Update: September 30, 2011

A settlement was announced September 30, 2011 in the case of Vanessa Adams, a Federal Bureau of Prisons (BOP) inmate at FMC Butner in North Carolina who has gender identity disorder (GID). Ms. Adams sued BOP in order to receive appropriate treatment for her GID.

Ms. Adam’s challenge to BOP’s treatment of transgender prisoners resulted in BOP ending its so-called “freeze frame” policy in which treatment for any person with GID is kept frozen at the level provided at the time he or she entered the federal prison system.  In Ms. Adams’ case, this meant that because she had not received treatment for GID before being incarcerated, BOP refused to provide her with medically necessary care even though its own doctors diagnosed her with GID, told her about treatments available for GID, and knew about the seriousness of her medical condition.

“BOP’s freeze frame policy trapped transgender prisoners in despair, leading often to depression, suicide attempts, and in many cases, serious self-harm, as was the case with Vanessa,” said Jennifer L. Levi, Transgender Rights Project Director for Gay & Lesbian Advocates & Defenders (GLAD).

The change in policy was promulgated via two memoranda, dated May 31, 2011 and June 15, 2010, from BOP’s Medical Director to all BOP’s chief executive officers.  The May 2011 memorandum ends:

In summary, inmates in the custody of the Bureau with a possible diagnosis of GID will receive a current individualized assessment and evaluation.  Treatment options will not be precluded solely due to level of services received, or lack of services, prior to incarceration.

The memo also states that “current, accepted standards of care will be used as a reference for developing the treatment plan.”

The memos have been distributed to all individuals in the prison system who have been diagnosed with GID, as well as to the medical staff treating these prisoners.


GLAD, in conjunction with the National Center for Lesbian Rights, Florida Institutional Legal Services, and Bingham McCutchen LLP, challenged the federal Bureau of Prisons (“BOP”) policy that prohibited medical care for transgender inmates who came into the BOP without a treatment plan for transition. When the case began, our client, Vanessa Adams, was being denied medically necessary hormone therapy and prevented from otherwise expressing a female gender identity because she was diagnosed with GID post incarceration. In an initial victory, Vanessa was allowed to begin hormone therapy.  GLAD and co-counsel opposed the BOP’s motion to dismiss the case, however, in order to ensure continued proper treatment for our client as well as challenge the Bureau’s other denials of transition-related medical care and the policy itself.

In a June 7, 2010 ruling, Federal District Court Judge Joseph L. Tauro rejected the BOP’s argument that Vanessa’s claim is invalid because they started her on hormone therapy after she filed her case. Citing the BOP’s initial denial of Vanessa’s treatment, and the fact that BOP does not disavow the policy, the court ruled that the policy’s constitutionality and BOP’s practice remain in question.  The court also rejected the BOP’s efforts to have the case transferred to Missouri where Vanessa was, until recently, incarcerated, finding that enough significant events occurred while she was in Massachusetts to make the Massachusetts venue appropriate.

The case has been ordered to mediation as the discovery and pre-trial process proceeds.

Press Release on the June 7, 2010 denial of the BOP’s motion to dismiss