Case: 3:18-cv-156 As of: 03/10/2020 09:57 AM CDT 1 of 29
CASREF,CJRA_A,JRJ−PST,NOT SELECTED
U.S. District Court Southern District of Illinois (East St. Louis) CIVIL DOCKET FOR CASE #: 3:18−cv−00156−NJR

Monroe et al v. Rauner et al Assigned to: Chief Judge Nancy J. Rosenstengel Cause: 42:1983 Prisoner Civil Rights
Plaintiff

Date Filed: 01/31/2018 Jury Demand: Defendant Nature of Suit: 550 Prisoner: Civil Rights Jurisdiction: Federal Question

Janiah Monroe

represented by John A. Knight Roger Baldwin Foundation of ACLU, Inc. ACLU of Illinois 150 N. Michigan Avenue Suite 600 Chicago, IL 60601 312−201−9740 Fax: 312−288−5225 Email: jknight@aclu−il.org LEAD ATTORNEY ATTORNEY TO BE NOTICED

Amelia H. Bailey Kirkland & Ellis LLP − Chicago 300 North LaSalle Chicago, IL 60654 312−862−2000 Email: amelia.bailey@kirkland.com TERMINATED: 08/17/2018

Anne J. Hudson Kirkland & Ellis LLP − Chicago 300 North LaSalle Chicago, IL 60654 312−862−2000 Fax: 312−862−2200 Email: anne.hudson@kirkland.com ATTORNEY TO BE NOTICED

Austin B. Stephenson Kirkland & Ellis LLP − Chicago 300 N. LaSalle Street Chicago, IL 60654 312−862−2000 Email: austin.stephenson@kirkland.com ATTORNEY TO BE NOTICED

Brent P. Ray Kirkland & Ellis LLP − Chicago 300 N. LaSalle Street Chicago, IL 60654 312−862−2000 Email: bray@kslaw.com PRO HAC VICE ATTORNEY TO BE NOTICED

Cameron N. Custard Kirkland & Ellis LLP − Chicago 300 N. LaSalle Street Chicago, IL 60654 312−862−2000 Email: cameron.custard@kirkland.com

Case: 3:18-cv-156 As of: 03/10/2020 09:57 AM CDT 2 of 29
TERMINATED: 11/18/2019
Camille E. Bennett Roger Baldwin Foundation of ACLU, Inc. ACLU of Illinois 150 N. Michigan Avenue Suite 600 Chicago, IL 60601 312−201−9740 Fax: 312−288−5225 Email: cbennett@aclu−il.org ATTORNEY TO BE NOTICED
Carolyn M. Wald Roger Baldwin Foundation of ACLU, Inc. ACLU of Illinois 150 N. Michigan Avenue Suite 600 Chicago, IL 60601 312−201−9740 Fax: 312−288−5225 Email: cwald@aclu−il.org ATTORNEY TO BE NOTICED
Catherine L. Fitzpatrick Kirkland & Ellis LLP − Chicago 300 North LaSalle Chicago, IL 60654 312−862−2000 Email: cfitzpatrick@kirkland.com ATTORNEY TO BE NOTICED
Erica B. Zolner Kirkland & Ellis LLP − Chicago 300 North LaSalle Chicago, IL 60654 312−862−2000 Email: ezolner@kirkland.com ATTORNEY TO BE NOTICED
Ghirlandi Guidetti Roger Baldwin Foundation of ACLU, Inc. ACLU of Illinois 150 N. Michigan Avenue Suite 600 Chicago, IL 60601 312−201−9740 Fax: 312−288−5225 Email: gguidetti@aclu−il.org ATTORNEY TO BE NOTICED
Matthew John Smart Kirkland & Ellis LLP − Chicago 300 North LaSalle Chicago, IL 60654 312−862−2000 Email: matthew.smart@kirkland.com TERMINATED: 09/26/2018
Megan M. New Kirkland & Ellis LLP − Chicago 300 North LaSalle Chicago, IL 60654 312−862−2000 Email: mnew@kirkland.com

Case: 3:18-cv-156 As of: 03/10/2020 09:57 AM CDT 3 of 29
ATTORNEY TO BE NOTICED
Samantha G. Rose Kirkland & Ellis LLP − Chicago 300 N. LaSalle Street Chicago, IL 60654 312−862−2000 Email: sam.rose@kirkland.com ATTORNEY TO BE NOTICED
Sarah Jane Hunt Kennedy Hunt P.C. 906 Olive Street Suite 200 St. Louis, MO 63101 314−872−9041 Fax: 314−872−9043 Email: sarahjane@kennedyhuntlaw.com ATTORNEY TO BE NOTICED
Scott H. Lerner Kirkland & Ellis LLP − Chicago 300 North LaSalle Chicago, IL 60654 312−862−2000 Email: scott.lerner@kirkland.com TERMINATED: 05/31/2019
Sydney L. Schneider Kirkland & Ellis LLP − Chicago 300 North LaSalle Chicago, IL 60654 312−862−2000 Email: sydney.schneider@kirkland.com ATTORNEY TO BE NOTICED
Thomas E. Kennedy , III Law Offices of Thomas E. Kennedy, III, L.C. 906 Olive Street Suite 200 St. Louis, MO 63101 314−872−9041 Fax: 314−872−9043 Email: tkennedy@tkennedylaw.com ATTORNEY TO BE NOTICED
Thomas J. Leahy Kirkland & Ellis LLP − Chicago 300 North LaSalle Chicago, IL 60654 312−862−2000 Fax: 312−862−2200 Email: thomas.leahy@kirkland.com ATTORNEY TO BE NOTICED
Timothy C. Pickert Kirkland & Ellis LLP − Chicago 300 North LaSalle Chicago, IL 60654 312−862−3787 Fax: 312−862−2200 Email: tim.pickert@kirkland.com TERMINATED: 04/02/2018

Case: 3:18-cv-156 As of: 03/10/2020 09:57 AM CDT 4 of 29

Jordan M. Heinz Kirkland & Ellis LLP − Chicago 300 N. LaSalle Street Chicago, IL 60654 312−862−7027 Fax: 312−862−2200 Email: jheinz@kirkland.com ATTORNEY TO BE NOTICED

Plaintiff Marilyn Melendez

represented by John A. Knight (See above for address) LEAD ATTORNEY ATTORNEY TO BE NOTICED

Amelia H. Bailey (See above for address) TERMINATED: 08/17/2018

Anne J. Hudson (See above for address) ATTORNEY TO BE NOTICED

Austin B. Stephenson (See above for address) ATTORNEY TO BE NOTICED

Brent P. Ray (See above for address) PRO HAC VICE ATTORNEY TO BE NOTICED

Cameron N. Custard (See above for address) TERMINATED: 11/18/2019

Camille E. Bennett (See above for address) ATTORNEY TO BE NOTICED

Carolyn M. Wald (See above for address) ATTORNEY TO BE NOTICED

Catherine L. Fitzpatrick (See above for address) ATTORNEY TO BE NOTICED

Erica B. Zolner (See above for address) ATTORNEY TO BE NOTICED

Ghirlandi Guidetti (See above for address) ATTORNEY TO BE NOTICED

Matthew John Smart (See above for address) TERMINATED: 09/26/2018

Megan M. New (See above for address) ATTORNEY TO BE NOTICED

Case: 3:18-cv-156 As of: 03/10/2020 09:57 AM CDT 5 of 29

Samantha G. Rose (See above for address) ATTORNEY TO BE NOTICED

Sarah Jane Hunt (See above for address) ATTORNEY TO BE NOTICED

Scott H. Lerner (See above for address) TERMINATED: 05/31/2019

Sydney L. Schneider (See above for address) ATTORNEY TO BE NOTICED

Thomas E. Kennedy , III (See above for address) ATTORNEY TO BE NOTICED

Thomas J. Leahy (See above for address) ATTORNEY TO BE NOTICED

Timothy C. Pickert (See above for address) TERMINATED: 04/02/2018

Jordan M. Heinz (See above for address) ATTORNEY TO BE NOTICED

Plaintiff
Ebony Stamps TERMINATED: 03/04/2020

represented by John A. Knight (See above for address) LEAD ATTORNEY ATTORNEY TO BE NOTICED

Amelia H. Bailey (See above for address) TERMINATED: 08/17/2018

Anne J. Hudson (See above for address) ATTORNEY TO BE NOTICED

Austin B. Stephenson (See above for address) ATTORNEY TO BE NOTICED

Brent P. Ray (See above for address) PRO HAC VICE ATTORNEY TO BE NOTICED

Cameron N. Custard (See above for address) TERMINATED: 11/18/2019

Carolyn M. Wald (See above for address) ATTORNEY TO BE NOTICED

Catherine L. Fitzpatrick

Case: 3:18-cv-156 As of: 03/10/2020 09:57 AM CDT 6 of 29

(See above for address) ATTORNEY TO BE NOTICED

Erica B. Zolner (See above for address) ATTORNEY TO BE NOTICED

Ghirlandi Guidetti (See above for address) ATTORNEY TO BE NOTICED

Matthew John Smart (See above for address) TERMINATED: 09/26/2018

Megan M. New (See above for address) ATTORNEY TO BE NOTICED

Samantha G. Rose (See above for address) ATTORNEY TO BE NOTICED

Sarah Jane Hunt (See above for address) ATTORNEY TO BE NOTICED

Scott H. Lerner (See above for address) TERMINATED: 05/31/2019

Sydney L. Schneider (See above for address) ATTORNEY TO BE NOTICED

Thomas E. Kennedy , III (See above for address) ATTORNEY TO BE NOTICED

Thomas J. Leahy (See above for address) ATTORNEY TO BE NOTICED

Timothy C. Pickert (See above for address) TERMINATED: 04/02/2018

Jordan M. Heinz (See above for address) ATTORNEY TO BE NOTICED

Plaintiff Lydia Helena Vision

represented by John A. Knight (See above for address) LEAD ATTORNEY ATTORNEY TO BE NOTICED

Amelia H. Bailey (See above for address) TERMINATED: 08/17/2018

Anne J. Hudson (See above for address) ATTORNEY TO BE NOTICED

Case: 3:18-cv-156 As of: 03/10/2020 09:57 AM CDT 7 of 29
Austin B. Stephenson (See above for address) ATTORNEY TO BE NOTICED
Brent P. Ray (See above for address) PRO HAC VICE ATTORNEY TO BE NOTICED
Cameron N. Custard (See above for address) TERMINATED: 11/18/2019
Camille E. Bennett (See above for address) ATTORNEY TO BE NOTICED
Carolyn M. Wald (See above for address) ATTORNEY TO BE NOTICED
Catherine L. Fitzpatrick (See above for address) ATTORNEY TO BE NOTICED
Erica B. Zolner (See above for address) ATTORNEY TO BE NOTICED
Ghirlandi Guidetti (See above for address) ATTORNEY TO BE NOTICED
Matthew John Smart (See above for address) TERMINATED: 09/26/2018
Megan M. New (See above for address) ATTORNEY TO BE NOTICED
Samantha G. Rose (See above for address) ATTORNEY TO BE NOTICED
Sarah Jane Hunt (See above for address) ATTORNEY TO BE NOTICED
Scott H. Lerner (See above for address) TERMINATED: 05/31/2019
Sydney L. Schneider (See above for address) ATTORNEY TO BE NOTICED
Thomas E. Kennedy , III (See above for address) ATTORNEY TO BE NOTICED
Thomas J. Leahy (See above for address) ATTORNEY TO BE NOTICED

Case: 3:18-cv-156 As of: 03/10/2020 09:57 AM CDT 8 of 29

Plaintiff Sora Kuykendall

Timothy C. Pickert (See above for address) TERMINATED: 04/02/2018
Jordan M. Heinz (See above for address) ATTORNEY TO BE NOTICED
represented by John A. Knight (See above for address) LEAD ATTORNEY ATTORNEY TO BE NOTICED
Amelia H. Bailey (See above for address) TERMINATED: 08/17/2018
Anne J. Hudson (See above for address) ATTORNEY TO BE NOTICED
Austin B. Stephenson (See above for address) ATTORNEY TO BE NOTICED
Brent P. Ray (See above for address) PRO HAC VICE ATTORNEY TO BE NOTICED
Cameron N. Custard (See above for address) TERMINATED: 11/18/2019
Camille E. Bennett (See above for address) ATTORNEY TO BE NOTICED
Carolyn M. Wald (See above for address) ATTORNEY TO BE NOTICED
Catherine L. Fitzpatrick (See above for address) ATTORNEY TO BE NOTICED
Erica B. Zolner (See above for address) ATTORNEY TO BE NOTICED
Ghirlandi Guidetti (See above for address) ATTORNEY TO BE NOTICED
Matthew John Smart (See above for address) TERMINATED: 09/26/2018
Megan M. New (See above for address) ATTORNEY TO BE NOTICED

Case: 3:18-cv-156 As of: 03/10/2020 09:57 AM CDT 9 of 29

Samantha G. Rose (See above for address) ATTORNEY TO BE NOTICED

Sarah Jane Hunt (See above for address) ATTORNEY TO BE NOTICED

Scott H. Lerner (See above for address) TERMINATED: 05/31/2019

Sydney L. Schneider (See above for address) ATTORNEY TO BE NOTICED

Thomas E. Kennedy , III (See above for address) ATTORNEY TO BE NOTICED

Thomas J. Leahy (See above for address) ATTORNEY TO BE NOTICED

Timothy C. Pickert (See above for address) TERMINATED: 04/02/2018

Jordan M. Heinz (See above for address) ATTORNEY TO BE NOTICED

Plaintiff Sasha Reed

represented by John A. Knight (See above for address) LEAD ATTORNEY ATTORNEY TO BE NOTICED

Amelia H. Bailey (See above for address) TERMINATED: 08/17/2018

Anne J. Hudson (See above for address) ATTORNEY TO BE NOTICED

Austin B. Stephenson (See above for address) ATTORNEY TO BE NOTICED

Brent P. Ray (See above for address) PRO HAC VICE ATTORNEY TO BE NOTICED

Cameron N. Custard (See above for address) TERMINATED: 11/18/2019

Camille E. Bennett (See above for address) ATTORNEY TO BE NOTICED

Carolyn M. Wald

Case: 3:18-cv-156 As of: 03/10/2020 09:57 AM CDT 10 of 29
(See above for address) ATTORNEY TO BE NOTICED
Catherine L. Fitzpatrick (See above for address) ATTORNEY TO BE NOTICED
Erica B. Zolner (See above for address) ATTORNEY TO BE NOTICED
Ghirlandi Guidetti (See above for address) ATTORNEY TO BE NOTICED
Matthew John Smart (See above for address) TERMINATED: 09/26/2018
Megan M. New (See above for address) ATTORNEY TO BE NOTICED
Samantha G. Rose (See above for address) ATTORNEY TO BE NOTICED
Sarah Jane Hunt (See above for address) ATTORNEY TO BE NOTICED
Scott H. Lerner (See above for address) TERMINATED: 05/31/2019
Sydney L. Schneider (See above for address) ATTORNEY TO BE NOTICED
Thomas E. Kennedy , III (See above for address) ATTORNEY TO BE NOTICED
Thomas J. Leahy (See above for address) ATTORNEY TO BE NOTICED
Timothy C. Pickert (See above for address) TERMINATED: 04/02/2018
Jordan M. Heinz (See above for address) ATTORNEY TO BE NOTICED

V.
Defendant
Bruce Rauner TERMINATED: 11/30/2018

represented by Lisa A. Cook Office of the Attorney General−Springfield 500 South Second Street Springfield, IL 62701 217−782−9014 Fax: 217−782−8767

Case: 3:18-cv-156 As of: 03/10/2020 09:57 AM CDT 11 of 29
Email: lcook@atg.state.il.us LEAD ATTORNEY ATTORNEY TO BE NOTICED
Christopher L. Higgerson Illinois Attorney General's Office − Springfield 500 South Second Street Springfield, IL 62701 217−782−1841 Fax: 217−782−8767 Email: chiggerson@atg.state.il.us ATTORNEY TO BE NOTICED
Joseph E. Okon , Illinois Attorney General's Office − Springfield
500 South Second Street

