Nearly a year after the Justice Department filed a lawsuit against Utah alleging the state discriminated against a transgender woman incarcerated at the state prison by providing inadequate and delayed medical care, lawmakers are weighing cutting off access to gender-affirming care altogether.
A bill from House Majority Whip Karianne Lisonbee would, among other things, stop incarcerated transgender people from transitioning by barring them from starting hormone treatments or pursuing gender-affirmation surgery. People who enter custody receiving hormone therapy would be able to continue that care.
“Transgender State Custody Amendments,” or HB252, passed out of the House Judiciary Committee after a party-line vote on Friday, and is now being considered by the full House.
“Correctional facilities are a fundamentally unsuitable environment for inmates to make potentially permanent medical decisions such as hormone therapy or surgeries, especially at taxpayer expense,” Lisonbee, a Clearfield Republican, argued in front of the committee.
Salt Lake City Rep. Grant Miller, one of the two Democrats on the committee opposing the bill, said before voting, “I do believe that this is fundamentally a health care issue, and I’m worried about potential litigation that can grow out of the lack of health care access.”
Her presentation of the bill took place one day after President Donald Trump issued an executive order ending medical treatments tied to gender transition. A person incarcerated in a federal facility sued to stop the order Sunday.
(Chris Samuels | The Salt Lake Tribune) House Majority Whip Karianne Lisonbee, R-Clearfield, gives remarks during a news conference at the Capitol in Salt Lake City, Monday, Jan. 6, 2025, announcing proposed legislation to support the incoming Trump administration’s focus on immigration policy.
“Unnecessarily delayed and restricted” care
The bill comes amid a lawsuit the Justice Department filed against the Utah Department of Corrections and the Utah Department of Health and Human Services in April after a transgender woman faced a deepening mental health crisis for being denied gender-affirming care, and eventually “performed dangerous self-surgery and removed her own testicles.”
Gender dysphoria is a condition that is covered under the Americans with Disabilities Act. While being transgender is not considered a disability, some trans people experience the medical condition which causes severe mental and emotional distress when a person’s assigned sex at birth and their gender identity don’t align.
As the incarcerated woman at the center of the lawsuit sought gender-affirming care, such treatment had to be approved by a Gender Dysphoria Committee. That process, the Justice Department reported, “unnecessarily delayed and restricted” her access to care as members of the committee “expressed bias against individuals who are transgender and reluctance to prescribe medically appropriate treatment for gender dysphoria.”
Once the woman did receive access to care, her physician at the prison allegedly tried to talk her out of the hormone therapy she had been asking for over the 15 previous months. When that therapy started being administered, her physician “failed to take basic steps to ensure that it was provided safely and effectively,” according to the Justice Department
When the Justice Department released its findings on the matter, and before it sued, Utah Department of Corrections Executive Director Brian Redd said in a statement that the state was “blindsided” by the report, and that “we fundamentally disagree with the DOJ on key issues, and are disappointed with their approach.”
The events largely took place before the state shifted the responsibility for medical care in correctional facilities from the Department of Corrections to the Department of Health and Human Services in July 2023.
Utah asked to have the lawsuit thrown out several months ago, at the end of July. A federal judge has yet to rule on the motion.
It’s possible the lawsuit will dissolve under the Trump administration, which in recent days froze actions by the Justice Department’s civil rights division, The Washington Post reported. A spokesperson for the U.S. attorney for Utah did not respond to a request for comment on the status of the lawsuit.
“A bill based on recent Idaho legislation”
Records obtained by The Salt Lake Tribune suggest the Utah Department of Corrections and the Utah Department of Health and Human Services — the two agencies named in the Justice Department lawsuit — conferred with Lisonbee as she drafted the bill last year.
The representative’s name is mentioned in the minutes of Gender Dysphoria Committee meetings three times — in September, October and November.
“Lisonbee potentially running a bill based on recent Idaho legislation,” multiple entries read. A spokesperson for the Utah Department of Corrections confirmed that there was at least one meeting including the department in which the bill was discussed.
“We see the Legislature as the policymakers, and we stand ready to implement what they see fit,” a Department of Corrections spokesperson said in an interview. A representative for the Department of Health and Human Services said that agency is taking a similar position.
The Idaho bill that reportedly inspired Lisonbee’s legislation has attracted legal attacks, too.
Idaho passed a broader law last year titled “No Public Funds for Gender Transition,” which prohibited government money from going toward any gender-affirming health care — which includes care provided through Medicaid, by physicians whose salaries are publicly funded or health care given in correctional facilities.
But after transgender people in Idaho Department of Corrections’ custody filed a lawsuit seeking access to care, a federal judge put the law on hold and awarded plaintiffs class-action status.
The case, the judge said, raises concerns as to whether state policies that limit access to gender-affirming health care violate the Eighth Amendment’s protections against “cruel and unusual punishment.”
