Zayre-Brown v. The North Carolina Department of Public Safety

The American Civil Liberties Union, ACLU of North Carolina, and Patterson Harkavy LLP filed a complaint on behalf of Kanautica Zayre-Brown, a transgender woman incarcerated at Anson Correctional Institution, who is being denied essential gender-affirming health care. North Carolina Department of Public Safety (DPS) officials’ denial of gender-affirming healthcare and pattern of inhumane treatment has caused Mrs. Zayre-Brown extreme emotional and psychological distress, which has led to self-harm and thoughts of suicide. In addition to denying her gender-affirming health care, DPS housed Mrs. Zayre-Brown in male facilities for nearly two years before transferring her to a women’s facility, despite knowing that she is a transgender woman since she entered DPS custody.

DPS’s refusal to provide necessary health care for Mrs. Zayre-Brown violates the U.S. and North Carolina Constitutions, the Americans with Disabilities Act (ADA), and the Rehabilitation Act of 1973. The complaint seeks damages and an injunction requiring DPS to provide Mrs. Zayre-Brown with necessary medical care and accommodations for her gender dysphoria, including the use of appropriate names and pronouns, consistent hormone therapy maintenance, and gender-affirming surgery.

In response to litigation from the ACLU and ACLU affiliates, courts across the country have consistently recognized the right of incarcerated transgender people to adequate health care and safety measures. In late December 2021, a federal court ruled on a motion and ordered the Bureau of Prisons to evaluate Cristina Nichole Iglesias for gender-affirming surgery. This landmark decision marks the first time a court has ordered the federal government to address an incarcerated person’s medical need for gender-affirming surgery.

UPDATE: On April 16, 2024, the district court granted in part plaintiff’s motion for summary judgment, ruling that defendants violated plaintiff’s rights under the 8th Amendment by failing to provide her an individualized determination of the medical necessity of her receiving gender-affirming genital surgery. The court gave defendants 30 days to either provide that surgery or form a new committee to reassess plaintiff’s need for such surgery that contains at least two medical doctors with gender dysphoria expertise. That re-assessment is underway. Defendants appealed the court’s order to the Fourth Circuit, which on November 26, 2024 dismissed the appeal as moot because plaintiff was released from custody on November 2, 2024.