The ACLU of Illinois represents a class of all people in the custody of the Illinois Department of Corrections (IDOC) who have requested treatment for gender dysphoria. Gender dysphoria is a medical condition characterized by distress arising from the discrepancy between a person’s gender identity and their sex assigned at birth. Many people who are transgender experience gender dysphoria. The case challenges the grossly inadequate medical care IDOC provides to people with gender dysphoria. IDOC has systematically failed to provide the class members with even minimally adequate medical care. When class members receive medical treatment at all, it often comes after long delays and ignores entirely or flouts the applicable medical standards.

These grave problems seriously hurt transgender people, causing them constant suffering, and raising the real prospect of even more dangerous health outcomes, including death. One client waited approximately three years after requesting treatment before her hormone therapy was finally started—and only after several attempts to treat herself by self-castration. There is no medical reason for such excruciatingly painful and risky denials, delays, and other missteps in providing treatment to prisoners with gender dysphoria.

The lawsuit was filed on behalf of five women – Janiah Monroe, Marilyn Melendez, Lydia Helena Vision, Sora Kuykendall, and Sasha Reed – who now represent a class of over one hundred people in IDOC custody seeking treatment for gender dysphoria. The case seeks to force IDOC to reform its medical care system to put an end to the needless suffering it is currently causing people with gender dysphoria by denying them the medical care they need 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 medically necessary hormone therapy, access to clinicians qualified to treat gender dysphoria, and the ability to socially transition.

In August 2020, we asked the Court to appoint an independent monitor to help make sure that IDOC made the changes it was ordered to make under the December 2019 preliminary injunction. We acted after sworn testimony from IDOC officials revealed that the Department was not meaningfully complying with the court’s preliminary injunction order, causing ongoing harm to our clients. The Court declined to appoint a monitor but expressed reservations about whether IDOC is in compliance with the injunction and rejected its argument that the injunction is no longer in effect. The Court also denied IDOC’s motion for summary judgment on February 4, 2021, finding that we provided much evidence to “indicate” that Plaintiffs continue to suffer due to their inability to obtain necessary medical treatment while in IDOC custody.” 

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.


Questions and Answers

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



Camille Bennett, Michelle García, Alexis Picard (ACLUIL) Amelia Bailey, T.J. Leahy, Ashton Dubey (Kirkland & Ellis), Brent Ray, Abby Parsons (King & Spalding), and Thomas E. Kennedy, III, Sarah Jane Hunt (Law Offices of Thomas E. Kennedy, III)

Date filed

January 31, 2018


U.S. District Court for the Southern District of Illinois