No Hormones, No Help
An inside look at how the loss of gender-affirming care is impacting incarcerated trans people in Georgia.
by B Speaks
In a painful rewind of progress, the Georgia Department of Corrections is now denying medically necessary gender-affirming care to transgender inmates. More than just a shift in policy, the change is causing real, immeasurable harm to trans people who already face a lack of adequate access to medical and mental health care while incarcerated. Some inmates are mounting a legal challenge, arguing that this rollback is unconstitutional. Their stories paint a bleak picture of suffering behind bars.
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The law at the center of the crisis—Senate Bill 185—was signed by Governor Brian Kemp in May 2025. It prohibits the use of state funds or resources for any gender-affirming care, including hormone replacement therapy and surgeries, even in cases where inmates are willing to cover the costs themselves. According to the Georgia Department of Corrections, state officials are, “prohibited from facilitating or transporting anyone to receive gender affirming care.” The law technically allows exceptions for non-gender dysphoria medical conditions, but in practice, that clause does little to protect those whose treatment is essential to their mental health and identity.
Assigned Media spoke with incarcerated sources at a facility in Central Georgia. Those who identify as trans expressed a mixture of shock and depression, and sometimes anger. Others said that, even for non-trans prisoners, the results of this policy shift are creating notable ripple effects. Throughout the trans communities in Georgia Prisons as well as those supporting them, the effects are immeasurable. An inmate directly affected by Senate Bill 185 has been forced to face a new reality behind bars far from the legislative chambers in which the bill was strongly supported.
One incarcerated trans woman we spoke with, Dionne (whose name we’re changing to protect her from potential consequences for speaking out) says she is struggling to find hope without access to hormone therapy once provided by the facility. “I received a call out to mental health, and saw a mental health manager.” The manager stated to the group, “They passed a new bill that would stop the hormone treatments, and in the process of them stopping it if you need mental health counseling it will be provided.” The feeling in the room was palpable, she says, describing a mixture of shock and depression throughout the facility, for those affected as well as the people supporting those affected in the dorms, including members of the staff.
In the coming days after the announcement, the day to day for Dionne became uncertain. The process, Dionne explained, was that the facility would wean her and others off of the hormone therapy medication, giving only two additional injections at half dose. At the time of this publication there are no longer prisoners receiving any dose of hormone therapy at the facility.
Five transgender inmates—two trans men and three trans women—are leading a class-action lawsuit on behalf of nearly 300 others similarly affected, such as Dionne. “I notified my family of the changes that occurred, they were available to talk to me for support, and told me to wait it out to see if the lawsuits changed anything," Dionne said.
Supported by the Center for Constitutional Rights and Bondurant Mixson & Elmore LLP, the lawsuit argues that denying gender-affirming care violates the Eighth Amendment’s ban on cruel and unusual punishment. Attorney Chinyere Ezie representing the group told the Advocate, “It’s really unfortunate, I think that it has and will cost people’s lives… I think that the plan is to really just eradicate trans people from public life entirely.”
Past courts have seen transgender inmates winning similar fights. A comparable ban in Wisconsin was ruled unconstitutional in 2010. Georgia’s new law, the lawsuit argues, disregards established medical standards and directly endangers the lives and mental health of those it targets. However, under the new climate of hatred for trans people driven by the right, it is uncertain whether the courts will follow precedents like these.
The human toll is already evident. Fantasia Horton, one of the plaintiffs and a trans woman currently incarcerated at Phillips State Prison, had been on hormone therapy since 2019. After the law took effect, her medication was halted with no tapering, despite prior assurances it would be phased out gradually by prison staff. The complaint states: “Due to Defendants’ policies and actions in terminating her treatment, Ms. Horton is now at grave risk of physical and psychological harm.” Horton’s past experience with even a one-week interruption in her therapy, according to the complaint, led to a dramatic decline in her mental health, plunging her back into depression without needed support.
In 2015, Ashley Diamond, a Black trans woman, sued the GDC for denying her hormone therapy and placing her in men’s prisons. Her case led to a 2016 settlement and limited reforms, but when she was reincarcerated in 2019, the same abuse, neglect, and medical denial returned. She was isolated, unsafe, and deeply traumatized. Her words from a story in 2020 by Pink News still ring out: “Being a woman in a men’s prison is a nightmare… I’ve been stripped of my identity. I never feel safe. “
Dr. Christy Perez is the co-founder and Managing Project Director of the Dreaming Justice Project, and a formerly incarcerated Afro-Latina transsexual woman who fought the Georgia Department of Corrections herself. Assigned Media spoke with Perez, who said that she takes the existence and implementation of these policies personally. “The removal of hormones from prisons is a deliberate act of cruelty that strips trans people of medically necessary care and basic dignity. I know this firsthand — in 2014 I had to sue the Georgia Department of Corrections just to access hormone therapy, and again in 2021 to fight for laser facial hair removal and sex reassignment surgery. This is part of a long pattern of state violence against trans people behind bars.”
“Systemic violence is almost always tested first on incarcerated people, and this is no different. The removal of hormones in prisons mirrors a broader political regime’s attacks on trans people everywhere — but this isn’t just a ‘trans issue,’” Perez continued. “People need to understand the interconnectedness: these policy shifts are part of a larger assault on autonomy, expression, race, class, and even religion. What is tested in the carceral sphere reverberates across society, shaping the lives and freedoms of us all.”
Under President Biden, the Department of Justice filed a statement of interest supporting the rights of incarcerated trans people to receive treatment for gender dysphoria, as they would any medically necessary care. More recently, the Justice Department for the Trump Administration removed this statement of support. In a press release, Assistant Attorney General Harmeet K. Dhillon, who once spearheaded efforts to bring nuisance lawsuits from detransitioners suing their former providers, stated, “There has never been an Eighth Amendment right for inmates to demand elective and experimental surgeries. States’ limited resources need not be wasted to provide these dubious surgeries to inmates.”
Medical experts are clear that abruptly stopping hormone therapy can cause symptoms like nausea, vomiting, severe mood changes, and suicidal thoughts. “Abrupt cessation or forced weaning of medically necessary, ongoing treatment is a health risk,” a physician assistant at the Georgia facility told Assigned Media. “Physical effects of hormone withdrawal are accompanied by psychological distress, which may manifest as anxiety, depression, and suicidality.”
The long term fallout can be even more severe. Transgender inmates already face an outsized risk of abuse and violence. Without access to gender-affirming care, these risks escalate. The trauma of forced detransition has led to alarming cases of self-harm, including suicide attempts and even self-castration.
“They are in violation of my rights to medical treatment, and I feel as if I am being discriminated against because of who I am,” Dionne explained. “At the moment it’s very depressing to see my rights being violated for no apparent reason.”
Right now, transgender inmates in Georgia are being forced to choose between emotional collapse and legal resistance. Their lawsuit and the plight of formerly incarcerated and currently incarcerated transgender men and women are taking a stand not only for their health, but for their humanity.
You can learn more about the Center for Constitutional Rights or donate on their website ccrjustice.org.
B Speaks is a writer and advocate interested in prison/criminal justice reform, LGBTQ rights, and government/cultural criticism. A graduate of the University of South Carolina, B served as a political strategist and grassroots organizer in Washington D.C. Currently incarcerated in Georgia, B writes to expose and challenge the realities of the carceral system, advocating for justice reform and the voices often left unheard.