Defendant John Baldwin TERMINATED: 01/31/2020
Defendant Steve Meeks

Springfield, IL 62701
217−782−2077 Fax: 217−524−5091 Email: MABecker@atg.state.il.us TERMINATED: 10/11/2019
Kyle Rockershousen Office of the Attorney General−Springfield 500 South Second Street Springfield, IL 62701 217−782−1841 Fax: 217−782−8767 Email: gls@atg.state.il.us TERMINATED: 12/20/2018
represented by Lisa A. Cook (See above for address) LEAD ATTORNEY ATTORNEY TO BE NOTICED
Christopher L. Higgerson (See above for address) ATTORNEY TO BE NOTICED
Joseph E. Okon Illinois Attorney General's Office − Springfield 500 South Second Street Springfield, IL 62701 217−782−2077 Fax: 217−524−5091 Email: MABecker@atg.state.il.us TERMINATED: 10/11/2019
Kyle Rockershousen (See above for address) TERMINATED: 12/20/2018
represented by Lisa A. Cook (See above for address)

Case: 3:18-cv-156 As of: 03/10/2020 09:57 AM CDT 12 of 29

LEAD ATTORNEY ATTORNEY TO BE NOTICED

Christopher L. Higgerson (See above for address) ATTORNEY TO BE NOTICED

Joseph E. Okon , (See above for address) TERMINATED: 10/11/2019

Kyle Rockershousen (See above for address) TERMINATED: 12/20/2018

Defendant Melvin Hinton

represented by Lisa A. Cook (See above for address) LEAD ATTORNEY ATTORNEY TO BE NOTICED

Christopher L. Higgerson (See above for address) ATTORNEY TO BE NOTICED

Joseph E. Okon , (See above for address) TERMINATED: 10/11/2019

Kyle Rockershousen (See above for address) TERMINATED: 12/20/2018

Defendant
Rob Jeffreys substituted per Order at doc. 204

represented by Lisa A. Cook (See above for address) LEAD ATTORNEY ATTORNEY TO BE NOTICED

Christopher L. Higgerson (See above for address) ATTORNEY TO BE NOTICED

Date Filed 01/31/2018
01/31/2018 02/01/2018 02/01/2018

# Docket Text
1 COMPLAINT against All Defendants ( Filing fee $ 400 receipt number 0754−3463190.), filed by All Plaintiffs. (Attachments: # 1 Civil Cover Sheet, # 2 Summons to Bruce Rauner, # 3 Summons to John Baldwin, # 4 Summons to Steve Meeks, # 5 Summons to Melvin Hinton)(Heinz, Jordan) (Entered: 01/31/2018)
2 NOTICE of Appearance by Jordan M. Heinz on behalf of All Plaintiffs (Heinz, Jordan) (Entered: 01/31/2018)
3 Notice of Judge Assignment. Judge David R. Herndon assigned. All future documents must bear case number 18−156−DRH. (dmw2) (Entered: 02/01/2018)
4 ORDER REFERRING CASE TO MAGISTRATE JUDGE. Plaintiffs are prisoners in the custody of the Illinois Department of Corrections. Represented by counsel, they bring this civil rights action pursuant to 42 U.S.C. § 1983, on behalf of themselves and other similarly situated inmates, and have prepaid the $400 filing fee. The named Plaintiffs are currently in various institutions both within and outside the Southern District of Illinois; those located in this District are Kuykendall (Menard Correctional Center), and Reed (Lawrence Correctional Center). Plaintiffs identify themselves as

Case: 3:18-cv-156 As of: 03/10/2020 09:57 AM CDT 13 of 29

02/02/2018 02/02/2018 02/02/2018 02/02/2018 02/02/2018 02/05/2018 02/05/2018 02/05/2018 02/05/2018 02/05/2018 02/05/2018
02/05/2018

transgender women, and have sought evaluation and/or treatment for gender dysphoria during their IDOC custody. They allege that the IDOC has denied and/or delayed evaluation and medically necessary treatment and accommodations for their gender dysphoria, causing them to suffer physical and psychological distress, including self−harm and suicide attempts. They contend that incarceration under these conditions violates their Eighth Amendment rights. They seek class action certification, and declaratory and injunctive relief. Under 28 U.S.C. § 1915A, the Court is required to conduct a prompt threshold review of the Complaint. Accepting Plaintiffs' allegations as true, the Court finds that Plaintiffs have articulated a colorable federal cause of action against Defendants for violations of their constitutional rights. Accordingly, pursuant to Local Rule 72.1(a)(2), this action is REFERRED to a United States Magistrate Judge for further pre−trial proceedings. Further, this entire matter shall be REFERRED to the United States Magistrate Judge for disposition, pursuant to Local Rule 72.2(b)(2) and 28 U.S.C. § 636(c), if all parties consent to such a referral. Counsel for Plaintiffs may initiate service without further delay. Defendants are ORDERED to timely file an appropriate responsive pleading to the Complaint and shall not waive filing a reply pursuant to 42 U.S.C. § 1997e(g). Signed by Judge David R. Herndon on 2/1/2018. (tjk)THIS TEXT ENTRY IS AN ORDER OF THE COURT. NO FURTHER DOCUMENTATION WILL BE MAILED. (Entered: 02/01/2018)
5 MOTION to Appear Pro Hac Vice by Attorney Catherine L. Fitzpatrick $200 fee paid,receipt number 0754−3465984 by on behalf of All Plaintiffs. (Fitzpatrick, Catherine) (Entered: 02/02/2018)
6 MOTION to Appear Pro Hac Vice by Attorney Megan M. New $200 fee paid,receipt number 0754−3466020 by on behalf of All Plaintiffs. (New, Megan) (Entered: 02/02/2018)
7 MOTION to Appear Pro Hac Vice by Attorney Scott H. Lerner $200 fee paid,receipt number 0754−3466074 by on behalf of All Plaintiffs. (Lerner, Scott) (Entered: 02/02/2018)
8 MOTION to Appear Pro Hac Vice by Attorney Amelia H. Bailey $200 fee paid,receipt number 0754−3466090 by on behalf of All Plaintiffs. (Bailey, Amelia) (Entered: 02/02/2018)
9 NOTICE of Appearance by John A. Knight on behalf of All Plaintiffs (Knight, John) (Entered: 02/02/2018)
10 MOTION to Appear Pro Hac Vice by Attorney Timothy C. Pickert $200 fee paid,receipt number 0754−3466842 by on behalf of All Plaintiffs. (Pickert, Timothy) (Entered: 02/05/2018)
11 MOTION to Appear Pro Hac Vice by Attorney Matthew John Smart $200 fee paid,receipt number 0754−3466851 by on behalf of All Plaintiffs. (Smart, Matthew) (Entered: 02/05/2018)
12 MOTION to Appear Pro Hac Vice by Attorney Erica B. Zolner $200 fee paid,receipt number 0754−3467202 by on behalf of All Plaintiffs. (Zolner, Erica) (Entered: 02/05/2018)
13 MOTION to Appear Pro Hac Vice by Attorney Sydney L. Schneider $200 fee paid,receipt number 0754−3467215 by on behalf of All Plaintiffs. (Schneider, Sydney) (Entered: 02/05/2018)
14 Summons Issued as to John Baldwin, Melvin Hinton, Steve Meeks, Bruce Rauner. (cjo) (Entered: 02/05/2018)
15 ORDER granting 5 Motion to Appear Pro Hac Vice filed by Catherine L. Fitzpatrick ; granting 6 Motion to Appear Pro Hac Vice filed by Megan M. New ; granting 7 Motion to Appear Pro Hac Vice filed by Scott H. Lerner ; granting 8 Motion to Appear Pro Hac Vice filed by Amelia H. Bailey on behalf of plaintiffs. (cjo)THIS TEXT ENTRY IS AN ORDER OF THE COURT. NO FURTHER DOCUMENTATION WILL BE MAILED. (Entered: 02/05/2018)
16 ORDER granting 10 Motion to Appear Pro Hac Vice filed by Timothy C. Pickert ; granting 11 Motion to Appear Pro Hac Vice filed by Matthew John Smart ; granting 12 Motion to Appear Pro Hac Vice filed by Erica B. Zolner; granting 13 Motion to

Case: 3:18-cv-156 As of: 03/10/2020 09:57 AM CDT 14 of 29

02/06/2018 02/06/2018 02/06/2018 02/06/2018 02/06/2018 02/06/2018 02/06/2018 02/06/2018 02/12/2018 02/12/2018 02/12/2018 02/12/2018 02/12/2018 02/14/2018 02/14/2018 02/16/2018 02/28/2018 02/28/2018
03/01/2018 03/01/2018 03/02/2018

Appear Pro Hac Vice filed by Sydney L. Schneider on behalf of plaintiffs.(cjo)THIS TEXT ENTRY IS AN ORDER OF THE COURT. NO FURTHER DOCUMENTATION WILL BE MAILED. (Entered: 02/05/2018)
17 NOTICE of Appearance by Catherine L. Fitzpatrick on behalf of All Plaintiffs (Fitzpatrick, Catherine) (Entered: 02/06/2018)
18 NOTICE of Appearance by Megan M. New on behalf of All Plaintiffs (New, Megan) (Entered: 02/06/2018)
19 NOTICE of Appearance by Scott H. Lerner on behalf of All Plaintiffs (Lerner, Scott) (Entered: 02/06/2018)
20 NOTICE of Appearance by Amelia H. Bailey on behalf of All Plaintiffs (Bailey, Amelia) (Entered: 02/06/2018)
21 NOTICE of Appearance by Timothy C. Pickert on behalf of All Plaintiffs (Pickert, Timothy) (Entered: 02/06/2018)
22 NOTICE of Appearance by Matthew John Smart on behalf of All Plaintiffs (Smart, Matthew) (Entered: 02/06/2018)
23 NOTICE of Appearance by Erica B. Zolner on behalf of All Plaintiffs (Zolner, Erica) (Entered: 02/06/2018)
24 NOTICE of Appearance by Sydney L. Schneider on behalf of All Plaintiffs (Schneider, Sydney) (Entered: 02/06/2018)
25 NOTICE of Appearance by Ghirlandi Guidetti on behalf of All Plaintiffs (Guidetti, Ghirlandi) (Entered: 02/12/2018)
26 SUMMONS Returned Executed by All Plaintiffs. Bruce Rauner served on 2/7/2018, answer due 2/28/2018. (Heinz, Jordan) (Entered: 02/12/2018)
27 SUMMONS Returned Executed by All Plaintiffs. John Baldwin served on 2/7/2018, answer due 2/28/2018. (Heinz, Jordan) (Entered: 02/12/2018)
28 SUMMONS Returned Executed by All Plaintiffs. Steve Meeks served on 2/7/2018, answer due 2/28/2018. (Heinz, Jordan) (Entered: 02/12/2018)
29 SUMMONS Returned Executed by All Plaintiffs. Melvin Hinton served on 2/7/2018, answer due 2/28/2018. (Heinz, Jordan) (Entered: 02/12/2018)
30 NOTICE of Appearance by Kyle Rockershousen on behalf of John Baldwin, Steve Meeks (Rockershousen, Kyle) (Entered: 02/14/2018)
31 NOTICE of Appearance by Kyle Rockershousen on behalf of Melvin Hinton (Rockershousen, Kyle) (Entered: 02/14/2018)
32 NOTICE of Appearance by Joseph E. Okon on behalf of John Baldwin, Melvin Hinton, Steve Meeks (Okon, Joseph) (Entered: 02/16/2018)
33 NOTICE of Appearance by Kyle Rockershousen on behalf of Bruce Rauner (Rockershousen, Kyle) (Entered: 02/28/2018)
34 MOTION for Extension of Time to File Responsive Pleading to Plaintiffs' Complaint by John Baldwin, Melvin Hinton, Steve Meeks, Bruce Rauner. (Rockershousen, Kyle) (Entered: 02/28/2018)
35 NOTICE of Appearance by Thomas E. Kennedy, III on behalf of All Plaintiffs (Kennedy, Thomas) (Entered: 03/01/2018)
36 NOTICE of Appearance by Sarah Jane Hunt on behalf of All Plaintiffs (Hunt, Sarah) (Entered: 03/01/2018)
37 ORDER GRANTING 34 MOTION for Extension of Time to File Responsive Pleading to Plaintiffs' Complaint filed by Melvin Hinton, Bruce Rauner, Steve Meeks, John Baldwin. John Baldwin answer due 3/28/2018; Melvin Hinton answer due 3/28/2018; Steve Meeks answer due 3/28/2018; Bruce Rauner answer due 3/28/2018. Signed by Magistrate Judge Donald G. Wilkerson on 3/2/2018. (sgp)THIS TEXT ENTRY IS AN

Case: 3:18-cv-156 As of: 03/10/2020 09:57 AM CDT 15 of 29

03/05/2018 03/12/2018 03/26/2018 03/27/2018 03/28/2018 04/02/2018 04/02/2018
04/02/2018
04/11/2018 04/11/2018
04/18/2018 04/18/2018 04/18/2018 04/20/2018

ORDER OF THE COURT. NO FURTHER DOCUMENTATION WILL BE MAILED. (Entered: 03/02/2018)
38 MOTION for Protective Order by John Baldwin, Melvin Hinton, Steve Meeks, Bruce Rauner. (Rockershousen, Kyle) (Entered: 03/05/2018)
39 PROTECTIVE ORDER (HIPAA). Signed by Magistrate Judge Donald G. Wilkerson on 3/12/2018. (sgp) (Entered: 03/12/2018)
40 MOTION to Withdraw as Attorney by All Plaintiffs. (Pickert, Timothy) (Entered: 03/26/2018)
41 MOTION to Dismiss for Failure to State a Claim by Bruce Rauner. Responses due by 4/30/2018 (Rockershousen, Kyle) (Entered: 03/27/2018)
42 Second MOTION for Extension of Time to File Responsive Pleading to Plaintiffs' Complaint by John Baldwin, Melvin Hinton, Steve Meeks. (Rockershousen, Kyle) (Entered: 03/28/2018)
43 ORDER granting 40 Motion to Withdraw as Attorney. Attorney Timothy C. Pickert terminated. Signed by Magistrate Judge Donald G. Wilkerson on 4/2/2018. (sgp)THIS TEXT ENTRY IS AN ORDER OF THE COURT. NO FURTHER DOCUMENTATION WILL BE MAILED. (Entered: 04/02/2018)
44 ORDER GRANTING 42 Second MOTION for Extension of Time to File Responsive Pleading to Plaintiffs' Complaint filed by Melvin Hinton, Steve Meeks, John Baldwin. John Baldwin answer due 4/11/2018; Melvin Hinton answer due 4/11/2018; Steve Meeks answer due 4/11/2018. Signed by Magistrate Judge Donald G. Wilkerson on 4/2/2018. (sgp)THIS TEXT ENTRY IS AN ORDER OF THE COURT. NO FURTHER DOCUMENTATION WILL BE MAILED. (Entered: 04/02/2018)
45 ORDER: Telephonic Scheduling Conference set for 4/19/2018 at 1:00 PM before Magistrate Judge Donald G. Wilkerson. Defendants to initiate the conference call. Parties shall submit a joint schedule, or individual schedules if there is no agreement, by April 12, 2018 using the Joint Report of Parties form located on the Court's webpage. Parties shall submit their proposed schedule by email and shall anticipate an April 2020 trial date. Signed by Magistrate Judge Donald G. Wilkerson on 4/2/2018. (sgp)THIS TEXT ENTRY IS AN ORDER OF THE COURT. NO FURTHER DOCUMENTATION WILL BE MAILED. (Entered: 04/02/2018)
46 Third MOTION for Extension of Time to File Answer re 1 Complaint, by John Baldwin, Melvin Hinton, Steve Meeks. (Rockershousen, Kyle) (Entered: 04/11/2018)
47 ORDER GRANTING 46 Third MOTION for Extension of Time to File Answer re 1 Complaint, filed by Melvin Hinton, Steve Meeks, John Baldwin., John Baldwin answer due 4/18/2018; Melvin Hinton answer due 4/18/2018; Steve Meeks answer due 4/18/2018. Signed by Magistrate Judge Donald G. Wilkerson on 4/11/2018. (sgp)THIS TEXT ENTRY IS AN ORDER OF THE COURT. NO FURTHER DOCUMENTATION WILL BE MAILED. (Entered: 04/11/2018)
48 NOTICE of Appearance by Lisa A. Cook on behalf of John Baldwin, Melvin Hinton, Steve Meeks, Bruce Rauner (Cook, Lisa) (Entered: 04/18/2018)
49 NOTICE of Appearance by Christopher L. Higgerson on behalf of John Baldwin, Melvin Hinton, Steve Meeks, Bruce Rauner (Higgerson, Christopher) (Entered: 04/18/2018)
50 ANSWER to 1 Complaint, and Affirmative Defenses by John Baldwin, Melvin Hinton, Steve Meeks.(Rockershousen, Kyle) (Entered: 04/18/2018)
51 Minute Entry for proceedings held before Magistrate Judge Donald G. Wilkerson: Telephonic Scheduling Conference held on 4/19/2018. Attorneys Knight, Guidetti, Smart, New, Higgeson, Rockershousen, Cook, and Okon for their respective clients. Scheduling Order to issue.(Court Reporter n/a.) (sgp)THIS TEXT ENTRY IS AN ORDER OF THE COURT. NO FURTHER DOCUMENTATION WILL BE MAILED. (Entered: 04/20/2018)

