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Keohane v. Inch

Location: Florida
Court Type: U.S. Supreme Court
Status: Closed (Judgment)
Last Update: October 4, 2021

What's at Stake

The American Civil Liberties Union (ACLU), the American Civil Liberties Union of Florida, and DLA Piper LLP filed a federal lawsuit challenging the Florida Department of Corrections’ (DOC) denial of medically necessary care for Reiyn Keohane, a transgender woman currently detained in a men’s prison.


The complaint seeks an injunction directing Defendants to provide Reiyn with medically necessary hormone therapy and access to female clothing and grooming standards.

Reiyn, 22, has known that she has a female gender identity since the age of 12. “Gender identity” refers to a person’s internal sense of their own gender. For transgender individuals, one’s gender identity differs from the sex assigned to them at birth. The medical diagnosis for the incongruence between one’s gender identity and assigned sex and the clinical distress resulting from this incongruence is “gender dysphoria.”

With the support of medical and mental-health professionals, Reiyn has been living as female since age 14. At age 17, she had her name legally changed from a traditionally male name, and she began hormone therapy under the care of an endocrinologist at the age of 19. While awaiting trial after her arrest in 2013, Keohane was abruptly removed from her hormone therapy by the Lee County Jail. Believing she would be allowed to resume hormone therapy after being transferred to DOC custody, Keohane accepted a plea deal in 2014.

In July 2014, Keohane repeatedly made clear to DOC officials that she needed to continue her treatment for her gender dysphoria, which included both hormone therapy and the ability to groom and dress consistent with her female gender identity. Not only was she denied restoration of the hormone therapy, but her hair was forcibly cut and she had her female clothing items confiscated. She filed numerous grievances to restore her treatment, but they were repeatedly denied.

“Comprehensive treatment for gender dysphoria is critically important for the health and wellbeing of many transgender people,” stated ACLU of Florida staff attorney Daniel Tilley. “It is unconstitutional for the DOC to deny inmates any care that is medically necessary to treat their serious medical needs, and that is exactly what the DOC has done to Reiyn.”

Reiyn wrote a letter describing her experiences and the discrimination and harassment she has faced as a transgender woman being denied treatment for her gender dysphoria in prison. It reads in part: “I know that I am not alone, that other women have been in my situation before, and had it better, or worse. […] I will fight this prejudice every step of the way so that there will be a better future for all other people who are thrown in prison, so that we may all have the treatment, dignity, and respect that every human being deserves, even if they have done wrong.”

The lawsuit asks the court to find that the DOC’s denial of treatment for Reiyn’s gender dysphoria is a violation of the Eighth Amendment to the U.S. Constitution’s ban on cruel and unusual punishment.

Read REIYN’s letter about being denied care

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