woman and continues to discriminate against her in this setting. Since her transfer, Monroe has been held in solitary confinement — deprived of all meaningful contact with other women and locked in a dark, cramped, airless cell alone for weeks on end. Solitary confinement damages the minds of even the healthiest of incarcerated people.

As bad as things are, Monroe is not the only transgender prisoner receiving abysmal treatment at the hands of Illinois prison officials. Illinois does not take seriously its responsibility to provide medical care and safety for transgender people and permits an unqualified committee of IDOC staff to oversee treatment for transgender prisoners. This committee — whose members lack basic familiarity with transgender health care, safety and security issues, including some members who lack any medical training whatsoever — routinely blocks treatment for transgender prisoners and makes housing decisions which place trans people in danger. The committee’s unwritten policy of never providing certain kinds of care flouts basic medical guidelines. IDOC knows its practices put transgender prisoners at risk and have even led to deaths, according to testimony during the recent trial of Monroe’s claims of inadequate medical treatment, but the state has not changed its ways.

Monroe is the lead plaintiff in a case alleging that the medical care IDOC provides to all transgender prisoners is so bad that it constitutes cruel and unusual punishment in violation of the United States Constitution.

State officials must end Monroe’s suffering. Illinois must release her from solitary confinement. They must provide her and every other transgender person in custody with the mental health and medical care they need, and protect them from the inhumane conditions endemic to the Illinois Department of Corrections.