Hormone Therapy for Transgender Prisoner

Josie Mills is a prisoner in the custody of the Michigan Department of Corrections (MDOC).  Although classified by MDOC as male, she has identified as female since she was a child.  Prior to her incarceration she was diagnosed with gender dysphoria and was prescribed estrogen. 

When Ms. Mills entered Michigan’s prison system, however, her hormone therapy was abruptly terminated.  MDOC’s own doctors confirmed her gender dysphoria diagnosis, but MDOC refused to authorize continued female hormone therapy for Ms. Mills even though that is the widely accepted standard treatment for gender dysphoria within the medical community. 

This failure to provide appropriate treatment took a serious toll on Ms. Mills’ medical and mental health, and in 2015 she castrated herself in prison and was hospitalized for several days.  Even after this terrible incident, MDOC continued to refuse estrogen treatment, at one point even offering testosterone therapy instead, which is clearly contrary to accepted medical standards. 

Beginning in January 2016, the ACLU of Michigan began advocating on Ms. Mills’s behalf, urging MDOC to undertake a comprehensive review and reconsideration of its treatment of Ms. Mills.  MDOC responded by eventually reversing its position, and Ms. Mills was able to begin female hormone therapy in August 2016.  

In June 2017, MDOC issued a new policy improving transgender health care.  Under the new policy, hormone therapy may be made available to prisoners based on an evaluation by an MDOC medical team with expertise in gender dysphoria, and Ms. Mills was able to have her estrogen dosage increased to levels appropriate to her female gender identity. 

(ACLU Staff Attorney Jay Kaplan.)

Read our Fall 2018 Legal Docket here.

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