Trans inmate wins judgment against Connecticut prison officials for ‘shocking’ inadequate care

US District Judge Vanessa L. Bryant ruled in favor of an incarcerated trans woman whose Eighth Amendment rights were violated when Connecticut prison officials impeded on her ability to receive gender-affirming care.
US District Judge Vanessa L. Bryant ruled in favor of an incarcerated trans woman whose Eighth Amendment rights were violated when Connecticut prison officials refused to allow her to receive gender-affirming care.

A transgender woman incarcerated for “essentially a life sentence in prison” has won a ruling by US District Judge Vanessa L. Bryant stipulating that three Connecticut Corrections health care providers violated the plaintiff’s Eighth Amendment right to be free of “cruel or unusual punishment” by their “deliberate indifference” to her serious condition of gender dysphoria. The September 15 ruling in favor of Veronica-May Clark’s constitutional claim also included a refusal to dismiss her state law claim of “intentional infliction of emotional distress.” The court gave the parties 35 days to submit a plan of action to deal with Clark’s gender dysphoria.

In order to deny the motion to dismiss the intentional infliction of emotional distress claim, the court had to find that Clark’s allegations supported a claim of “shocking” conduct by the defendants, which was easily found in this case.

Clark was convicted of murder, assault, burglary with a deadly weapon, and violation of a protective order. She was sentenced to 75 years without possibility of parole and remanded to the custody of the Connecticut Department of Correction (DOC) in 2007. At the time, she told prison officials that she was transgender, but she had not been formally diagnosed with gender dysphoria. What she encountered, apparently, was the state prison system that was totally unprepared to deal with a transgender inmate.

The named defendants in the case were originally the Commissioner of Corrections; a prison primary care physician who was principally responsible for Clark’s care, Dr. Gerald Valetta; Barbara Kimball-Goodman, a nurse practitioner; and Richard Bush, a clinical social worker. Clark originally filed her own complaint with the court in 2019, was granted appointed counsel, and then received representation from the ACLU of Connecticut and a private law firm. Her amended complaint, filed after obtaining counsel, dropped the commissioner and focused on the health care providers, Valetta, Kimball-Goodman, and Bush.

According to the opinion by District Judge Vanessa L. Bryant, none of these three had any training for providing gender-affirming care to a transgender person, which contributed to the inordinate delays documented in detail in the opinion.

When she requested cross-sex hormone treatment, she was told by Dr. Valetta that DOC had a policy against initiating gender transition for inmates. Only those who were already being treated before they were incarcerated would be provided with continued hormones. (Later, in his deposition, Dr. Valetta could not recall where he had learned of this “policy,” which was evidently not in writing.)  This sort of “freeze frame” policy, which was commonly encountered in prison systems until early in this century, was ultimately ruled unconstitutional under the Eighth Amendment in several cases around the country, but evidently Connecticut DOC was ignorant about this.

After failing to obtain any qualified care despite years of complaint, and being told repeatedly by Valetta that she could never get hormones because of the “policy,” out of desperation Clark decided to take things into her own hands. She concluded that the solution to her problem was to get rid of her testicles, which she attempted to do using a nail clipper in her cell, severely injuring herself and suffering excruciating pain without accomplishing her goal, and freaking out the prison personnel who discovered her in a sea of blood. After hospitalization and the intervention of law students from Columbia University, who planned to bring a lawsuit, Dr. Valetta was finally moved to refer her to an outside endocrinologist who diagnosed her gender dysphoria and prescribed the beginning of cross-sex hormone treatment to being physical transition. But the endocrinologist’s attempts to help were short-circuited by the failure of Valetta or the lack of follow-up as Valetta and the others failed to schedule the follow-up visits with the endocrinologist.

The low starter dosage of hormones was supposed to be gradually increased, but the failure to schedule follow-ups meant that the necessary bloodwork was not performed, the dosage not increased, and Clark’s testosterone level, which was supposed to be gradually reduced, actually increased. At first the beginning of treatment gave her hope and improved her mental condition, but recurring problems with her hormone prescriptions repeatedly expiring and the rising testosterone levels countermanded any progress in her treatment. She filed repeated complaints and grievances that got her nowhere until she finally filed this lawsuit, which prompted DOC to “reconsider” its policy and begin devising a new policy, which had not been formally adopted at the time the summary judgment motions were filed in this case.

It was only after the litigation commenced that the director of mental health services purportedly began searching — with no reported success — for a surgeon who could provide gender-affirming surgery for Clark.

The court concluded that this history compelled a finding of “deliberate indifference” by the defendants to Clark’s serious medical condition. Expert testimony was found to support her claim that the “care” she received in various DOC locations to which she was transferred was “inadequate” to such a degree as to constitute “cruel and unusual punishment” in violation of the Eighth Amendment.

At the same time the defendants moved for summary judgment on the constitutional claim, they also moved to dismiss Clark’s claim of intentional infliction of emotional distress.  This is a claim that rarely succeeds, because courts require proof that the defendants’ conduct was to “extreme and outrageous” to such a degree as to be “shocking.”  But Judge Bryant found that Clark’s factual allegations support such a claim, and refused to dismiss this claim, which continues in the case.  Also continuing, of course, is the need to enforce the summary judgment, which is why the court set a short deadline for the parties to propose a course of action, which presumably would involved stepping up DOC’s pathetic inability to find surgical services for Clark.

To read the opinion is to be astonished at the inept and ignorant response of the licensed health care professionals and the prison health care system of which they are a part.

Clark is represented by attorneys from the ACLU of Connecticut and the Stamford firm of Finn Dixon & Herling, LLP.  Senior District Judge Bryant was appointed by President George W. Bush.  She is the first African-American woman to serve as a federal trial judge anywhere in New England.