Case: 3:18-cv-156 As of: 03/10/2020 09:57 AM CDT 16 of 29

04/24/2018 04/25/2018
04/25/2018 04/26/2018 04/30/2018 05/07/2018 05/08/2018
05/08/2018 05/08/2018 05/08/2018 05/09/2018
05/14/2018 06/08/2018
06/11/2018 07/10/2018 07/13/2018

52 MOTION to Appear Pro Hac Vice by Attorney Austin B. Stephenson $200 fee paid,receipt number 0754−3545069 by on behalf of All Plaintiffs. (Stephenson, Austin) (Entered: 04/24/2018)
53 ORDER granting 52 Motion to Appear Pro Hac Vice filed by Attorney Austin B. Stephenson on behalf of All Plaintiffs. (cjo)THIS TEXT ENTRY IS AN ORDER OF THE COURT. NO FURTHER DOCUMENTATION WILL BE MAILED. (Entered: 04/25/2018)
54 NOTICE of Appearance by Austin B. Stephenson on behalf of All Plaintiffs (Stephenson, Austin) (Entered: 04/25/2018)
55 RESPONSE in Opposition re 41 MOTION to Dismiss for Failure to State a Claim filed by All Plaintiffs. (Lerner, Scott) (Entered: 04/26/2018)
56 Joint MOTION for Extension of Time to Submit Proposed Discovery Plan for Electronically Stored Information by John Baldwin, Melvin Hinton, Steve Meeks. (Rockershousen, Kyle) (Entered: 04/30/2018)
57 Second MOTION for Extension of Time to Submit Proposed Discovery Plan for Electronically Stored Information by John Baldwin, Melvin Hinton, Steve Meeks. (Rockershousen, Kyle) (Entered: 05/07/2018)
58 ORDER MOOTING 56 Joint MOTION for Extension of Time to Submit Proposed Discovery Plan for Electronically Stored Information filed by Melvin Hinton, Steve Meeks, John Baldwin and GRANTING 57 Second MOTION for Extension of Time to Submit Proposed Discovery Plan for Electronically Stored Information filed by Melvin Hinton, Steve Meeks, John Baldwin. Proposed ESI protocol due by May 14, 2018. Signed by Magistrate Judge Donald G. Wilkerson on 5/8/2018. (sgp)THIS TEXT ENTRY IS AN ORDER OF THE COURT. NO FURTHER DOCUMENTATION WILL BE MAILED. (Entered: 05/08/2018)
59 SCHEDULING ORDER: Discovery due by 12/2/2019. Dispositive Motions due by 12/16/2019.Signed by Magistrate Judge Donald G. Wilkerson on 5/4/2018. (jmp) Modified on 5/9/2018 (cjo). (Entered: 05/08/2018)
60 ORDER REGARDING DISCOVERY. Signed by Magistrate Judge Donald G. Wilkerson on 5/4/2018. (jmp) (Entered: 05/08/2018)
61 ORDER AND NOTICE OF SETTLEMENT CONFERENCE: Settlement Conference set for 10/8/2019 at 9:00 AM in East St. Louis Courthouse before Magistrate Judge Donald G. Wilkerson.(jmp) (Entered: 05/08/2018)
62 NOTICE OF MODIFICATION re 59 Scheduling Order. Clerk's office to modify the docket text to reflect the judge's signature date as indicated on the.pdf.(cjo)THIS TEXT ENTRY IS AN ORDER OF THE COURT. NO FURTHER DOCUMENTATION WILL BE MAILED. (Entered: 05/09/2018)
63 Third MOTION for Extension of Time to Submit Proposed Discovery Plan for Electronically Stored Information (Agreed) by John Baldwin, Melvin Hinton, Steve Meeks. (Rockershousen, Kyle) (Entered: 05/14/2018)
64 ORDER GRANTING 63 Motion for Extension of Time. Signed by Magistrate Judge Donald G. Wilkerson on 6/8/2018. (sgp)THIS TEXT ENTRY IS AN ORDER OF THE COURT. NO FURTHER DOCUMENTATION WILL BE MAILED. (Entered: 06/08/2018)
65 ESI PROTOCOL. Signed by Magistrate Judge Donald G. Wilkerson on 6/11/2018. (sgp) (Entered: 06/11/2018)
66 MOTION for status by John Finnegan.. (jaj) (Entered: 07/10/2018)
67 ORDER MOOTING 66 Motion for Status. Plaintiffs are represented by counsel. Mr. Finnegan is directed to contact class counsel to determine the status of this matter. John A. Knight, Roger Baldwin Foundation of ACLU, Inc., ACLU of Illinois, 150 N. Michigan Avenue, Suite 600, Chicago, IL 60601. Clerk shall send this Order to Mr. Finnegan at the address listed. Signed by Magistrate Judge Donald G. Wilkerson on 7/13/2018. (sgp)THIS TEXT ENTRY IS AN ORDER OF THE COURT. NO FURTHER DOCUMENTATION WILL BE MAILED. (Entered: 07/13/2018)

Case: 3:18-cv-156 As of: 03/10/2020 09:57 AM CDT 17 of 29

07/13/2018
07/17/2018 07/20/2018 07/24/2018
08/03/2018 08/03/2018 08/14/2018 08/17/2018 08/17/2018
09/17/2018 09/26/2018 10/01/2018 10/09/2018

68 ORDER re 1 Complaint, filed by Lydia Helena Vision, Marilyn Melendez, Sora Kuykendall, Ebony Stamps, Sasha Reed, Janiah Monroe: Plaintiffs filed this purported class action on behalf of themselves and other inmates who require evaluation or treatment for gender dysphoria. In filing this suit, Plaintiffs have elected to use their chosen names. These names, however, may not be their legal names or the name used by the Illinois Department of Corrections. Plaintiff are accordingly ORDERED to file a notice with the Court indicating their true, legal names, in addition to the IDOC number, by July 20, 2018. Upon receipt of the Notice, the Clerk of Court shall modify the docket to reflect the true names of Defendants and to indicate, as an AKA, their chosen names. Formal amendment of the pleadings will not be required. Signed by Magistrate Judge Donald G. Wilkerson on 7/13/2018. (sgp)THIS TEXT ENTRY IS AN ORDER OF THE COURT. NO FURTHER DOCUMENTATION WILL BE MAILED. (Entered: 07/13/2018)
Notice (see document #68) due by 7/20/2018. (cjo) (Entered: 07/17/2018)
69 NOTICE by All Plaintiffs re 68 Order,,, Notice and Response to July 13, 2018 Minute Order (Lerner, Scott) (Entered: 07/20/2018)
70 ORDER VACATING IN PART 68 and re 69 Notice (Other) filed by Lydia Helena Vision, Marilyn Melendez, Sora Kuykendall, Ebony Stamps, Sasha Reed, Janiah Monroe: No further action shall be taken by the Clerk to modify the docket sheet in this matter at this time. Signed by Magistrate Judge Donald G. Wilkerson on 7/24/2018. (sgp)THIS TEXT ENTRY IS AN ORDER OF THE COURT. NO FURTHER DOCUMENTATION WILL BE MAILED. (Entered: 07/24/2018)
71 MOTION for Extension of Time to Complete Discovery by John Baldwin, Melvin Hinton, Steve Meeks, Bruce Rauner. (Rockershousen, Kyle) (Entered: 08/03/2018)
72 RESPONSE to Motion re 71 MOTION for Extension of Time to Complete Discovery filed by All Plaintiffs. (Attachments: # 1 Exhibit 1)(Lerner, Scott) (Entered: 08/03/2018)
73 MOTION to Withdraw as Attorney by All Plaintiffs. (Bailey, Amelia) (Entered: 08/14/2018)
74 ORDER GRANTING 73 Motion to Withdraw as Attorney. Attorney Amelia H. Bailey terminated. Signed by Magistrate Judge Donald G. Wilkerson on 8/17/2018. (sgp)THIS TEXT ENTRY IS AN ORDER OF THE COURT. NO FURTHER DOCUMENTATION WILL BE MAILED. (Entered: 08/17/2018)
75 ORDER GRANTING 71 Motion for Extension of Time to Complete Discovery. Over Plaintiff's objections, Defendants are granted the requested extension to August 13, 2018. The Court assumes the discovery responses have been served. Signed by Magistrate Judge Donald G. Wilkerson on 8/17/2018.(sgp)THIS TEXT ENTRY IS AN ORDER OF THE COURT. NO FURTHER DOCUMENTATION WILL BE MAILED. (Entered: 08/17/2018)
76 MOTION to Withdraw as Attorney by All Plaintiffs. (Smart, Matthew) (Entered: 09/17/2018)
77 ORDER GRANTING 76 Motion to Withdraw as Attorney. Attorney Matthew John Smart terminated. Signed by Magistrate Judge Donald G. Wilkerson on 9/26/2018. (sgp)THIS TEXT ENTRY IS AN ORDER OF THE COURT. NO FURTHER DOCUMENTATION WILL BE MAILED. (Entered: 09/26/2018)
78 Joint MOTION for Protective Order by All Plaintiffs. (Lerner, Scott) (Entered: 10/01/2018)
79 ORDER: Plaintiffs have indicated that there is a discovery dispute as to requests to produce served in May 2018. Plaintiffs to email to chambers the disputed discovery requests and responses. Telephonic Discovery Dispute Conference set for 10/11/2018 at 3:00 PM before Magistrate Judge Donald G. Wilkerson. Plaintiffs to initiate the conference call. Signed by Magistrate Judge Donald G. Wilkerson on 10/9/2018. (sgp)THIS TEXT ENTRY IS AN ORDER OF THE COURT. NO FURTHER DOCUMENTATION WILL BE MAILED. (Entered: 10/09/2018)

Case: 3:18-cv-156 As of: 03/10/2020 09:57 AM CDT 18 of 29

10/11/2018 10/11/2018
10/11/2018 10/17/2018 10/18/2018 10/18/2018
10/18/2018 10/18/2018

80 MOTION to Stay Discovery as to Defendant Rauner by Bruce Rauner. (Rockershousen, Kyle) (Entered: 10/11/2018)
81 Minute Entry for proceedings held before Magistrate Judge Donald G. Wilkerson: Telephonic Discovery Dispute Conference held on 10/11/2018. Attorneys Stephenson, Lerner, and Sam Rose for Plaintiffs and attorneys Rockershousen and Okon for Defendants. Court heard argument on Plaintiff's requests to produce served in May 2018 and ESI discovery. Additional discovery dispute conference set for 10/18/18 at 2:00 p.m. Order to issue. (Court Reporter n/a.) (sgp)THIS TEXT ENTRY IS AN ORDER OF THE COURT. NO FURTHER DOCUMENTATION WILL BE MAILED. (Entered: 10/11/2018)
82 NOTICE of Hearing: Telephonic Discovery Dispute Conference set for 10/18/2018 at 2:00 PM before Magistrate Judge Donald G. Wilkerson. All counsel who shall appear shall ensure that they have entered on the case prior to the conference. Plaintiffs to initiate the conference call.(sgp)THIS TEXT ENTRY IS AN ORDER OF THE COURT. NO FURTHER DOCUMENTATION WILL BE MAILED. (Entered: 10/11/2018)
83 Joint MOTION for Protective Order by All Plaintiffs. (Lerner, Scott) (Entered: 10/17/2018)
84 Minute Entry for proceedings held before Magistrate Judge Donald G. Wilkerson: Telephonic Discovery Dispute Conference held on 10/18/2018. Attorneys Lerner, Stephenson, and Rose for Plaintiffs and attorneys Okon, Higgerson, and Rockershousen for Defendants. Order to issue. (Court Reporter n/a.) (sgp)THIS TEXT ENTRY IS AN ORDER OF THE COURT. NO FURTHER DOCUMENTATION WILL BE MAILED. (Entered: 10/18/2018)
85 STRICKEN − ORDER: Pursuant to the discovery dispute conference held on this day, the following his hereby ORDERED. Defendants shall produce ESI documents (subject to privilege) responsive to discovery requests within 30 days of the date of this Order. The Court, having reviewed the motion for protective Order and finding good cause pursuant to Rule 26(c), shall enter the same by separate docket entry. As such, the 78 Joint MOTION for Protective Order filed by Lydia Helena Vision, Marilyn Melendez, Sora Kuykendall, Ebony Stamps, Sasha Reed, Janiah Monroe is deemed MOOT and the 83 Joint MOTION for Protective Order filed by Lydia Helena Vision, Marilyn Melendez, Sora Kuykendall, Ebony Stamps, Sasha Reed, Janiah Monroe is GRANTED. A telephonic Status Conference is hereby SET for 11/19/2018 at 1:00 PM before Magistrate Judge Donald G. Wilkerson. Plaintiffs to initiate the conference call. Parties should be prepared to discuss any additional outstanding discovery disputes and the status of ESI discovery. Signed by Magistrate Judge Donald G. Wilkerson on 10/18/2018. (sgp)THIS TEXT ENTRY IS AN ORDER OF THE COURT. NO FURTHER DOCUMENTATION WILL BE MAILED. Modified on 10/19/2018 (cjo). (Entered: 10/18/2018)
86 NOTICE STRIKING ELECTRONICALLY FILED DOCUMENTS striking 85 Order. Document to be refiled. (jmp)THIS TEXT ENTRY IS AN ORDER OF THE COURT. NO FURTHER DOCUMENTATION WILL BE MAILED. (Entered: 10/18/2018)
87 ORDER: Pursuant to the discovery dispute conference held on this day, the following his hereby ORDERED. Defendants shall produce ESI documents (subject to privilege) responsive to discovery requests within 30 days of the date of this Order. The Court, having reviewed the motion for protective Order and finding good cause pursuant to Rule 26(c), shall enter the same by separate docket entry (parties shall note changes). As such, the 78 Joint MOTION for Protective Order filed by Lydia Helena Vision, Marilyn Melendez, Sora Kuykendall, Ebony Stamps, Sasha Reed, Janiah Monroe is deemed MOOT and the 83 Joint MOTION for Protective Order filed by Lydia Helena Vision, Marilyn Melendez, Sora Kuykendall, Ebony Stamps, Sasha Reed, Janiah Monroe is GRANTED IN PART. A telephonic Status Conference is hereby SET for 11/19/2018 at 1:00 PM before Magistrate Judge Donald G. Wilkerson. Plaintiffs to initiate the conference call. Parties should be prepared to discuss any additional outstanding discovery disputes and the status of ESI discovery. Signed by Magistrate Judge Donald G. Wilkerson on 10/18/2018. (sgp)THIS TEXT ENTRY IS AN ORDER OF THE COURT. NO FURTHER DOCUMENTATION WILL BE MAILED. (Entered: 10/18/2018)

Case: 3:18-cv-156 As of: 03/10/2020 09:57 AM CDT 19 of 29

10/18/2018 10/25/2018 11/01/2018 11/09/2018 11/14/2018 11/14/2018
11/16/2018 11/20/2018 11/30/2018 11/30/2018
12/07/2018 12/10/2018

