Monroe v. Jeffreys

The ACLU of Illinois represents a class of all people in the custody of the Illinois Department of Corrections (IDOC) who have requested evaluation or treatment for gender dysphoria. The case challenges the grossly inadequate medical care IDOC provides to people with gender dysphoria, causing them constant suffering, and raising the real prospect of even more dangerous health outcomes, including death.

The lawsuit was filed on behalf of five women – Janiah Monroe, Marilyn Melendez, Lydia Helena Vision, Sora Kuykendall, and Sasha Reed in 2018. Ms. Monroe and Ms. Melendez now represent a certified class of more than four hundred people in IDOC custody seeking treatment for gender dysphoria. We want IDOC to provide medical care and other treatment for gender dysphoria on a timely basis and consistent with well-established medical standards.

In December 2019, a federal district court granted our clients a preliminary injunction, ordering IDOC to overhaul the way it provides medical care to prisoners who have gender dysphoria. Most importantly, the court ordered IDOC to change its practice of using a committee of non-experts to make decisions about medical care for transgender prisoners. IDOC was ordered to provide class members with medically necessary hormone therapy, access to clinicians qualified to treat gender dysphoria, and the ability to socially transition.

The case went to trial over four days in August of 2021, including extensive testimony from our clients who were able to directly express to the court the ways in which they suffer because of the denial of access to basic medical treatment, including hormone therapy, gender-affirming commissary items, shower and search accommodations, and surgery. In a rare oral order from the bench, the judge concluded that IDOC is still violating the Eighth Amendment by not providing constitutionally adequate care. The Court stated it "has never seen such deliberate indifference to a serious medical need" and outlined the steps IDOC must take immediately to improve the quality of health care and appropriate housing for our clients, and left the door open for additional relief, including the appointment of a monitor.

In December 2024, the Seventh Circuit Court of Appeals held that the injunction entered in 2022 which ordered medical care to treat our class members’ gender dysphoria had automatically expired under the Prison Reform Litigation Act (PLRA). The Seventh Circuit remanded the case to the district court for further proceedings.

After the appellate court ruling, the district held an evidentiary hearing on our motion concerning horrific circumstances for class members at Menard Correctional Center where they received no medical care for gender dysphoria and faced physical and sexual violence. In September 2025, the court entered a preliminary injunction ordering transfer of all class members out of that prison (and no new placements there). A further evidentiary hearing in early December 2025 led the court to reissue that injunction.

On March 12, 2026, we successfully won another reissuance of the preliminary injunction after an evidentiary hearing, and this injunction will expire in June 2026. A new trial is anticipated in 2027.

Questions and Answers

Find out more about our work to protect transgender prisoners in the federal prison system

Case Documents