The Virginia Department of Corrections (VADOC) is facing a lawsuit from an incarcerated Virginia transgender man after continually denying him “medically necessary” gender-affirming medical treatment for his gender dysphoria.
Right To Health Care
The lawsuit was filed by LGBTQ legal advocacy organization Lambda Legal on behalf of Jason Yoakam, who is currently serving time at Fluvanna Correctional Center for Women (FCCW) after being convicted of first-degree murder in 2004. Yoakam, who lived as openly as a trans man prior to his conviction, was formally diagnosed as having gender dysphoria in 2017 by medical providers at FCCW.
Yoakam started hormone replacement treatment and was provided a binder afterward, but the VADOC denied further treatment for his condition. According to the filing, the VADOC denied Yoakam access to mental health treatment from qualified providers and blocked requests for Yoakam to get a bilateral mastectomy, or top surgery, saying it “was not medically necessary.”
“Mr. Yoakim is not seeking special treatment, just access to medically necessary health care and reasonable accommodations for his gender dysphoria,” said Lambda Legal senior attorney Richard Saenz. “Every incarcerated person has a right to basic health care based on their medical needs and should not face discrimination because of their sex.”
Multiple medical professionals external to the VADOC, including providers from the University of Virginia, have issued referrals that Yoakam received a bilateral mastectomy as part of his treatment for gender dysphoria since his initial diagnosis. But every request has been denied by VADOC officials despite the requests adhering to the internationally recognized Standards of Care for gender dysphoria established by the World Professional Association for Transgender Health.
“Defendants knew that denying Mr. Yoakam chest surgery placed him at a substantial risk of serious harm including depression, anxiety, mental impairment, physical self-harm, and suicide, and future harm as his condition worsened,” the filing states.
The suit claims that the VADOC’s denial of gender-affirming care violates Yoakam’s Eighth and 14th Amendment rights, characterizing the VADOC’s treatment of Yoakam as cruel and unusual punishment. The filing also cites that Yoakam’s case constitutes violations of the Americans with Disability Act and non-discrimination protections based on sex cited in the Affordable Care Act.
“The only thing I am asking is to be treated fairly and have access to the same standard of healthcare that other incarcerated people receive,” Yoakam said. “It has been traumatizing, isolating, and stigmatizing to be denied health care services to treat the gender dysphoria that VDOC’s own providers have diagnosed.”
Excessive Binder Use
The filing also cites that the VADOC regularly provides “medical treatment and surgical interventions” to other incarcerated individuals at FCCW “based on individual assessment and medical need.” While FCCW provided Yoakam with chest compression binders as a form of treatment, he regularly uses them beyond the recommended daily period of use because of his lack of treatment options. The suit claims that Yoakam “keeps his binder on throughout all hours of the day,” including sleeping in it, only taking it off to shower.
According to a 2017 study on the health effects of chest binding conducted by University of Michigan’s Dr. Sarah Peitzmeier, individuals should only wear binders for eight hours a day, should never sleep while wearing a binder and should take at least one day off a week from binding. Longer binding sessions can increase the risk of negative health conditions.
According to the suit, those negative health effects are present in Yoakam’s medical records due to excessive binder use. “The binder sometimes is so tight that it cuts into Mr. Yoakam’s skin and causes him to bleed,” the complaint states. “He has also developed scars, rashes and acne from the binder. These injuries have also led to infections from the binder. Unless he receives chest surgery, Mr. Yoakam will have to continue to use the binder and suffer the resulting injuries.”
“This is about health care,” Saenz told NBC News. “Mr. Yoakam and other incarcerated people have a right to health care under the Constitution, and here the Virginia Department of Corrections is not providing him with the medical care that his doctors have deemed medically necessary for him.”
Virginia Trans: Previously on Towleroad
Image courtesy fo Lambda Legal