88 PROTECTIVE ORDER (parties will note changes to paragraphs 2 and 3). Signed by Magistrate Judge Donald G. Wilkerson on 10/18/2018. (sgp)THIS TEXT ENTRY IS AN ORDER OF THE COURT. NO FURTHER DOCUMENTATION WILL BE MAILED. (Entered: 10/18/2018)
89 RESPONSE in Opposition re 80 MOTION to Stay Discovery as to Defendant Rauner filed by All Plaintiffs. (Lerner, Scott) (Entered: 10/25/2018)
90 NOTICE of Hearing: In person Discovery Dispute Conference set for 11/9/2018 at 10:00 AM in East St. Louis Courthouse before Magistrate Judge Donald G. Wilkerson. Parties should be prepared to discuss on−going issues related to medical records, ESI discovery, and any other discovery disputes that have arisen. (sgp)THIS TEXT ENTRY IS AN ORDER OF THE COURT. NO FURTHER DOCUMENTATION WILL BE MAILED. (Entered: 11/01/2018)
91 REPORT AND RECOMMENDATIONS re 80 MOTION to Stay Discovery as to Defendant Rauner filed by Bruce Rauner, 41 MOTION to Dismiss for Failure to State a Claim filed by Bruce Rauner. Objections to R&R due by 11/29/2018. Signed by Magistrate Judge Donald G. Wilkerson on 11/9/2018. (sgp) (Entered: 11/09/2018)
92 Minute Entry for proceedings held before Magistrate Judge Donald G. Wilkerson: Discovery Dispute Conference held on 11/9/2018. Attorneys Lerner and Hunt for Plaintiffs and attorney Higgerson for Defendants. Court heard argument on discovery dispute. Text Order to issue. (Court Reporter n/a.) (sgp)THIS TEXT ENTRY IS AN ORDER OF THE COURT. NO FURTHER DOCUMENTATION WILL BE MAILED. (Entered: 11/14/2018)
93 ORDER re 92 Discovery Dispute Conference: Defendants shall produce medical records of IDOC inmates who may be potential class members pursuant to the Protective Order by December 7, 2018. Defendants indicated that they will be producing medical records of Plaintiffs forthwith. In light of the discussion on ESI and the search term "trans" resulting in a significant amount of false hits, the word "trans" (as a standalone term) is stricken from the search terms list. The parties indicate that they are in agreement as to other search terms. ESI Documents responsive to discovery requests shall be served by December 7, 2018. Parties shall contact the Court promptly if additional discovery disputes arise. Signed by Magistrate Judge Donald G. Wilkerson on 11/14/2018. (sgp)THIS TEXT ENTRY IS AN ORDER OF THE COURT. NO FURTHER DOCUMENTATION WILL BE MAILED. (Entered: 11/14/2018)
94 ORDER: In light of this Court's Orders on discovery, the status conference set for 11/19/18 is hereby CANCELLED. Signed by Magistrate Judge Donald G. Wilkerson on 11/16/2018. (sgp)THIS TEXT ENTRY IS AN ORDER OF THE COURT. NO FURTHER DOCUMENTATION WILL BE MAILED. (Entered: 11/16/2018)
95 OBJECTION to 91 Report and Recommendations by All Plaintiffs. (Lerner, Scott) (Entered: 11/20/2018)
96 ORDER granting 41 Motion to Dismiss for Failure to State a Claim; finding as moot 80 Motion to Stay; adopting in part Report and Recommendations re 91 . The Court DISMISSES without prejudice defendant Rauner. See Memorandum and Order for details. Signed by Judge David R. Herndon on 11/29/2018. (klh) (Entered: 11/30/2018)
97 AMENDED Memorandum and ORDER granting 41 Motion to Dismiss for Failure to State a Claim; finding as moot 80 Motion to Stay; and adopting Report and Recommendations 91 . The Court DISMISSES with prejudice defendant Rauner. The Court DIRECTS the Clerk of the Court to enter judgment reflecting the same at the close of the case. See Memorandum and Order for details. Further, the Court VACATES the November 29, 2018 96 Order on Motion to Dismiss for Failure to State a Claim, Order on Motion to Stay, and Order on Report and Recommendations. Signed by Judge David R. Herndon on 11/30/2018. (klh) (Entered: 11/30/2018)
98 MOTION for Extension of Time by Melvin Hinton, Steve Meeks. (Okon, Joseph) (Entered: 12/07/2018)
99 Amended MOTION for Extension of Time to Comply with the Court's November 14, 2018 Order (Doc. 93) by Melvin Hinton, Steve Meeks. (Okon, Joseph) (Entered:

Case: 3:18-cv-156 As of: 03/10/2020 09:57 AM CDT 20 of 29

12/13/2018
12/18/2018 12/19/2018 12/19/2018 12/20/2018
01/08/2019 01/15/2019
01/15/2019 01/15/2019 01/16/2019 01/17/2019 01/17/2019
01/17/2019 01/17/2019 01/18/2019

12/10/2018)
100 ORDER GRANTING 98 MOTION for Extension of Time filed by Melvin Hinton, Steve Meeks; GRANTING 99 Amended MOTION for Extension of Time to Comply with the Court's November 14, 2018 Order (Doc. 93) filed by Melvin Hinton, Steve Meeks. Over Plaintiffs' objection, Defendants shall produce ESI discovery and medical records by December 21, 2018. Defendants shall nonetheless produce documents on a rolling basis as they become available prior to that date. Signed by Magistrate Judge Donald G. Wilkerson on 12/13/2018. (sgp)THIS TEXT ENTRY IS AN ORDER OF THE COURT. NO FURTHER DOCUMENTATION WILL BE MAILED. (Entered: 12/13/2018)
101 NOTICE of Appearance by Carolyn M. Wald on behalf of All Plaintiffs (Wald, Carolyn) (Entered: 12/18/2018)
102 Case Reassigned to Judge Nancy J. Rosenstengel. Judge David R. Herndon no longer assigned to the case. (dmw2) (Entered: 12/19/2018)
103 MOTION Motion to Terminate Kyle Rockershousen as Counsel for Defendants by John Baldwin, Melvin Hinton, Steve Meeks. (Cook, Lisa) (Entered: 12/19/2018)
104 ORDER GRANTING 103 MOTION Motion to Terminate Kyle Rockershousen as Counsel for Defendants filed by Melvin Hinton, Steve Meeks, John Baldwin. Attorney Kyle Rockershousen terminated. Signed by Magistrate Judge Donald G. Wilkerson on 12/20/2018. (sgp)THIS TEXT ENTRY IS AN ORDER OF THE COURT. NO FURTHER DOCUMENTATION WILL BE MAILED. (Entered: 12/20/2018)
105 Case Reassigned to Magistrate Judge Mark A. Beatty. Magistrate Judge Donald G. Wilkerson no longer assigned to the case. (slj2) (Entered: 01/08/2019)
106 NOTICE of Hearing: Discovery Dispute Conference set for 1/29/2018 at 1:30 PM before Magistrate Judge Mark A. Beatty. Instructions for placing the conference call are as follows: 877−336−1829; when prompted enter Access Code 4442281; followed by Security Code 2111.(arf)THIS TEXT ENTRY IS AN ORDER OF THE COURT. NO FURTHER DOCUMENTATION WILL BE MAILED. (Entered: 01/15/2019)
Set/Reset Hearings (correcting year only): Discovery Dispute TeleConference set for 1/29/2019 at 1:30 PM before Magistrate Judge Mark A. Beatty. (arf) (Entered: 01/15/2019)
Set/Reset Hearings (reassigning Judge only): Settlement Conference set for 10/8/2019 09:00 AM in East St. Louis Courthouse before Magistrate Judge Mark A. Beatty. (arf) Modified on 2/8/2019 − removed court only restriction(arf). (Entered: 01/15/2019)
107 MOTION to Appear Pro Hac Vice by Attorney Samantha G. Rose $200 fee paid,receipt number 0754−3773343 by on behalf of All Plaintiffs. (Rose, Samantha) (Entered: 01/16/2019)
108 MOTION to Appear Pro Hac Vice by Attorney Cameron N. Custard $200 fee paid,receipt number 0754−3773664 by on behalf of All Plaintiffs. (Custard, Cameron) (Entered: 01/17/2019)
109 ORDER granting 107 Motion to Appear Pro Hac Vice of Attorney Samantha G. Rose on behalf of all plaintiffs; granting 108 Motion to Appear Pro Hac Vice of Attorney Cameron N. Custard on behalf of all plaintiffs.(lmb)THIS TEXT ENTRY IS AN ORDER OF THE COURT. NO FURTHER DOCUMENTATION WILL BE MAILED. Modified on 1/18/2019 (cjo). (Entered: 01/17/2019)
110 NOTICE of Appearance by Samantha G. Rose on behalf of All Plaintiffs (Rose, Samantha) (Entered: 01/17/2019)
111 NOTICE of Appearance by Cameron N. Custard on behalf of All Plaintiffs (Custard, Cameron) (Entered: 01/17/2019)
112 NOTICE OF MODIFICATION re 109 Order on Motion to Appear Pro Hac Vice. Docket text modified to remove the Judge's signature date.(cjo)THIS TEXT ENTRY IS AN ORDER OF THE COURT. NO FURTHER DOCUMENTATION WILL BE MAILED. (Entered: 01/18/2019)

Case: 3:18-cv-156 As of: 03/10/2020 09:57 AM CDT 21 of 29

01/25/2019
01/29/2019 01/29/2019
01/29/2019 02/21/2019 03/08/2019 03/12/2019 04/15/2019

113 ORDER RESETTING FINAL PRETRIAL CONFERENCE AND TRIAL DATE: Having received this case from the docket of United States District Judge David R. Herndon, the undersigned District Judge RESETS the following hearings as follows: the Final Pretrial Conference is set for March 12, 2020 at 1:30 PM and the Jury Trial is set for April 7, 2020 at 9:00 AM. This Order does not affect any other deadlines set in this case. If the parties seek a different or earlier trial date, they remain free to consent to trial before Magistrate Judge Mark A. Beatty. (Consent is mentioned only as one available option. Adverse consequences will not result from failing to consent). Signed by Judge Nancy J. Rosenstengel on 1/25/2019. (drb)THIS TEXT ENTRY IS AN ORDER OF THE COURT. NO FURTHER DOCUMENTATION WILL BE MAILED. Modified on 1/29/2019 (drb). (Entered: 01/25/2019)
114 NOTICE OF MODIFICATION re 113 Order. The Order has been amended to reflect the correct trial date as April 7, 2020. No further action is required by the filer in relation to this notification. (drb)THIS TEXT ENTRY IS AN ORDER OF THE COURT. NO FURTHER DOCUMENTATION WILL BE MAILED. (Entered: 01/29/2019)
115 Minute Entry for proceedings held before Magistrate Judge Mark A. Beatty: Telephonic Discovery Dispute Conference held on 1/29/2019. Attorneys Scott Lerner and Samantha Rose appear on behalf of Plaintiffs. Attorneys Lisa Cook and Christopher Higgerson appear on behalf of Defendants. Defendants are ordered to continue to produce documents to Plaintiffs on a rolling basis. Defendants are directed to provide Plaintiffs with an accounting of information regarding the ongoing document production (examples of benchmark information were discussed on the record on 1/29/2019) so that the parties and the Court can meaningfully assess the progress of production. A status conference will be set in 30 days to discuss the progress made on the document production. (Court Reporter Laura Esposito.) (arf)THIS TEXT ENTRY IS AN ORDER OF THE COURT. NO FURTHER DOCUMENTATION WILL BE MAILED. (Entered: 01/29/2019)
116 NOTICE of Hearing: Telephonic Status Conference to discuss production of documents set for 3/5/2019 at 10:00 AM in East St. Louis Courthouse before Magistrate Judge Mark A. Beatty. Instructions for placing the conference call are as follows: 877−336−1829; when prompted enter Access Code 4442281; followed by Security Code 3854. (arf)THIS TEXT ENTRY IS AN ORDER OF THE COURT. NO FURTHER DOCUMENTATION WILL BE MAILED. (Entered: 01/29/2019)
117 NOTICE of Hearing: On the Court's own motion, the Telephonic Status Conference is RESET for 3/8/2019 at 2:00 PM in East St. Louis Courthouse before Magistrate Judge Mark A. Beatty. Instructions for placing the conference call are as follows: 877−336−1829; when prompted enter Access Code 4442281; followed by Security Code 3854. (arf)THIS TEXT ENTRY IS AN ORDER OF THE COURT. NO FURTHER DOCUMENTATION WILL BE MAILED. (Entered: 02/21/2019)
118 Minute Entry for proceedings held before Magistrate Judge Mark A. Beatty: Telephonic Status Conference held on 3/8/2019. Attorney Scott Lerner appears on behalf of Plaintiffs. Attorneys Lisa Cook, Christopher Higgerson, and Joseph Okon appear on behalf of Defendants. Defendants are directed to complete document production on or before 4/5/2019. The parties will submit a joint amended schedule with an agreed proposed deadline for the class certification motion of 5/10/2019. A status conference will be set by further order of the Court. (Court Reporter: proceedings not recorded.) (Court Reporter proceedings not recorded.) (arf) (Entered: 03/12/2019)
119 NOTICE of Hearing:Telephonic Status Conference set for 5/30/2019 at 3:00 PM in East St. Louis Courthouse before Magistrate Judge Mark A. Beatty. Instructions for placing the conference call are as follows: Call toll free 877−336−1829; when prompted enter Access Code 4442281; followed by Security Code 7863. (arf)THIS TEXT ENTRY IS AN ORDER OF THE COURT. NO FURTHER DOCUMENTATION WILL BE MAILED. (Entered: 03/12/2019)
120 AMENDED SCHEDULING AND DISCOVERY ORDER: Plaintiffs' motion for class certification due 5/10/2019. Signed by Magistrate Judge Mark A. Beatty on 4/15/2019. (Attachments: # 1 Amended Joint Report of the Parties)(arf) (Entered: 04/15/2019)

Case: 3:18-cv-156 As of: 03/10/2020 09:57 AM CDT 22 of 29

04/16/2019 04/24/2019 04/30/2019 05/02/2019
05/02/2019
05/02/2019 05/02/2019 05/02/2019 05/09/2019
05/15/2019 05/21/2019
05/23/2019 05/24/2019

Plaintiffs' motion for class certification due 5/10/2019 − Action due by 5/10/2019. (cjo) (Entered: 04/16/2019)
121 MOTION for Leave to File Excess Pages Unopposed Motion Requesting Additional Pages for Preliminary Injunction Motion and Memorandum by All Plaintiffs. (Lerner, Scott) (Entered: 04/24/2019)
122 ORDER GRANTING 121 Motion for Leave to File Excess Pages. Plaintiffs are permitted 35 pages for their motion and memorandum in support of a preliminary injunction. Signed by Chief Judge Nancy J. Rosenstengel on 4/30/2019. (jmp2)THIS TEXT ENTRY IS AN ORDER OF THE COURT. NO FURTHER DOCUMENTATION WILL BE MAILED. (Entered: 04/30/2019)
123 MOTION for Preliminary Injunction by All Plaintiffs. (Attachments: # 1 Declaration of Dr. Randi Ettner, # 2 Declaration of Dr. Vin Tangpricha, # 3 Declaration of Janiah Monroe, # 4 Declaration of Marilyn Melendez, # 5 Declaration of Lydia Helena Vision, # 6 Declaration of Sora Kuykendall, # 7 Declaration of Sasha Reed, # 8 Exhibit 1, # 9 Exhibit 2, # 10 Exhibit 3, # 11 Exhibit 4, # 12 Exhibit 5, # 13 Exhibit 6, # 14 Exhibit 7, # 15 Exhibit 8, # 16 Exhibit 9, # 17 Exhibit 10, # 18 Exhibit 11, # 19 Exhibit 12, # 20 Exhibit 13, # 21 Exhibit 14, # 22 Exhibit 15)(Heinz, Jordan) Exhibits 11−15 replaced per Order at doc. 142. Docket modified on 6/11/2019 (jlrr). (Entered: 05/02/2019)
124 MOTION to Certify Class by All Plaintiffs. Responses due by 6/6/2019 (Attachments: # 1 Declaration of Dr. Randi Ettner, # 2 Declaration of Dr. Vin Tangpricha, # 3 Declaration of Janiah Monroe, # 4 Declaration of Marilyn Melendez, # 5 Declaration of Lydia Helena Vision, # 6 Declaration of Sora Kuykendall, # 7 Declaration of Sasha Reed, # 8 Exhibit 1, # 9 Exhibit 2, # 10 Exhibit 3, # 11 Exhibit 4, # 12 Exhibit 5, # 13 Exhibit 6, # 14 Exhibit 7, # 15 Exhibit 8, # 16 Exhibit 9, # 17 Exhibit 10)(Heinz, Jordan) (Entered: 05/02/2019)
125 MOTION to Seal Plaintiffs' Motion for Leave to File Documents Under Seal by All Plaintiffs. (Heinz, Jordan) (Entered: 05/02/2019)
126 Sealed Document re 123 Motion for Preliminary Injunction,, by All Plaintiffs. (Attachments: # 1 Exhibit 11, # 2 Exhibit 12, # 3 Exhibit 13, # 4 Exhibit 14, # 5 Exhibit 15)(Heinz, Jordan) (Entered: 05/02/2019)
127 Sealed Document re 124 Motion to Certify Class,, by All Plaintiffs. (Attachments: # 1 Exhibit 1, # 2 Exhibit 2, # 3 Exhibit 3)(Heinz, Jordan) (Entered: 05/02/2019)
128 ORDER: A Telephonic Status Conference with all counsel is set for 5/15/2019 at 2:00 PM before Chief Judge Nancy J. Rosenstengel. Instructions for the conference call are as follows: (1) call toll−free, 877−336−1831; (2) when prompted, enter the seven−digit Access Code: 9139610; (3) when prompted, enter the four−digit Security Code: 9342. Signed by Chief Judge Nancy J. Rosenstengel on 5/9/2019. (drb)THIS TEXT ENTRY IS AN ORDER OF THE COURT. NO FURTHER DOCUMENTATION WILL BE MAILED. (Entered: 05/09/2019)
129 Minute Entry for proceedings held before Chief Judge Nancy J. Rosenstengel: Telephonic Status Conference held on 5/15/2019. (Court Reporter Molly Clayton.) (drb) (Entered: 05/15/2019)
130 NOTICE of Hearing: The Telephonic Status Conference set 5/30/2019 is RESET for 6/19/2019 at 2:00 PM in East St. Louis Courthouse before Magistrate Judge Mark A. Beatty. Instructions for placing the conference call are as follows: Call toll free 877−336−1829; when prompted enter Access Code 4442281; followed by Security Code 7863. (arf)THIS TEXT ENTRY IS AN ORDER OF THE COURT. NO FURTHER DOCUMENTATION WILL BE MAILED. (Entered: 05/21/2019)
131 MOTION to Appear Pro Hac Vice by Attorney Brent P. Ray $200 fee paid,receipt number 0754−3888308 by on behalf of All Plaintiffs. (Ray, Brent) (Entered: 05/23/2019)
132 ORDER granting 131 Motion to Appear Pro Hac Vice filed by Attorney Brent P. Ray on behalf of All Plaintiffs. (cjo)THIS TEXT ENTRY IS AN ORDER OF THE COURT. NO FURTHER DOCUMENTATION WILL BE MAILED. (Entered: 05/24/2019)

