Respect Equality

ACLU sues NC Department of Public Safety for denying gender-affirming care to trans inmate

A transgender inmate in North Carolina has been repeatedly denied access to adequate gender-affirming care and the use of her legal name and gender-consistent pronouns, the lawsuit alleges.
(Rizky Panuntun/Getty Images)

Story at a glance

  • The ACLU, its North Carolina affiliate and the law firm Patterson Harkavy LLP on Thursday filed a lawsuit on behalf of Zayre-Brown, a transgender inmate in North Carolina.

  • The lawsuit alleges the state’s Department of Public Safety (DPS) has ignored its “constitutional obligation” in failing to provide Zayre-Brown with consistent gender-affirming care.

  • The complaint claims DPS violated Zayre-Brown’s state and federal constitutional rights, the Americans with Disabilities Act (ADA) and the Rehabilitation Act of 1973.

The American Civil Liberties Union (ACLU) has filed a lawsuit against the North Carolina Department of Public Safety (DPS), alleging the department violated the rights of a transgender inmate by denying her access to gender-affirming care.

In a complaint filed Thursday by the ACLU, its North Carolina affiliate and the law firm  Patterson Harkavy LLP, DPS is accused of withholding “essential” medical care to Kanautica Zayre-Brown, a transgender woman who has been in state custody since 2017 and has been diagnosed with gender dysphoria.

According to the lawsuit, Zayre-Brown, 40, legally changed her name and began hormone therapy in 2012 and underwent several gender-affirming surgeries beginning in 2013.

She is currently being housed at Anson Correctional Institution  – a women’s facility – in Polkton, N.C., where she was transferred in 2019, after spending nearly two years in male facilities.


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The complaint alleges that Zayre-Brown since entering DPS custody has requested certain treatment and accommodations for her gender dysphoria, including gender-affirming hormone therapy and use of her legal name and gender-consistent pronouns – all which have been unmet.

Zayre-Brown’s requests “have been met with unjustified delays that have needlessly prolonged her suffering,” the lawsuit reads. “Even when DPS has granted approval for these requests, it has failed to provide these necessary treatments and accommodations consistently.”

Despite “extensive documentation” and pre-incarceration medical records indicating that she had been receiving testosterone for more than four years, Zayre-Brown was denied treatment during her first eight months in DPS custody.

Since then, Zayre-Brown has experienced “unwarranted and repeated interruptions of her hormone therapy,” according to the complaint, and her hormone levels have been inconsistently and inadequately monitored.

The lawsuit states that medical providers referred to Zayre-Brown by DPS have agreed that gender-affirming surgery is “medically necessary for her” and Zayre-Brown has met the criteria necessary to receive gender-affirming care while in DPS custody under the department’s current transgender inmate policy.

“Mrs. Zayre-Brown has a serious medical condition that DPS’s own health care providers have recognized requires treatment including gender-affirming surgery,” Jaclyn Maffetore, a staff attorney with the ACLU of North Carolina, said Thursday in a news release announcing the lawsuit.

According to Maffetore, DPS by denying gender-affirming care to Zayre-Brown is ignoring its “constitutional obligation” to provide medically necessary care to her because she is transgender.

“DPS’s denial of treatment is not only discriminatory – it is inhumane,” Maffetore said. “By refusing to treat her gender dysphoria, DPS subjects Mrs. Zayre-Brown to needless suffering and places her life at risk.”

Zayre-Brown’s gender dysphoria has caused her “extreme” mental and psychological anguish, according to the complaint, and the department’s unwillingness to treat her has put her “at grave risk of physical assault and sexual assault.”

Zayre-Brown was at one point placed on suicide watch.

The lawsuit claims that the department’s refusal to adequately treat Zayre-Brown’s gender dysphoria violates her state and federal constitutional rights, the Americans with Disabilities Act (ADA) and the Rehabilitation Act of 1973.

The complaint seeks damages and an injunction requiring DPS to provide Zayre-Brown with medical care and accommodations for her gender dysphoria, including the use of her legal name, gender-consistent pronouns, consistent hormone therapy and gender-affirming surgery.

“The discrimination, mistreatment, and neglect perpetrated against Mrs. Zayre-Brown is far too common for transgender people who are incarcerated,” Taylor Brown, staff attorney for the LGBTQ & HIV Rights Project at the ACLU, said Thursday. “The North Carolina Department of Public Safety will now have to answer for their unlawful and discriminatory behavior.”

Last week, an Illinois judge ordered the Bureau of Prisons (BOP) to find a qualified surgeon to provide the first-ever gender-affirming surgery for a transgender inmate in federal custody.

Changing America has reached out for comment.