A trans inmate wins health care and will move to women's prison after suing Minnesota

Christina Lusk, a transgender woman who sued the Minnesota Department of Corrections over her treatment while in prison, has reached a settlement that includes a move to the state's women-only Shakopee prison and access to gender-affirming health care.

Lusk had been fighting for these rights since she was incarcerated in 2019 and filed the lawsuit against the Minnesota Department of Corrections nearly a year ago.

As part of the settlement, Lusk will also receive a $495,000 payout, which includes about $250,000 in legal fees.

"With this settlement, the Department of Corrections takes an important and necessary step toward fulfilling its responsibilities to the people in its care," said Gender Justice Legal Director Jess Braverman. The organization represented Lusk in this case, along with Robins Kaplan LLP.

"Thanks to Christina Lusk's willingness to speak out, transgender people in custody will now have expanded access to the housing and health care they need, and the legal protections they deserve," Braverman said.

A new Minnesota Department of Corrections (DOC) transgender policy — which covers medical treatments and allowing transgender or gender non-conforming individuals to request a facility matching their gender identity — went into effect in January, months after Lusk filed her lawsuit.

The DOC says it currently houses 48 transgender people out of a total incarcerated population of just over 8,000. Lusk is the first transgender person to be moved to a facility matching their gender identity, the department said in a statement.

"As part of settling the lawsuit and in accordance with the DOC's new transgender policy, the DOC has agreed to provide [Lusk] access to a transgender healthcare specialist to determine if gender-affirming surgery is medically necessary. The DOC will also assist her in obtaining surgery if the specialist determines it is necessary," the DOC said in a statement.

"The DOC is constitutionally obligated to provide medically necessary care for incarcerated people, which includes treatment for gender dysphoria," said Minnesota DOC Commissioner Paul Schnell. "Based on the facts of this specific case, the incarcerated person will now have access to the medical care she needs, she deserves, and we have a legal obligation to provide."

NPR covered Lusk's case last fall and how it fits into the larger issues facing incarcerated transgender inmates in the U.S. prison system.

Lusk's situation is one that's shared by many transgender people behind bars in the United States. They are often forced to stay in prisons according to their assigned sex at birth or their genitalia at the time they were arrested. This puts them at greater risk of assault, discrimination and abuse, NPR's previous reporting has highlighted.

Many advocates and attorneys have said that lawsuits are the main way that individuals have been able to be moved into facilities that align with their gender identity, as Lusk's case shows.

After her guilty plea in 2019, Lusk was sent to the Moose Lake men's facility. This happened despite the fact that Lusk had a reissued birth certificate that states she is female and had undergone gender-affirming procedures.

(It should be noted that the authenticity around a trans person's gender identity is not inherently tied to surgeries, other medical treatments or changes to legal documents. Some people don't take these steps for a variety of reasons.)

It was at Moose Lake where Lusk said she dealt with harassment and assault, was denied gender-affirming health care and was consistently misgendered by the DOC, she alleged.

In her lawsuit, Lusk said the DOC's discriminatory policies and practices violated the Minnesota Human Rights Act and the Minnesota Constitution's guarantee of equal protection under the law, bodily autonomy and freedom from cruel or unusual punishment.

Lusk also wanted the judge to rule that the DOC denying her gender-affirming surgery was unconstitutional.

While the settlement stops short of that, Minnesota's DOC has agreed to strengthen its policies to better protect "the basic rights, health and safety
of any transgender people incarcerated in Minnesota," Gender Justice said in a statement.

The DOC will follow the World Professional Association for Transgender Health's standards of care, contract with a WPATH-certified health care provider, train staff on providing appropriate care for transgender people and honor the name changes of incarcerated transgender people.

Federal guidelines call for housing decisions for transgender inmates to be made on a case-by-case basis. But NPR found that some states explicitly don't do this.

Others states have policies that are in line with federal standards, but in practice, they tend toward housing inmates based on assigned sex at birth.

The policies of the vast majority of states, including Minnesota, align with federal guidelines. They say decisions are made on a case-by-case basis, with the inmate's gender identity being a piece of that consideration. The inmate's safety is considered a priority.

Lusk is up for release in May 2024.

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