Case: 3:18-cv-156 As of: 03/10/2020 09:57 AM CDT 23 of 29

05/24/2019 05/30/2019 05/30/2019 05/31/2019 05/31/2019 06/03/2019 06/03/2019
06/04/2019 06/05/2019
06/06/2019 06/07/2019
06/07/2019

133 NOTICE of Appearance by Brent P. Ray on behalf of All Plaintiffs (Ray, Brent) (Entered: 05/24/2019)
134 MOTION to Withdraw as Attorney by All Plaintiffs. (Lerner, Scott) (Entered: 05/30/2019)
135 Second MOTION for Extension of Time to File Response/Reply as to 123 MOTION for Preliminary Injunction by John Baldwin, Melvin Hinton, Steve Meeks. (Cook, Lisa) (Entered: 05/30/2019)
136 ORDER GRANTING 134 Motion to Withdraw as Attorney. Attorney Scott H. Lerner terminated as counsel of record for Plaintiffs. Signed by Magistrate Judge Mark A. Beatty on 5/31/2019. (klh2)THIS TEXT ENTRY IS AN ORDER OF THE COURT. NO FURTHER DOCUMENTATION WILL BE MAILED. (Entered: 05/31/2019)
137 ORDER: If Plaintiffs wish to respond or otherwise object to 135 Defendants' Second MOTION for Extension of Time, such response is due on or before June 5, 2019. Signed by Magistrate Judge Mark A. Beatty on 5/31/2019. (klh2)THIS TEXT ENTRY IS AN ORDER OF THE COURT. NO FURTHER DOCUMENTATION WILL BE MAILED. (Entered: 05/31/2019)
Set/Reset Deadlines as to 135 Second MOTION for Extension of Time to File Response/Reply as to 123 MOTION for Preliminary Injunction . Responses due by 6/5/2019 (kls3) (Entered: 06/03/2019)
138 ORDER: By agreement of the parties, a hearing as to 123 Motion for Preliminary Injunction is set for July 31, 2019 and August 1, 2019 at 9:30 AM in East St. Louis Courthouse before Chief Judge Nancy J. Rosenstengel. Counsel is instructed to email Deana Brinkley, Courtroom Deputy, at deana_brinkley@ilsd.uscourts.gov with the names of plaintiffs and/or witnesses who will need to appear at this hearing either in person or by video conference. Signed by Chief Judge Nancy J. Rosenstengel on 6/3/2019. (drb)THIS TEXT ENTRY IS AN ORDER OF THE COURT. NO FURTHER DOCUMENTATION WILL BE MAILED. (Entered: 06/03/2019)
139 RESPONSE to 135 Motion for Extension of Time to File Response/Reply, 137 Order, Plaintiffs' Non−Opposition and Response to Defendants' Second Motion for Extension of Time to Respond to Plaintiffs' Motion for Preliminary Injunction filed by All Plaintiffs. (Ray, Brent) (Entered: 06/04/2019)
140 ORDER GRANTING 135 Second Motion for Extension of Time to File Response. Defendants' response to 123 Motion for Preliminary Injunction is now due on or before June 13, 2019. Any further extensions are unlikely to be granted because the Court needs to allow sufficient time for Plaintiffs to file their reply brief and to review the parties submissions in advance of the motion hearing set to begin on July 31, 2019 (Docs. 129, 138). Plaintiffs' reply, if any, is due on or before June 20, 2019. Signed by Chief Judge Nancy J. Rosenstengel on 6/5/2019. (jmp2)THIS TEXT ENTRY IS AN ORDER OF THE COURT. NO FURTHER DOCUMENTATION WILL BE MAILED. (Entered: 06/05/2019)
Reset Deadlines as to 123 MOTION for Preliminary Injunction . Responses due by 6/13/2019 Replies due by 6/20/2019. (cjo) (Entered: 06/06/2019)
141 NOTICE of Hearing: Telephonic Status Conference RESET for 9/3/2019 at 3:30 PM in East St. Louis Courthouse before Magistrate Judge Mark A. Beatty. Instructions for placing the conference call are as follows: Call toll free 877−336−1829; when prompted enter Access Code 4442281; followed by Security Code 7863. (arf)THIS TEXT ENTRY IS AN ORDER OF THE COURT. NO FURTHER DOCUMENTATION WILL BE MAILED. (Entered: 06/07/2019)
142 ORDER GRANTING in part and DENYING in part 125 Motion to Seal: The motion is GRANTED as to Exhibits 1−3 of the Motion to Certify Class. The motion is DENIED as to Exhibits 11−15 of the Motion for Preliminary Injunction. The Clerk of Court is DIRECTED to replace Exhibits 11−15 to the Motion for Preliminary Injunction (Doc. 123) with those filed under seal at Doc. 126 (omitting the first page of each sealed exhibit). The exhibits to the Motion to Certify Class (Doc. 124) shall remain sealed at Doc. 127. Signed by Chief Judge Nancy J. Rosenstengel on 6/7/2019. (jmp2) (Entered: 06/07/2019)

Case: 3:18-cv-156 As of: 03/10/2020 09:57 AM CDT 24 of 29

06/13/2019 06/14/2019 06/14/2019 06/17/2019
06/20/2019 06/26/2019
06/28/2019 07/30/2019 07/31/2019
07/31/2019 07/31/2019 08/01/2019 08/08/2019

143 RESPONSE to Motion re 123 MOTION for Preliminary Injunction filed by John Baldwin, Melvin Hinton, Steve Meeks. (Attachments: # 1 Exhibit 1, # 2 Exhibit 2, # 3 Exhibit 3, # 4 Exhibit 4)(Cook, Lisa) (Attachment 3 replaced on 7/31/2019) (jlrr). (Entered: 06/13/2019)
144 MOTION for Leave to File Excess Pages Unopposed Motion Requesting Additional Pages for Plaintiffs' Reply in Support of Motion for a Preliminary Injunction by All Plaintiffs. (Ray, Brent) (Entered: 06/14/2019)
145 RESPONSE to Motion re 124 MOTION to Certify Class filed by John Baldwin, Melvin Hinton, Steve Meeks. (Attachments: # 1 Exhibit 1)(Cook, Lisa) (Entered: 06/14/2019)
146 ORDER GRANTING 144 Motion for Leave to File Excess Pages: Plaintiffs' reply to Defendants' response to the motion for preliminary injunction shall not exceed 10 pages. Signed by Chief Judge Nancy J. Rosenstengel on 6/17/2019. (jmp2)THIS TEXT ENTRY IS AN ORDER OF THE COURT. NO FURTHER DOCUMENTATION WILL BE MAILED. (Entered: 06/17/2019)
147 REPLY to Response to Motion re 123 MOTION for Preliminary Injunction filed by All Plaintiffs. (Attachments: # 1 Exhibit 1)(Ray, Brent) (Entered: 06/20/2019)
148 ORDER: The Court has set aside July 31 and August 1, 2019 to hear 123 Motion for Preliminary Injunction. Counsel for Plaintiffs are ORDERED to submit a witness list to Deana Brinkley, courtroom deputy, on or before July 3, 2019. The list should consist of the name of the witness, inmate number, and whether or not the witness shall appear in person or via video conference. Failure to submit this list will result in the cancellation of the hearing. Signed by Chief Judge Nancy J. Rosenstengel on 6/26/2019. (drb)THIS TEXT ENTRY IS AN ORDER OF THE COURT. NO FURTHER DOCUMENTATION WILL BE MAILED. (Entered: 06/26/2019)
149 REPLY to Response to Motion re 124 MOTION to Certify Class filed by All Plaintiffs. (Ray, Brent) (Entered: 06/28/2019)
152 MOTION To Substitute Exhibit 3 of Their Response to Plaintiff's Motion for Preliminary Injunction re 143 Response to Motion by John Baldwin, Melvin Hinton, Steve Meeks. (Cook, Lisa) (Entered: 07/30/2019)
153 ORDER,GRANTING 152 Motion To Substitute Exhibit 3 of Their Response to Plaintiff's Motion for Preliminary Injunction re 143 Response to Motion. Signed by Chief Judge Nancy J. Rosenstengel on 7/31/2019. (drb)THIS TEXT ENTRY IS AN ORDER OF THE COURT. NO FURTHER DOCUMENTATION WILL BE MAILED. (Entered: 07/31/2019)
154 NOTICE OF MODIFICATION re 143 Response to Motion, filed by Melvin Hinton, Steve Meeks, John Baldwin. Pursuant to the Order at docket entry 153, Exhibit 143−3 has been replaced with the attached copy. No further action required by the parties at this time. (jlrr) (Entered: 07/31/2019)
155 Minute Entry for proceedings held before Chief Judge Nancy J. Rosenstengel: Day 1 of Preliminary Injunction Hearing held on 7/31/2019. Day 2 of hearing is set for 8/1/2019 at 9:30 AM in East St. Louis Courthouse before Chief Judge Nancy J. Rosenstengel. (Court Reporter Molly Clayton.) (drb) (Entered: 07/31/2019)
156 Minute Entry for proceedings held before Chief Judge Nancy J. Rosenstengel: Day 2 of Preliminary Injunction Hearing held on 8/1/2019. Motion taken under advisement. (Court Reporter Molly Clayton.) (drb) (Entered: 08/02/2019)
157 Transcript of Day 1 of Preliminary Injunction Hearing (pgs. 1 − 224) held on 7/31/2019, before Judge Nancy J. Rosenstengel. Court Reporter Molly Clayton, Telephone number 618.482.9226.

NOTICE: Attorneys and unrepresented parties have 7 calendar days to file a Notice of Intent to Request Redaction of this transcript and 21 calendar days to file a Redaction Request. If redactions are not requested, the transcript will be made remotely available to the public without redaction after 90 calendar days. See the full Transcript Policy on the website at http://www.ilsd.uscourts.gov/forms/TransPolicy.pdf

Case: 3:18-cv-156 As of: 03/10/2020 09:57 AM CDT 25 of 29

08/08/2019

Transcript may be viewed at the public terminal or purchased through the Court Reporter before the deadline for Release of Transcript Restriction. After that date it may be obtained through PACER. Redaction Request due 8/29/2019. Redacted Transcript Deadline set for 9/9/2019. Release of Transcript Restriction set for 11/6/2019. (mnc) (Entered: 08/08/2019)
158 Transcript of Day 2 of Preliminary Injunction Hearing (pgs 225−417) held on 8/01/2019, before Judge Nancy J. Rosenstengel. Court Reporter Molly Clayton, Telephone number 618.482.9226.

NOTICE: Attorneys and unrepresented parties have 7 calendar days to file a Notice of Intent to Request Redaction of this transcript and 21 calendar days to file a Redaction Request. If redactions are not requested, the transcript will be made remotely available to the public without redaction after 90 calendar days. See the full Transcript Policy on the website at http://www.ilsd.uscourts.gov/forms/TransPolicy.pdf

08/21/2019 08/22/2019 08/26/2019 08/27/2019 09/03/2019
09/03/2019

Transcript may be viewed at the public terminal or purchased through the Court Reporter before the deadline for Release of Transcript Restriction. After that date it may be obtained through PACER. Redaction Request due 8/29/2019. Redacted Transcript Deadline set for 9/9/2019. Release of Transcript Restriction set for 11/6/2019. (mnc) (Entered: 08/08/2019)
159 MOTION for Leave to File Excess Pages Joint Motion Requesting Additional Pages for Parties' Proposed Findings of Fact and Conclusions of Law by All Plaintiffs. (Ray, Brent) (Entered: 08/21/2019)
160 ORDER GRANTING 159 Motion for Leave to File Excess Pages: The parties' proposed findings of fact and conclusions of law shall not exceed thirty pages. Signed by Chief Judge Nancy J. Rosenstengel on 8/22/2019. (jmp2)THIS TEXT ENTRY IS AN ORDER OF THE COURT. NO FURTHER DOCUMENTATION WILL BE MAILED. (Entered: 08/22/2019)
161 NOTICE of Appearance by Camille E. Bennett on behalf of Sora Kuykendall, Janiah Monroe, Sasha Reed, Lydia Helena Vision, and Marilyn Melendez . (Bennett, Camille) Modified on 8/27/2019 (cjo). (Entered: 08/26/2019)
162 NOTICE OF MODIFICATION re 161 Notice of Appearance filed by Lydia Helena Vision, Sora Kuykendall, Sasha Reed, Janiah Monroe. Filer failed to select party Marilyn Melendez as a filer and therefore counsel is not associated to Marilyn Melendez on the docket. Clerk's office modified docket text to include the party and associated counsel to the party as necessary. No further action is required by the filer in relation to this notification. (cjo)THIS TEXT ENTRY IS AN ORDER OF THE COURT. NO FURTHER DOCUMENTATION WILL BE MAILED. (Entered: 08/27/2019)
163 Minute Entry for proceedings held before Magistrate Judge Mark A. Beatty: Telephonic Status Conference held on 9/3/2019. Attorneys Austin Stephenson, Brent Ray, Carolyn Wald, Ghirlandi Guidetti, Samantha Rose, and Jordan Heinz appear on behalf of Plaintiffs. Attorney Christopher Higgerson appears on behalf of Defendants. The Court will cancel the settlement conference set 10/8/2019 due to it being premature. Plaintiffs request a date certain for document production. The parties are directed to meet and confer regarding this discovery issue. If the parties cannot agree on a deadline and the parameters for the deadline, they may contact the Court to schedule a discovery dispute conference. The parties are reminded that interim discovery deadlines do not require Court approval. Upon Plaintiffs' request, Defendants agree to prioritize the production of Plaintiff Janiah Monroe's medical records. A status conference will be set by further order of the Court. (Court Reporter: proceedings not recorded.) (arf)THIS TEXT ENTRY IS AN ORDER OF THE COURT. NO FURTHER DOCUMENTATION WILL BE MAILED. (Entered: 09/03/2019)
164 NOTICE of Hearing: Telephonic Status Conference set for 12/4/2019 at 3:00 PM in East St. Louis Courthouse before Magistrate Judge Mark A. Beatty. Instructions for placing the conference call are as follows: Call toll free 877−336−1829; when prompted enter Access Code 4442281; followed by Security Code 7863. (arf)THIS

