For the past three years, Ashley Diamond has been denied health care as well as protection from recurring violence from the men around her. But she has been fighting back — and her fight has been making headlines and wresting small changes from the Georgia Department of Corrections. Her story starkly illustrates the challenges facing trans women behind bars — from frequent violence and sexual assaults to the denial of hormones and other medical neglect. But Diamond’s experiences are far from unique, or even unusual. Nor is her decision to challenge prison policies around trans health care and safety an exception. Across the country, trans people have individually challenged and collectively organized to be free from physical, sexual and medical violence.
In 2012, Ashley Diamond, a black trans woman, was sentenced and sent to a men’s prison. There, she was denied access to the hormones she had been taking prior to her arrest. This was in line with Georgia’s policy to “freeze” treatment and current levels when a person is first sent to prison and to deny “new” hormone treatment. In Diamond’s case, it was unclear why she was denied her existing treatment. Without the estrogen, progestin creams, testosterone blockers and anti-androgen medications, her body began to change.
But medical neglect was not the only form of violence she experienced. Although new standards under the Prison Rape Elimination Act recognized trans people as an especially vulnerable group whose placement should be considered and continually reviewed, officials ignored these standards when placing Diamond, who announced that she was a trans woman during intake. Despite her declaration, officials assigned her to a high-security men’s prison. Within a month, six gang members attacked her, punching, stomping, raping and knocking her unconscious. She was transferred to another high-security prison, where she endured repeated harassments and sexual assaults. When she reported the assaults to prison officials, she said that they told her, ‘You brought this on yourself.’”
In February 2015, she filed a lawsuit challenging the Georgia Department of Corrections’ blanket denial of new hormone therapy to trans people within its prisons as well as requesting that the judge order her transferred to a lower-security prison. The New York Times profiled her and her safety efforts in April 2015. Then the Department of Justice got involved, arguing that denying Diamond treatment violated the Eighth Amendment ban on cruel and unusual punishment.
Less than a week later, Georgia announced that it was ending its blanket denial of hormone therapy to trans people in prison and would provide “constitutionally appropriate medical and mental health treatment.” In doing so, Georgia is not going above and beyond their responsibility. People in jails and prisons have a constitutional right to medical care — a right that prison administrators and staff frequently ignore.
While she has made numerous headlines in recent weeks, Diamond is not the first trans person to force prison systems to provide needed health care. In 2005, after Wisconsin banned hormone treatment, civil rights groups challenged the law. It took six years, but a federal appeals court finally agreed that the ban was unconstitutional and overturned the law. In August 2013, Chelsea Manning announced that she was a woman and that she would be seeking hormone therapy from military prison. This past February, the Defense Department approved hormone therapy, the first time they had ever done so.
However, not every lawsuit has forced a blanket change — or garnered as much media attention. On the heels of Diamond’s much-publicized victory, Vice reported the story of Ashley Jean Arnold, a trans woman incarcerated at the Federal Correctional Facility in Petersberg, Virginia. After she entered prison, Arnold was diagnosed with gender identity disorder. But the Bureau of Prisons also had a freeze frame policy denying new hormone therapy to people who could not prove having it before their incarceration. (The policy was changed in 2011 after the Obama administration settled a lawsuit.) Like Diamond, Arnold, with the assistance of jailhouse lawyers Sangye Rinchen (another trans woman) and Christopher Zoukis, filed suit challenging the denial of treatment. Although Arnold was placed on hormones six months later, the judge dismissed her case, ruling that prison officials had provided her with “constitutionally adequate treatment.” The following year, on February 24, 2015, Arnold hung herself in her cell. Rinchen and Zoukis are now petitioning the Department of Justice to open a criminal investigation into the sexual harassment and retaliation that Arnold suffered after filing her suit. Zoukis has also vowed to continue helping other trans people fight for medical care within the prison.
In Georgia, although Diamond has succeeded in changing policy, changing practice may still remain a battle. According to her lawyers, her hormone dosage seemed to be too low to be therapeutic. The courts initially issued another blow, denying her request to be transferred to a lower-security prison where she might avoid the constant violence inflicted upon her since she entered prison.
