Georgia's prison system must continue hormone therapy for transgender prisoners, judge rules

ATLANTA — A federal judge has permanently ordered Georgia's prison system to keep providing some kinds of gender-affirming care for transgender prisoners, although the state plans to appeal.

U.S. District Judge Victoria Marie Calvert last week ruled that a new state law denying hormone therapy to inmates violated their protection against cruel and unusual punishment under the Eighth Amendment to the U.S. Constitution. She ordered the state to keep providing hormones to inmates who had been receiving therapy and to allow others medically diagnosed as needing hormone therapy to begin receiving treatment.

“The court finds that there is no genuine dispute of fact that gender dysphoria is a serious medical need," Calvert wrote in her order. "Plaintiffs, through their experts, have presented evidence that a blanket ban on hormone therapy constitutes grossly inadequate care for gender dysphoria and risks imminent injury.”

Calvert had already issued a preliminary order in September blocking the law before finalizing it.

It is the latest turn in legal battles over federal and state efforts to regulate the lives of transgender people, including which sports competitions they can join and which bathrooms they can use. In June, the U.S. Supreme Court upheld Tennessee's ban on gender-affirming care for transgender minors. President Donald Trump's administration in April sued Maine for not complying with the government's push to ban transgender athletes in girls sports.

The Republican president also has sought to block federal spending on gender-affirming medical care for those under age 19 — instead promoting talk therapy only to treat young transgender people. And the Supreme Court has allowed him to kick transgender service members out of the military, even as court fights continue.

The Georgia case was brought on behalf of transgender inmates by the Center for Constitutional Rights after Georgia enacted a law in May banning the use of state money to pay for hormone therapy, gender-transition surgery or other methods to change the appearance of sexual characteristics.

“It is not a health care issue that should be the responsibility of the taxpayers,” said Sen. Randy Robertson, a Cataula Republican who sponsored Senate Bill 185.

Lawyers for the state have already filed a notice of appeal to the 11th U.S. Circuit Court of Appeals. Attorney General Chris Carr, an elected Republican running for governor, has vowed to fight the lawsuit “all the way to the Supreme Court,” calling it ”absurd."

The measure roiled the 2025 Georgia legislative session, with most House Democrats walking out of their chamber to boycott the final vote on the bill. But Gov. Brian Kemp signed it into law in May, and prison medical officials began making plans to gradually reduce and then end hormone therapy to inmates who were receiving it by October.

Georgia had begun providing hormone therapy in 2016 after a lawsuit by another inmate represented by the Center for Constitutional Rights. Prison officials counted more than 340 inmates who had been diagnosed with gender dysphoria in custody in mid-August, and said 107 inmates were receiving hormone therapy as of June 30.

The state presented studies to argue that denying or removing people from hormone therapy doesn't meet the legal standard of “deliberate indifference,” but Calvert rejected their consideration. Calvert also rejected testimony from physicians in the prison system, saying they weren’t deciding that inmates had no medical need for hormone therapy but instead were just following the law’s directives. She said the counseling and monitoring promised by the state was inadequate.

“Defendants cannot deny medical care and then defeat an injunction by saying nothing bad has happened yet," Calvert wrote.

Lawyers for the state argued Calvert was ignoring recent court decisions, including the Tennessee ban, as well as a recent 11th Circuit decision deciding that a Georgia county didn't have to pay for a sheriff deputy's gender-transition surgery.

“It is crystal clear the state legislatures have wide deference to enact laws regulating sex-change procedures like the cross-sex hormonal interventions at issue in this case,” lawyers for the state wrote in November.