Case: 3:18-cv-156 As of: 03/10/2020 09:57 AM CDT 26 of 29

09/03/2019 09/23/2019 09/24/2019 09/25/2019 09/26/2019 09/26/2019 09/26/2019 10/10/2019 10/11/2019
10/11/2019 10/17/2019
10/17/2019

TEXT ENTRY IS AN ORDER OF THE COURT. NO FURTHER DOCUMENTATION WILL BE MAILED. (Entered: 09/03/2019)
165 NOTICE OF CANCELLATION of Hearing: The Settlement Conference set 10/8/2019 is CANCELLED. (arf)THIS TEXT ENTRY IS AN ORDER OF THE COURT. NO FURTHER DOCUMENTATION WILL BE MAILED. (Entered: 09/03/2019)
166 MOTION to Supplement Plaintiffs' Motion for Leave to Supplement Preliminary Injunction Record by All Plaintiffs. (Attachments: # 1 Exhibit 1 − Supplemental Declaration of Dr. Randi Ettner, # 2 Exhibit 2 − Supplemental Declaration of Janiah Monroe)(Heinz, Jordan) (Entered: 09/23/2019)
167 ORDER: Defendants are DIRECTED to respond to Plaintiffs' motion to supplement (Doc. 166) on or before September 26, 2019 at 12 p.m. Signed by Chief Judge Nancy J. Rosenstengel on 9/24/2019. (jmp2)THIS TEXT ENTRY IS AN ORDER OF THE COURT. NO FURTHER DOCUMENTATION WILL BE MAILED. (Entered: 09/24/2019)
Set Deadlines as to 166 MOTION to Supplement. Response due by 9/26/2019 at 12 p.m. (kek) (Entered: 09/25/2019)
168 OBJECTION to 166 Motion to Supplement, by John Baldwin, Melvin Hinton, Steve Meeks . (Attachments: # 1 Exhibit 1)(Cook, Lisa) (Entered: 09/26/2019)
169 Sealed Document EXHIBIT 2 re 168 Objection by John Baldwin, Melvin Hinton, Steve Meeks. (Cook, Lisa) (Entered: 09/26/2019)
170 Sealed Document EXHIBIT 3 re 168 Objection by John Baldwin, Melvin Hinton, Steve Meeks. (Cook, Lisa) (Entered: 09/26/2019)
171 MOTION to Terminate Counsel by John Baldwin, Melvin Hinton, Steve Meeks. (Cook, Lisa) (Entered: 10/10/2019)
172 NOTICE of Hearing: Telephonic Discovery Dispute Conference set for 10/17/2019 at 10:00 AM in East St. Louis Courthouse before Magistrate Judge Mark A. Beatty. Instructions for joining the conference call are as follows: Call toll free 877−336−1829; when prompted enter Access Code 4442281; followed by Security Code 2779.(arf)THIS TEXT ENTRY IS AN ORDER OF THE COURT. NO FURTHER DOCUMENTATION WILL BE MAILED. (Entered: 10/11/2019)
173 ORDER GRANTING 171 Motion to Terminate Counsel. Attorney Joseph E. Okon is TERMINATED as counsel of record for Defendants. Signed by Magistrate Judge Mark A. Beatty on 10/11/2019. (klh2)THIS TEXT ENTRY IS AN ORDER OF THE COURT. NO FURTHER DOCUMENTATION WILL BE MAILED. (Entered: 10/11/2019)
174 Minute Entry for proceedings held before Magistrate Judge Mark A. Beatty: Telephonic Discovery Dispute Conference held on 10/17/2019. Austin Stephenson, Brent Ray, Ghirlandi Guidetti, and Samantha Rose appear on behalf of Plaintiffs. Chris Higgerson and Lisa Cook appear on behalf of Defendants. The Court enforces Paragraph 1 of the Scheduling and Discovery Order as written. Discovery prior to class certification must be sufficient to permit the Court to determine whether the requirements of Federal Rule of Civil Procedure 23 are satisfied, including a sufficient inquiry into the merits of the case to ensure appropriate management of the case as a class action. This has been completed, given that Plaintiffs have filed their motion for class certification, which is pending before Chief Judge Rosenstengel. The Court will not allow Plaintiffs to proceed with the merits based discovery they seeks at this time while class certification is pending therefore Plaintiffs request to compel discovery is denied at this time. The Court will set this matter for status conference at a later date by separate notice.(Court Reporter Liberty Recording.) (lmt)THIS TEXT ENTRY IS AN ORDER OF THE COURT. NO FURTHER DOCUMENTATION WILL BE MAILED. (Entered: 10/17/2019)
175 MOTION to Supplement Plaintiffs' Second Motion for Leave to Supplement Preliminary Injunction Record by All Plaintiffs. (Attachments: # 1 Exhibit 1, # 2 Exhibit 2, # 3 Exhibit 3)(Heinz, Jordan) (Entered: 10/17/2019)

Case: 3:18-cv-156 As of: 03/10/2020 09:57 AM CDT 27 of 29

10/18/2019
10/22/2019 10/22/2019 10/22/2019 10/24/2019
11/15/2019 11/18/2019
12/02/2019 12/04/2019
12/17/2019 12/19/2019
12/19/2019 12/20/2019 12/20/2019 01/06/2020

176 ORDER: Defendants are DIRECTED to respond to Plaintiffs' motion to supplement (Doc. 175) on or before October 22, 2019 at 5 p.m. Signed by Chief Judge Nancy J. Rosenstengel on 10/18/2019. (anb2)THIS TEXT ENTRY IS AN ORDER OF THE COURT. NO FURTHER DOCUMENTATION WILL BE MAILED. (Entered: 10/18/2019)
177 NOTICE by Janiah Monroe re 175 MOTION to Supplement Plaintiffs' Second Motion for Leave to Supplement Preliminary Injunction Record Declaration of Janiah Monroe in Support of Plaintiffs' Second Motion for Leave to Supplement Preliminary Injunction Record (Heinz, Jordan) (Entered: 10/22/2019)
178 RESPONSE in Opposition re 175 MOTION to Supplement Plaintiffs' Second Motion for Leave to Supplement Preliminary Injunction Record filed by John Baldwin, Melvin Hinton, Steve Meeks. (Attachments: # 1 Exhibit 2, # 2 Exhibit 3)(Cook, Lisa) (Entered: 10/22/2019)
179 Sealed Document Exhibit 4 re 178 Response in Opposition to Motion, by John Baldwin, Melvin Hinton, Steve Meeks. (Cook, Lisa) (Entered: 10/22/2019)
180 NOTICE of Hearing: Per Document 164 , a Telephonic Status Conference remains set for 12/4/2019 at 3:00 PM in East St. Louis Courthouse before Magistrate Judge Mark A. Beatty. Instructions for placing the conference call are as follows: Call toll free 877−336−1829; when prompted enter Access Code 4442281; followed by Security Code 7863. (arf)THIS TEXT ENTRY IS AN ORDER OF THE COURT. NO FURTHER DOCUMENTATION WILL BE MAILED. (Entered: 10/24/2019)
181 MOTION to Withdraw as Attorney by All Plaintiffs. (Custard, Cameron) (Entered: 11/15/2019)
182 ORDER GRANTING 181 Motion to Withdraw as Attorney. Attorney Cameron N. Custard terminated as counsel of record for Plaintiffs. Signed by Magistrate Judge Mark A. Beatty on 11/18/2019. (klh2)THIS TEXT ENTRY IS AN ORDER OF THE COURT. NO FURTHER DOCUMENTATION WILL BE MAILED. (Entered: 11/18/2019)
183 NOTICE OF CANCELATION of Hearing: On the Court's own motion, the Telephonic Status Conference set 12/4/2019 at 3:00 p.m. is CANCELED. (arf)THIS TEXT ENTRY IS AN ORDER OF THE COURT. NO FURTHER DOCUMENTATION WILL BE MAILED. (Entered: 12/02/2019)
184 ORDER: Pursuant to Administrative Order 257, effective immediately, this case will no longer be referred to a Magistrate Judge for pretrial proceedings. Magistrate Judge Mark A. Beatty no longer assigned to case. All future documents must bear case number 18−156−NJR. Signed by Chief Judge Nancy J. Rosenstengel on 12/4/2019. (jaj)THIS TEXT ENTRY IS AN ORDER OF THE COURT. NO FURTHER DOCUMENTATION WILL BE MAILED. (Entered: 12/04/2019)
185 MOTION for status Plaintiffs' Unopposed Motion for Status Conference by All Plaintiffs. (Heinz, Jordan) (Entered: 12/17/2019)
186 ORDER: The 123 Motion for Preliminary Injunction filed by Plaintiffs is GRANTED. See attached Order for further details. Plaintiffs' motions for leave to supplement the record (Docs. 166 , 175 ) and Motion for Status Conference (Doc. 185 ) are DENIED. Signed by Chief Judge Nancy J. Rosenstengel on 12/19/2019. (mlp) (Entered: 12/19/2019)
187 VACATED PRELIMINARY INJUNCTION. Signed by Chief Judge Nancy J. Rosenstengel on 12/19/2019. (mlp) Modified on 3/5/2020 (ack). (Entered: 12/19/2019)
Set/Reset Deadlines: Action due by 1/6/2020, per Order at Doc. 186. (kls3) (Entered: 12/20/2019)
Status Report due from defendants by 1/22/2020, per Order at Doc.186. (kls3) (Entered: 12/20/2019)
188 NOTICE by All Plaintiffs re 186 Order,, Terminate Motions,, Set Deadlines, Plaintiffs' Court−Ordered Update Regarding Janiah Monroe's Condition (Attachments: # 1 Exhibit A)(Heinz, Jordan) (Entered: 01/06/2020)

Case: 3:18-cv-156 As of: 03/10/2020 09:57 AM CDT 28 of 29

01/06/2020 01/06/2020 01/06/2020 01/07/2020
01/07/2020 01/07/2020 01/07/2020
01/07/2020 01/07/2020 01/14/2020
01/15/2020
01/15/2020 01/15/2020 01/22/2020 01/29/2020 01/31/2020

189 NOTICE by All Plaintiffs re 188 Notice (Other) Declaration of Dr. Randi Ettner in Support of Plaintiffs' Court−Ordered Update Regarding Janiah Monroe's Condition (Heinz, Jordan) (Entered: 01/06/2020)
190 NOTICE of Appearance by Amelia H. Bailey on behalf of All Plaintiffs (Bailey, Amelia) (Entered: 01/06/2020)
191 MOTION for Extension of Time to Read Transcripts and Certify by John Baldwin, Melvin Hinton, Steve Meeks. (Cook, Lisa) (Entered: 01/06/2020)
192 ORDER granting 191 Motion for Extension of Time. Defendants shall read the transcript of the evidentiary hearing held on July 31−August 1, 2019, and certify that they have done so by January 14, 2020. Signed by Chief Judge Nancy J. Rosenstengel on 1/7/2020. (jrj)THIS TEXT ENTRY IS AN ORDER OF THE COURT. NO FURTHER DOCUMENTATION WILL BE MAILED. (Entered: 01/07/2020)
193 MOTION to Appear Pro Hac Vice by Attorney Anne J. Hudson $200 fee paid,receipt number 0754−4078309 by on behalf of All Plaintiffs. (Hudson, Anne) (Entered: 01/07/2020)
194 MOTION to Appear Pro Hac Vice by Attorney Thomas J. Leahy $200 fee paid,receipt number 0754−4078319 by on behalf of All Plaintiffs. (Leahy, Thomas) (Entered: 01/07/2020)
195 ORDER granting 193 Motion to Appear Pro Hac Vice as to Attorney Anne J. Hudson and granting 194 Motion to Appear Pro Hac Vice as to Attorney Thomas J. Leahy. (ack)THIS TEXT ENTRY IS AN ORDER OF THE COURT. NO FURTHER DOCUMENTATION WILL BE MAILED. (Entered: 01/07/2020)
196 NOTICE of Appearance by Anne J. Hudson on behalf of All Plaintiffs (Hudson, Anne) (Entered: 01/07/2020)
197 NOTICE of Appearance by Thomas J. Leahy on behalf of All Plaintiffs (Leahy, Thomas) (Entered: 01/07/2020)
198 STRICKEN NOTICE by John Baldwin, Melvin Hinton, Steve Meeks re 186 Order,, Terminate Motions,, Set Deadlines, (Attachments: # 1 Exhibit Certification, # 2 Exhibit Certification, # 3 Exhibit Certification)(Cook, Lisa) Modified on 1/15/2020 (ack). (Entered: 01/14/2020)
199 NOTICE STRIKING ELECTRONICALLY FILED DOCUMENTS striking 198 Notice (Other) filed by Melvin Hinton, Steve Meeks, John Baldwin. Document contains a defendant that is not a party to the case. In addition, this document also includes Attorney Kwame Raoul, who is not council of record. E−filer is instructed to re−file a corrected version. (ack)THIS TEXT ENTRY IS AN ORDER OF THE COURT. NO FURTHER DOCUMENTATION WILL BE MAILED. (Entered: 01/15/2020)
200 MOTION to Substitute Party by John Baldwin, Melvin Hinton, Steve Meeks. (Higgerson, Christopher) (Entered: 01/15/2020)
201 NOTICE by John Baldwin, Melvin Hinton, Steve Meeks re 186 Order,, Terminate Motions,, Set Deadlines, (Cook, Lisa) (Entered: 01/15/2020)
202 RESPONSE to 186 Order,, Terminate Motions,, Set Deadlines, 187 Order filed by John Baldwin, Melvin Hinton, Steve Meeks. (Attachments: # 1 Exhibit)(Cook, Lisa) (Entered: 01/22/2020)
203 MOTION for Reconsideration re 186 Order,, Terminate Motions,, Set Deadlines, 187 Order by Melvin Hinton, Steve Meeks. (Cook, Lisa) (Entered: 01/29/2020)
204 Order: Plaintiffs shall have until February 14, 2020, to file a reply, if at all, to Defendants' Report on Compliance with Preliminary Injunction Orders (Doc. 202 ). Responses to the Motion for Reconsideration (Doc. 203 ) filed by Defendants shall be filed in accordance with Local Rule 7.1(g). Motion to Substitute Party (Doc. 200 ) is GRANTED. Rob Jeffreys is SUBSTITUTED for John Baldwin. Because the Notice at Doc. 198 was stricken, Defendants are ORDERED to refile Defendants' certifications attesting that they read the transcripts form the hearing beginning on July 31, 2019. Signed by Chief Judge Nancy J. Rosenstengel on 1/31/2020. (jrj)THIS TEXT ENTRY

Case: 3:18-cv-156 As of: 03/10/2020 09:57 AM CDT 29 of 29

02/04/2020 02/11/2020 02/14/2020 02/21/2020 02/24/2020
02/28/2020 03/04/2020
03/04/2020 03/04/2020 03/04/2020

IS AN ORDER OF THE COURT. NO FURTHER DOCUMENTATION WILL BE MAILED. (Entered: 01/31/2020)
205 EXHIBIT by Melvin Hinton, Steve Meeks. Exhibit to 201 Notice (Other) . (Attachments: # 1 Exhibit, # 2 Exhibit)(Cook, Lisa) (Entered: 02/04/2020)
206 RESPONSE to Motion re 203 MOTION for Reconsideration re 186 Order,, Terminate Motions,, Set Deadlines, 187 Order filed by All Plaintiffs. (Heinz, Jordan) (Entered: 02/11/2020)
207 RESPONSE to 202 Response Plaintiffs' Response to Defendants' Report on Compliance with the Court's Preliminary Injunction Order filed by All Plaintiffs. (Attachments: # 1 Exhibit A)(Heinz, Jordan) (Entered: 02/14/2020)
208 MOTION for Extension of Time to File Response/Reply as to 207 Response, 202 Response to Report on Compliance by Melvin Hinton, Rob Jeffreys, Steve Meeks. (Cook, Lisa) (Entered: 02/21/2020)
209 ORDER granting 208 Motion for Extension of Time. Defendants are ordered to file a reply to 207 Plaintiffs' Response to 202 Defendants' Report on Compliance, if at all, by February 28, 2020. In addition to any arguments Defendants may wish to present to the Court, Defendants' are ORDERED to address and reply to Plaintiffs' request for a court−appointed medical expert to oversee implementation of the preliminary injunctive order. Signed by Chief Judge Nancy J. Rosenstengel on 2/24/2020. (jrj)THIS TEXT ENTRY IS AN ORDER OF THE COURT. NO FURTHER DOCUMENTATION WILL BE MAILED. (Entered: 02/24/2020)
210 RESPONSE Reply re Report on Compliance filed by Melvin Hinton, Rob Jeffreys, Steve Meeks. (Attachments: # 1 Exhibit 1)(Cook, Lisa) (Entered: 02/28/2020)
211 ORDER: The Court VACATES its previous preliminary injunction order (Doc. 187 ) to the extent that the Order could be construed to enjoin past wrongs for the denial and delay of hormone therapy and GRANTS in part and DENIES in part Defendants' Motion for Reconsideration. (Doc. 203 ). Signed by Chief Judge Nancy J. Rosenstengel on 3/4/2020. (jrj) (Entered: 03/04/2020)
212 AMENDED PRELIMINARY INJUNCTION. Signed by Chief Judge Nancy J. Rosenstengel on 3/4/2020. (jrj) (Entered: 03/04/2020)
213 ORDER granting 124 Motion to Certify Class. Pursuant to this Order, Ebony Stamps is dismissed from this case. Signed by Chief Judge Nancy J. Rosenstengel on 3/4/2020. (jrj) (Entered: 03/04/2020)
214 ORDER: ORDER: In light of the Court granting class certification, the previously imposed stay on merits based discovery is LIFTED. The current final pretrial conference and trial dates are CANCELED. The parties are DIRECTED to meet and confer and submit a joint proposed scheduling order to the Court by March 19, 2020. The proposed order should be emailed to NJRpd@ilsd.uscourts.gov. Signed by Chief Judge Nancy J. Rosenstengel on 3/4/2020. (drb)THIS TEXT ENTRY IS AN ORDER OF THE COURT. NO FURTHER DOCUMENTATION WILL BE MAILED. (Entered: 03/04/2020)

 
 Case 3:18-cv-00156-DRH-DGW Document 1 Filed 01/31/18 Page 1 of 39 Page ID #1

IN THE UNITED STATES DISTRICT COURT FOR THE SOUTHERN DISTRICT OF ILLINOIS

)

JANIAH MONROE, MARILYN MELENDEZ, )

EBONY STAMPS, LYDIA HELÉNA VISION, )

SORA KUYKENDALL, and SASHA REED, )

)

Plaintiffs,

)

)

v.