Diamond and Arnold’s experiences of constant violence and harassment are not exceptional. Rather, in men’s prisons, they seem to be the rule. Trans women sent to male prisons are at high risk for sexual assault — one study found that 59 percent of trans women in California’s male prisons had been sexually assaulted while incarcerated compared to 4 percent of the cisgender male population. As Diamond’s story demonstrates, staff often blame them for the assaults; the solution offered is to place them in “protective custody,” a form of solitary confinement in which they are confined to their cells nearly 24 hours a day without access to programming or human contact. Staff often perpetuate other forms of violence, such as harassment, humiliation and excessive strip searches as well as the refusal to recognize their gender identity.
Jenni Gann, currently incarcerated at California’s Kern Valley State Prison, can attest to that. After renouncing her gang membership in 2002, she was sent to one of the Sensitive Needs Yards in California’s prison system, where former gang members are sent ostensibly to avoid retaliation. The yard also holds people vulnerable to violence for other reasons, such as their sexuality or gender identity. Gann, who had quietly been struggling with her own gender identity for years, recalled in a recent letter, “I was so encouraged and inspired by the beauty and strength of some queens [a term used to describe flamboyant gay men] in particular that I said, ‘Fuck the haters!’” She came out as trans in 2006 and began her gender transition; the following year, she began estrogen hormone therapy and connected with the trans community inside and out.
Gann has endured repeated sexual harassment during strip searches, with guards ridiculing her anatomy, threatening her and exposing her to incarcerated men. She notes that other trans women have experienced similar abuse from staff. Staff hostility could also be fatal: In November 2013, Carmen Guerrero, a trans woman at Kern Valley, was killed by her cellmate. The cellmate, who was housed in the yard for renouncing his gang membership, had repeatedly and openly told staff that he would murder Guerrero. Neither he nor Guerrero were moved. Then he strangled her. While prison officials launched an investigation into Crespo’s actions, Gann reports that the officer whom he had told about his planned murder remains on duty and has faced no consequences.
Gann and others have not been keeping quiet. In every letter, Gann reminds me that Carmen Guerrero’s murder could have been prevented had prison staff acted when Crespo first started making threats. “It’s not safe for trans women [here],” she wrote, adding that she and another trans woman have been pressing for policy changes so that trans women can be housed in California’s women’s prisons where they are less likely to face the brutal transphobic violence that occurs daily in men’s prisons.
Gann has reached across the bars to help organize and alert people about trans women’s incarceration. For the past five years, she was a member of the leadership circle of Black and Pink, an organization of incarcerated queer and trans people and their non-incarcerated allies, and started the California chapter. Through Black and Pink’s newsletter, as well as a blog on Between the Bars, she’s reminded people about Carmen’s murder and the lack of accountability, as well as the everyday injustices trans women face behind bars. Recently, she has also joined the leadership team of the TGI Justice Project, a group of trans people inside and outside of prison fighting for change, as well as the Gender Anarky Collective, a group of trans women incarcerated throughout California’s prison system.
She and others have also reached out to support each other inside the prison. To combat the lack of information and trans-specific health care, they contact outside groups for up-to-date information and then share it with each other. “Because of the complex interdisciplinary treatment of gender dysphoria, which involves both mental health and medical care aspects, it’s very important for us to be aware of the process of transitioning and to be an active participant in making the decision to proceed with each stage of triadic therapy,” she explained in a recent letter. “For someone just coming out as trans, the support and advice of other queens is most important.”
After hearing the judge deny her request for a transfer, Diamond reportedly hugged her mother and sister before guards shackled her and returned her to prison. “It’s not over,” she said. “It’s just the beginning. Y’all stay strong.” It wasn’t over. One month later, the Georgia Department of Corrections transferred her to a medium-security prison, where Diamond says she feels safer.
Victoria Law is the co- editor of Don’t Leave Your Friends Behind: Concrete Ways to Support Families in Social Justice Movements and Communities, and the author of Resistance Behind Bars: The Struggles of Incarcerated Women 2nd ed.