Kosilek v. Maloney.

U.S. District Court

FAILURE TO PROVIDE CARE

TRANSSEXUAL 

DELIBERATE INDIFFERENCE

Kosilek v. Maloney, 221 F.Supp.2d 156 (D.Mass. 2002). An inmate brought an action against a director of corrections, seeking an injunction that would require medical treatment for gender identity disorder. The district court held that the corrections department's medical treatment plans for the inmate were not adequate, but that the director was not deliberately indifferent to the serious medical needs of the inmate. The inmate suffered from a severe form of a rare, medically recognized, major mental illness--gender identity disorder--and was a transsexual. The court found that the treatment plans were not developed pursuant to any clinical decision by a doctor or social worker concerning the inmate's condition or particular needs, but were derived from an administrative decision that created a blanket policy that prohibited initiation of hormones for inmates who were not prescribed hormones prior to their incarceration. Although the inmate's treatment was found inadequate, the court declined to provide injunctive relief, reasoning that the director was no longer likely to be indifferent to the inmate's needs in the future as a result of the litigation. The court noted that "ordinarily, the Commissioner of the DOC would not be the appropriate defendant in a case involving the inmate's claim alleging denial of medical care. As Commissioner, Maloney does not usually make decisions concerning medical care ... Because of Kosilek's lawsuit, Maloney, as a practical matter, has made the major decisions relating to Kosilek's medical care." After the lawsuit was filed, the Commissioner consulted with attorneys and doctors employed by the department and adopted a blanket policy that was aimed at "freezing" a transsexual in the condition he was in when incarcerated. The policy prohibited the provision of hormones to inmates such as the plaintiff who had only taken "black market" hormones previously, and categorically excluded the possibility that an inmate would receive sex reassignment surgery. The court concluded that "Because Maloney removed from the professionals employed by the DOC their usual discretion concerning Kosilek's medical needs and care, Maloney's conduct is properly the focus of this case." (Massachusetts Department of Corrections)