)

)

BRUCE RAUNER, JOHN BALDWIN,

)

STEVE MEEKS, and MELVIN HINTON, )

)

Defendants.

)

)

Case No. 3:18-cv-156

COMPLAINT

Plaintiffs hereby file this Complaint against Defendants, and state as follows:

PRELIMINARY STATEMENT

1. Plaintiffs are women currently in the custody of the Illinois Department of

Corrections (“IDOC”) who are transgender. Plaintiffs bring this class action on behalf of a class

of all prisoners in the custody of IDOC who have requested from IDOC evaluation or treatment

for gender dysphoria.

2. The Eighth Amendment to the United States Constitution prohibits cruel and

unusual punishment. Failure to properly treat prisoners with serious medical conditions,

including by unreasonably delaying treatment, serves no penological purpose and instead inflicts

pain and suffering in violation of the Constitution. Prison officials therefore have a

constitutional obligation to provide adequate medical care, including mental health care.

3. Gender dysphoria is the condition marked by clinically significant “distress that

may accompany the incongruence between one’s experienced or expressed gender and one’s

assigned gender.” It is recognized as a serious medical condition, including by the American

Case 3:18-cv-00156-DRH-DGW Document 1 Filed 01/31/18 Page 2 of 39 Page ID #2
Medical Association, the American Psychiatric Association, the American Psychological Association, the Endocrine Society, the World Professional Association for Transgender Health, and courts across the country. Treatment for gender dysphoria, often consisting of social transition, hormone therapy, and surgery, is medically necessary for many transgender people.
4. IDOC systematically fails to provide necessary medical treatment for gender dysphoria. Among other common and medically necessary treatments, IDOC routinely fails to provide adequate hormone therapy and to accommodate social transition so that a prisoner can live consistently with his or her gender identity. And while gender affirming surgery also is medically necessary for some patients with gender dysphoria, IDOC has adopted a policy that such surgery can be approved only in “extraordinary circumstances,” which in practice means that IDOC never has approved any prisoner for surgical gender dysphoria treatment. If a prisoner does manage to obtain any medical treatment, it is typically after substantial delay, and the treatment ultimately falls woefully short of accepted medical standards.
5. IDOC further requires that medical care decisions for gender dysphoria be submitted to a “Gender Identity Disorder Committee” (the “GID Committee”)—which centralizes those decisions in the hands of persons who are not specialists in the treatment of gender dysphoria and typically have never examined or even seen the persons whose course of treatment they are deciding. The GID Committee approval process further degrades the quality of medical care provided for gender dysphoria. The GID Committee sometimes denies treatments prescribed by health providers and always introduces additional, and often extreme, delays in receiving medically necessary treatments, causing needless harm, pain, and suffering.
2

Case 3:18-cv-00156-DRH-DGW Document 1 Filed 01/31/18 Page 3 of 39 Page ID #3
6. Plaintiffs accordingly seek declaratory and injunctive relief to force IDOC to provide constitutionally adequate medical treatment for prisoners seeking evaluation and treatment for gender dysphoria.
JURISDICTION AND VENUE 7. Jurisdiction is conferred upon this Court pursuant to 28 U.S.C. § 1331 and 28 U.S.C. § 1343 because the matters in controversy arise under the Constitution and laws of the United States. This civil action seeks declaratory and injunctive relief under 28 U.S.C. §§ 1343, 2201, and 2202 and 42 U.S.C. § 1983. 8. Venue is proper in this Court under 28 U.S.C. § 1391(b) because a substantial part of the events or omissions giving rise to Plaintiffs’ claims occurred in the Southern District of Illinois. 9. One or more of the named Plaintiffs have exhausted administrative remedies reasonably available to them prior to bringing their 42 U.S.C. § 1983 civil rights claims in accordance with the Prison Litigation Reform Act, 42 U.S.C. § 1997(e)(a).
PARTIES I. NAMED PLAINTIFFS
10. Plaintiffs Janiah Monroe, Marilyn Melendez, Ebony Stamps, Lydia Heléna Vision, Sora Kuykendall, and Sasha Reed (collectively, the “Named Plaintiffs”) are transgender women currently incarcerated in IDOC facilities and, like all other prisoners in the class defined below, have requested evaluation or treatment for gender dysphoria and have suffered serious harm and are at substantial risk of suffering additional serious harm as a result of Defendants’ deliberate indifference to their serious medical needs.
11. The Named Plaintiffs do not seek damages in their capacity as proposed class representatives; they seek only declaratory and injunctive relief.
3

Case 3:18-cv-00156-DRH-DGW Document 1 Filed 01/31/18 Page 4 of 39 Page ID #4
Plaintiff Janiah Monroe: 12. Janiah Monroe (Patterson) is 28 years old and was born on the south side of Chicago. She knew she was a girl from a very young age. Janiah’s family was not supportive of her gender identity; her father, who was a pastor, was particularly hostile towards Janiah after she told him she felt like a girl. Around the age of twelve Janiah began dressing in female clothing and taking hormones. 13. Janiah entered IDOC custody at the age of sixteen. During her intake, Janiah informed prison officials that she is transgender. While incarcerated, Janiah has been evaluated by multiple health professionals who repeatedly reconfirmed her diagnosis of gender dysphoria and recommended that she begin hormone therapy. 14. During this waiting period, Janiah experienced increased distress relating to her gender dysphoria. She declared a hunger strike because IDOC refused to provide her with medical treatment. Janiah made several attempts at self-castration, after which in some instances she removed the sutures from the wounds and refused antibiotics with the hope that her genitalia would need to be amputated as a result of infection. Janiah was put in restraints and told that IDOC would not amputate her genitalia. Janiah attempted suicide numerous times as well. Janiah reported to IDOC medical staff that her self-castration and suicide attempts were a result of their failure to provide her with treatment for gender dysphoria. Despite these attempts, Janiah’s diagnosis and treatment recommendations, and her history of living as a woman, Janiah experienced a wait of roughly three years before she received hormone therapy. 15. Even after receiving hormones, Janiah was denied appropriate therapeutic dosages, denied access to a bra, and denied access to a hair removal product. Though Janiah continued to report dysphoria related to her genitalia, and continued to self-harm, she has been
4

Case 3:18-cv-00156-DRH-DGW Document 1 Filed 01/31/18 Page 5 of 39 Page ID #5
continually denied evaluation for gender affirming surgery. Janiah’s request to be considered for transfer to a female facility was denied because she has not had gender affirming surgery.
16. Janiah is now a prisoner at Dixon Correctional Center. She seeks and Defendants have denied her necessary medical treatment for gender dysphoria, including proper hormone treatment, social transition, and surgery.
Plaintiff Marilyn Melendez: 17. Marilyn Melendez grew up in Waukegan, Illinois. From a young age, Marilyn knew that she was a girl. As a child, Marilyn often went into her mother’s room and tried on her mother’s clothes and makeup. She attempted to pierce her own ears. When her mother asked Marilyn whether she preferred to play with toys for boys or girls, Marilyn always chose those toys she perceived as girls’ toys. While many of Marilyn’s family members tried to make Marilyn dress and “act like a boy,” Marilyn’s mother was supportive of her female identity. Marilyn took estrogen and a testosterone blocker in her pre-teen years. 18. Marilyn’s access to hormones was interrupted at the age of 13 because her mother could no longer afford them. Marilyn’s mother warned her that her body would start changing as a result of the cessation. Marilyn became extremely depressed and suffered from serious anxiety when her body began to change and become more masculine in appearance because of puberty. She became distraught when her shoulders began to broaden and she started experiencing more frequent erections; she no longer looked and felt like herself. Marilyn felt confused and upset by the changes in her body, and the teasing from other kids led Marilyn to stand up for herself and get into fights. 19. Marilyn entered the juvenile detention system at age 14. The juvenile detention facility denied Marilyn access to hormone therapy while she was detained in the juvenile prison.
5

Case 3:18-cv-00156-DRH-DGW Document 1 Filed 01/31/18 Page 6 of 39 Page ID #6
20. When Marilyn turned 17, she was transferred from the juvenile facility to the IDOC adult prison system. Marilyn initially hesitated to out herself as transgender because she feared retaliation from other prisoners. After she was transferred to Stateville Correctional Center, she told prison officials that she is transgender and requested treatment for gender dysphoria. IDOC refused her request for hormone treatment because there were no records of her prior hormone treatment. Marilyn continued to request hormone therapy but was denied treatment by the GID Committee.
21. After a prolonged wait, Marilyn eventually was able to start again on hormone therapy. However, Marilyn’s care is not meeting her medical needs. Marilyn has an ongoing and unmet need for a therapeutically appropriate hormone compound, appropriate bloodwork and laboratory testing, and to be evaluated for gender affirming surgery.
22. Marilyn is now a prisoner at Pontiac Correctional Center. She seeks and Defendants have denied her necessary medical treatment for gender dysphoria, including proper hormone dosages, social transition, and gender affirming surgery.
Plaintiff Ebony Stamps: 23. Ebony Stamps grew up on the South Side of Chicago. She came out as gay around age 13, which was also around the time that she became a ward of the state. On one of the occasions when Ebony was placed into foster care, her foster mother was homophobic and sent Ebony to a mental health facility because she believed that there was no such thing as a lesbian, gay, bisexual, or transgender person. Ebony often ran away from her foster care homes and residential facilities because “she couldn’t stay somewhere she couldn’t be who she wanted to be.”
6

Case 3:18-cv-00156-DRH-DGW Document 1 Filed 01/31/18 Page 7 of 39 Page ID #7
24. Ebony ultimately was placed in a residential facility on the north side of Chicago. While living there, Ebony met for the first time in her life a woman who was transgender. Before that meeting, Ebony always assumed that she would grow up to be a woman but Ebony now understood how that could happen—through undergoing a gender transition.
25. The residential facility where Ebony was housed refused to allow her to live as a woman. She was denied hormone therapy, and barred from wearing traditionally feminine clothing. Ebony and other transgender minors in the foster care system protested against these constraints on their right to live according to their gender identity by petitioning the Illinois Department of Child and Family Service (“DCFS”) to change its policies.
26. Ebony ultimately was successful in persuading DCFS to provide her with hormones, gender affirming items, and access to an endocrinologist. This experience propelled Ebony to continue serving as an advocate for LGBT rights, including running a support group for homeless transgender youth.
27. Ebony was detained in Cook County jail starting on April 3, 2013 when she was 22. Ebony was provided hormone therapy during her time in custody there.
28. Ebony entered IDOC custody in 2013, and after a long delay was provided hormone therapy for approximately nine months while at Lawrence Correctional Center—albeit a dosage that was too low and not therapeutically appropriate. Ebony was then sent to Hill Correctional Center in 2016. When Ebony arrived at Hill, prison officials kept her in orientation and out of general population because she was taking hormones. Orientation is usually meant to be a temporary holding area for new prisoners who have just arrived at the prison, who remain there for a couple weeks at the most. However, Ebony was kept there for much longer, and during this time was denied a cellmate and denied opportunities to interact with the rest of the
7

Case 3:18-cv-00156-DRH-DGW Document 1 Filed 01/31/18 Page 8 of 39 Page ID #8
prison’s general population. When Ebony asked why she was being kept in isolation, a prison official informed her that as long as she was on hormones, she would be kept in orientation and isolated. Being kept in social isolation caused Ebony to experience significant distress and depression. Ebony cut off all her hair, stopped coming out of her cell altogether, and refused to take showers.
29. Ultimately, in order to regain social contact, Ebony ceased taking her hormones. Soon after, Ebony was released into general population. Ebony never wanted to stop taking her hormones, but she felt that if she did not have social contact, she would suffer another mental breakdown that she would not survive. Being effectively forced to stop taking her hormones has taken a severe physical and emotional toll on her, causing her to be severely depressed and hopeless about the future.
30. Ebony no longer recognizes the person she sees in the mirror and is terrified that she will never again look like, or be, the woman she was when she entered IDOC custody. She becomes desperate at times, is afraid of another mental breakdown, and is so deeply depressed that she thinks at times about hurting herself.
31. A few months after Ebony was released back into the general population at Hill Correctional Center, she told prison officials she wanted to restart hormone therapy. She was not provided this treatment and filed a grievance documenting her need for hormone therapy and requesting that she be put back on the medication. Yet, she did not receive her hormones while at Hill. Ebony recently was transferred to Graham Correctional Center. She was told that when she arrived at Graham she would have the opportunity to meet with the psychologist and restart her hormone therapy. But Ebony has been at Graham for over three months and IDOC has not resumed her hormone treatment.
8

Case 3:18-cv-00156-DRH-DGW Document 1 Filed 01/31/18 Page 9 of 39 Page ID #9
32. Ebony remains a prisoner at Graham Correctional Center. She seeks and Defendants have denied her necessary medical treatment for gender dysphoria, including proper hormone treatment, access to someone with expertise in treating persons with gender dysphoria, and social transition.
Plaintiff Lydia Heléna Vision: 33. Lydia Vision (Padilla) is 38 years old. She was raised in Granite City, Illinois. Lydia identified as female and had outwardly feminine traits and mannerisms from a young age. Around the age of eight or nine, Lydia attempted to cut off her penis. She was told by her family that she needed to “man up” and “act more masculine.” Because of her family’s lack of support, Lydia suppressed her femininity and transgender identity until years later. 34. Lydia entered IDOC custody in June of 2004. Lydia has taken advantage of the educational opportunities offered in prison and has earned her associate’s degree while in custody. She is currently taking collegiate-level classes. So that Lydia could continue to receive her ongoing education, she was transferred to Danville Correctional Center in December 2015. 35. While at Danville, Lydia informed IDOC personnel that she is transgender and was diagnosed with gender dysphoria in March 2016. At this time, Lydia began requesting treatment for gender dysphoria. Yet despite her diagnosis and her repeated requests for hormone treatment and gender affirming clothing and grooming items, she has been denied these treatments. Prison officials have instead required her to attend sessions for an unrelated posttraumatic stress disorder (PTSD) diagnosis saying that she must complete them before being treated with hormone therapy. 36. In July of 2016, Lydia was referred to an IDOC psychiatrist who evaluated her via Skype and confirmed the prior diagnosis of gender dysphoria. During the evaluation, the
9

Case 3:18-cv-00156-DRH-DGW Document 1 Filed 01/31/18 Page 10 of 39 Page ID #10
psychiatrist confirmed that Lydia’s continued lack of hormone treatments was causing her extreme distress. Yet despite these multiple diagnoses, IDOC has provided Lydia no treatment beyond individual therapy sessions for her gender dysphoria.
37. Lydia is currently a prisoner at Danville Correctional Center. She seeks and Defendants have denied her necessary medical treatment for gender dysphoria, including hormone treatments and social transition.
Plaintiff Sora Kuykendall: 38. Sora Kuykendall is 25 years old. Sora was raised in Columbia, Illinois and first identified as female at the age of 6 when she asked her family to call her by her preferred feminine name. She stopped trying to present as female, however, once her brother began to bully her for using a feminine name and having feminine mannerisms. Sora was 11 or 12 before she finally had a way of describing what she was experiencing, and she came out as transgender in January 2014. Sora believes her family mistakenly thought she was just going through a phase and that they were in denial about the reality of Sora’s female gender. Sora’s family has become more accepting, but she still has limited contact with most family members. 39. Sora entered IDOC custody in November 2014. During intake at Menard Correctional Center, a social worker asked Sora “you’re a boy, right,” to which Sora responded “no.” Within her first week of incarceration, Sora asked for hormones and explained that she wanted to transition. IDOC did not evaluate Sora for gender dysphoria and did not provide any treatment. As a result, and after becoming disturbed by the fact that she was for the first time growing facial hair, Sora attempted to castrate herself by tying her testicles in order to stop the flow of testosterone. When Sora was denied hormones, she felt like she was in the wrong body, which was agonizing.
10

Case 3:18-cv-00156-DRH-DGW Document 1 Filed 01/31/18 Page 11 of 39 Page ID #11
40. Following repeated requests, Sora began taking hormones on approximately February 28, 2015. Sora first requested a bra in June 2015 but did not receive one until almost six months later. Sora repeatedly has requested gender affirming clothing and grooming items and gender affirming surgery throughout her incarceration, but she has never received any of these items other than a bra and never has been evaluated for surgery by IDOC officials.
41. Sora is now a prisoner at Menard Correctional Center. She seeks and Defendants have denied her necessary medical treatment for gender dysphoria, including therapeutically appropriate estrogen compounds at a proper dosage, appropriate bloodwork and laboratory testing, gender affirming surgery, and social transition.
Plaintiff Sasha Reed: 42. Sasha Reed is 26 years old and was raised outside of Chicago. When she was 3 years old, DCFS took Sasha away from her mother after a fire broke out in their home. Sasha’s aunt adopted her in 1999, but two years later, she was sent to Maryville Academy in Des Plaines, Illinois. Beginning in 2004, Sasha lived in Allendale Association in Lake Villa, Illinois, where she first felt and presented as female. In 2011, Sasha moved to a transitional living program in Chicago. By that time, she was consistently presenting as female in private. 43. Sasha entered IDOC custody in July 2013. During the intake process at Stateville Correctional Center, Sasha told a female corrections officer that she is transgender. Despite this, IDOC never referred Sasha to a mental health professional at Stateville. In part because of her untreated gender dysphoria, Sasha tried to harm herself while housed there, including a suicide attempt. 44. Sasha was transferred to Menard Correctional Center in March 2015, and in November 2015 she told a mental health professional at Menard that she is transgender and
11

Case 3:18-cv-00156-DRH-DGW Document 1 Filed 01/31/18 Page 12 of 39 Page ID #12
wanted to begin hormone therapy. The mental health professional asked Sasha to fill out a questionnaire and told her that it would be sent to the GID Committee for review. In February 2016, the GID committee responded and denied hormones because they needed to “rule out a psychotic process.” Sasha was told that she needed to wait six weeks while doctors investigated her conceptualization of gender identity. Instead, Sasha waited sixteen months before starting hormones in April 2017.
45. Sasha is now housed at Lawrence Correctional Center. She continues to seek and Defendants have denied her necessary medical treatment for gender dysphoria, including proper hormone treatment and appropriate bloodwork and laboratory testing, social transition, and gender affirming surgery. II. DEFENDANTS
46. Defendant Bruce Rauner is the Governor of the State of Illinois. He is sued in his official capacity. The Governor is the Chief Executive Officer of the State of Illinois. He is responsible for ensuring the provision of constitutionally adequate medical care for all prisoners in the custody of IDOC, including those who have requested evaluation or treatment for gender dysphoria. In all his actions described in this Complaint, Defendant Governor Rauner is acting under color of state law and in the course of his employment.
47. Defendant John R. Baldwin is Director of IDOC and is sued in his official capacity. As Director of IDOC, Defendant Baldwin is responsible for establishing, monitoring, and enforcing overall operations, policies, and practices of the Illinois state prison system, which includes the provision of constitutionally adequate medical care for all prisoners in the custody of IDOC, including those who have requested evaluation or treatment for gender dysphoria. In all his actions described in this Complaint, Defendant Baldwin is acting under color of state law and in the course of his employment.
12

Case 3:18-cv-00156-DRH-DGW Document 1 Filed 01/31/18 Page 13 of 39 Page ID #13
48. Defendant Dr. Steve Meeks is the Chief of Health Services for IDOC and is sued in his official capacity. As Chief of Health Services, Defendant Meeks is responsible for ensuring that IDOC healthcare policies, directives, and protocols are properly implemented at all facilities and for updating and creating administrative directives, clinic, and health guidelines, including those that relate to care for gender dysphoria. In all his actions described in this Complaint, Defendant Meeks is acting under color of state law and in the course of his employment.
49. Defendant Dr. Melvin Hinton is the statewide Mental Health Supervisor for IDOC and is being sued in his official capacity. As Mental Health Supervisor, Defendant Hinton acts as the statewide mental health supervisor and facilitates and oversees several facets of mental health services. He oversees and provides psychological care, psychiatric evaluations, and crisis intervention. These services include treatments that relate to the care for gender dysphoria. In all of his actions described in this Complaint, Defendant Hinton is acting under color of state law and in the course of his employment.
50. Defendants Meeks and Hinton are also members of the GID Committee for IDOC. The members of the GID Committee are responsible for health related treatment plans for transgender prisoners, including medical treatment for gender dysphoria.
NATURE OF THE CLASS CASE AND FACTUAL ALLEGATIONS I. TRANSGENDER IDENTITY AND GENDER DYSPHORIA.
51. Transgender persons have a gender identity that does not align with the gender they were assigned at birth. Gender identity is “a person’s deeply felt, inherent sense of being a girl, woman, or female; a boy, a man, or male; a blend of male or female; or an alternative gender.” Everyone has a gender identity.
13

Case 3:18-cv-00156-DRH-DGW Document 1 Filed 01/31/18 Page 14 of 39 Page ID #14
52. Most people have a gender identity consistent with the sex that they were assigned at birth. Transgender persons have a gender identity that is not fully aligned with their assigned gender. Attempting to conform an individual’s gender identity to their assigned sex by trying to change an individual’s gender identity is not only futile and unethical, but also may exacerbate the distress associated with the incongruity between a transgender individual’s assigned gender and the gender they know themselves to be.
53. Indeed, while not all transgender or gender nonconforming persons experience clinically significant psychological distress as a result of the conflict between gender identity and assigned sex at birth, for others this distress can be extreme. The medical diagnosis of gender dysphoria refers to the condition characterized by clinically significant “distress that may accompany the incongruence between one’s experienced or expressed gender and one’s assigned gender.” Gender dysphoria is not a mild discomfort with one’s assigned sex. Rather, it is a profound disturbance that, if left untreated or inadequately treated, can lead to severe mental anguish and the inability to function normally at school, at work, or in a relationship. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (the “DSM-5”) classifies gender dysphoria as a serious medical condition.1
54. The DSM-5 lists six criteria which, when present in some combination, trigger a diagnosis of gender dysphoria. These are (i) a marked incongruence between one’s gender identity and one’s sex characteristics; (ii) a strong desire to be rid of one’s sex characteristics because of that incongruence; (iii) a strong desire for the sex characteristics of the other gender; (iv) a strong desire to be of another gender; (v) a strong desire to be treated as another gender;
1 In 2013, the DSM updated the relevant medical diagnosis from transsexualism or gender identity disorder (“GID”)—conditions which continue to be recognized in the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, published by the World Health Organization—to gender dysphoria.
14

Case 3:18-cv-00156-DRH-DGW Document 1 Filed 01/31/18 Page 15 of 39 Page ID #15
and (vi) a strong conviction that one’s feelings and reactions are typical of another gender. An individual must experience two or more of these criteria for at least six months to be diagnosed with gender dysphoria.
55. If not properly treated, gender dysphoria often causes anxiety, depression, substance-related disorders, self-harm, and suicide. Suicide attempt rates are particularly alarming: over forty percent of transgender individuals report having attempted suicide, as compared with between 1.6 and 4.6 percent of the general population. High levels of stigmatization, discrimination, and victimization cause and exacerbate these dangers.
56. The World Professional Association for Transgender Health (“WPATH”) is a nonprofit, multidisciplinary professional association dedicated to understanding and treating gender dysphoria. WPATH is recognized internationally as the leading professional organization devoted to the understanding and treatment of gender dysphoria. WPATH publishes and regularly updates the Standards of Care for the Health of Transsexual, Transgender, and Gender Nonconforming People (the “Standards of Care”), based upon the best available science and expert professional consensus. The seventh and current version of the Standards of Care was released in September 2011. The Standards of Care is widely recognized in the medical community as the authoritative standard for the provision of transgender healthcare. In particular, the Standards of Care have established medical treatment standards for persons living with gender dysphoria that are recognized and accepted within the medical community, and that reflect “the consensus expert opinion among professionals in this field on the basis of their collective clinical experience as well as a large body of outcome research.” Courts also have acknowledged that the Standards of Care provide widely accepted protocols for treating individuals with gender dysphoria.
15

Case 3:18-cv-00156-DRH-DGW Document 1 Filed 01/31/18 Page 16 of 39 Page ID #16
57. The Standards of Care explicitly state that they apply in institutional environments such as prisons:
The [Standards of Care] in their entirety apply to all transsexual, transgender, and gender nonconforming people, irrespective of their housing situation. People should not be discriminated against in their access to appropriate health care based on where they live, including institutional environments such as prisons …. Health care for transsexual, transgender, and gender nonconforming people living in an institutional environment should mirror that which would be available to them if they were living in a non-institutional setting within the same community. 58. The Standards of Care emphasize that “[a]ll elements of assessment and treatment … can be provided to people living in institutions,” and that “[a]ccess to these medically necessary treatments should not be denied on the basis of institutionalization or housing arrangements.” 59. Additionally, the National Commission on Correctional Healthcare recommends that medical care for prisoners with gender dysphoria “should follow accepted standards developed by professionals with expertise in transgender health,” citing the Standards of Care. 60. There are a variety of therapeutic treatments for individuals with a medical need for gender dysphoria treatment. The Standards of Care list the following principal types of treatment:
• Changes in gender expression and role, which may involve living part time or full time in another gender role, consistent with one’s gender identity;
• Hormone therapy to feminize or masculinize the body; • Surgery to change primary and/or secondary sex characteristics (e.g. breasts/chest,
external and/or internal genitalia, facial features, body contouring); • Psychotherapy (individual, couple, family, or group) for purposes such as
exploring gender identity, role, and expression; addressing the negative impact of
16

Case 3:18-cv-00156-DRH-DGW Document 1 Filed 01/31/18 Page 17 of 39 Page ID #17
gender dysphoria and stigma on mental health; alleviated internalized transphobia; enhancing social and peer support; improving body image; or promoting resilience. 61. For a given individual suffering from gender dysphoria, one or all of these components may be necessary for effective treatment. Various secondary treatment options are also listed in the Standards of Care, including (i) peer support groups, (ii) voice and communication therapy aimed towards facilitating gender identity comfort, (iii) hair removal, (iv) outward-appearance aids such as padding or prostheses, and (v) name and/or gender marker changes on identity documents. 62. When gender dysphoria is effectively treated through the therapies described above, the symptoms can be effectively addressed and the condition can be cured. Absent that treatment, persons with gender dysphoria will experience anxiety, depression, substance-related disorders, and/or the inability to function effectively at school, at work, or in a relationship. In the most serious cases, untreated gender dysphoria leads to self-harm, and suicide. II. IDOC POLICIES CONCERNING THE CARE OF TRANSGENDER PRISONERS AND PRISONERS WITH GENDER DYSPHORIA. 63. Despite the fact that proper diagnosis and effective treatment of gender dysphoria are well-understood among medical professionals, IDOC has adopted policies, procedures, and practices that deny prisoners evaluation and medically necessary treatment for gender dysphoria in contravention of medical science. 64. IDOC Administrative Directive 04.03.104, “Evaluation of Offenders with Gender Identity Disorders,” effective as of May 1, 2013 (the “GID Directive”), sets forth IDOC’s policies and procedures for the evaluation and treatment of prisoners with gender dysphoria.
17

Case 3:18-cv-00156-DRH-DGW Document 1 Filed 01/31/18 Page 18 of 39 Page ID #18
65. By mandating unnecessary requirements for approval of treatment for gender dysphoria, the GID Directive causes harmful delays in and interference with the treatment and care decisions of individuals with gender dysphoria. For example, the GID Directive states that “[t]he Department shall not perform or allow the performance of any surgery for the specific purpose of gender change, except in extraordinary circumstances as determined by the Director who has consulted with the Agency Medical Director.” Similarly, by requiring prior approval of the Agency Medical Director, the GID Directive restricts prisoners’ ability to receive hormone therapy, despite the fact that such therapy is medically necessary and prescribed by a medical professional. These policies have the design and effect of delaying necessary medical evaluation and treatment and making effective treatment more difficult to obtain.
66. The GID Directive also establishes the GID Committee. The GID Committee is responsible for reviewing “placements, security concerns, and overall health related treatment plans” for transgender prisoners. It is headed by IDOC’s medical director and includes, at a minimum, IDOC’s chief of mental health, transfer coordinator, and chief of operations. The GID Committee currently consists of Steve Meeks, the director of medical services; Melvin Hinton, the chief of mental health; Doug Stephens, the transfer coordinator; and Mike Atchison, the chief of operations.
67. The GID Committee is charged with evaluating “an offender who presents with gender identity issues . . . to make final recommendations” regarding a prisoner’s “overall health-related treatment plans” and “gender related accommodation[s].”
68. The Standards of Care recommend that all mental health professionals working with gender dysphoric adults should have a number of minimum credentials, including a master’s degree (or equivalent) in a clinical behavioral science field; competencies in using the
18

Case 3:18-cv-00156-DRH-DGW Document 1 Filed 01/31/18 Page 19 of 39 Page ID #19
DSM-5 and/or the International Classification of Diseases for diagnostic purposes; ability to recognize and diagnose co-existing mental health concerns and to distinguish these from gender dysphoria; documented supervised training and competence in psychotherapy or counseling; knowledge of gender nonconforming identities and expressions, and the assessment and treatment of gender dysphoria; and continuing education in the assessment and treatment of gender dysphoria.
69. None of the members of the GID Committee meet these minimum criteria and none are the prisoner’s treating medical professional. Despite lacking these requisite qualifications, the GID Committee oversees all medical treatment for gender dysphoria offered by IDOC. Typically without meeting or hearing directly from the prisoner, the GID Committee provides “final recommendations” for “hormone therapy, clothing, showers, searches,” housing, and other accommodations. The GID Committee can, and often does, deny a prisoner hormone therapy and other necessary medical interventions despite a diagnosis of gender dysphoria, sometimes overruling the medical judgment of the treating medical professional’s recommendations. Even if the GID Committee ultimately approves the treatment, it does so after causing significant delay, which causes severe harm to prisoners with gender dysphoria.
70. These IDOC policies related to the medical treatment of gender dysphoria have the design and effect of delaying necessary medical evaluation and treatment and making effective treatment more difficult to obtain. This causes great suffering to class members whose medically necessary treatment is delayed or denied outright. III. DEFENDANTS FAIL TO PROPERLY EVALUATE AND PROVIDE
NECESSARY MEDICAL CARE FOR GENDER DYSPHORIA. 71. IDOC and each of the named Defendants is and has been deliberately indifferent to the systemic failures to evaluate and provide treatment to prisoners with gender dysphoria.
19

Case 3:18-cv-00156-DRH-DGW Document 1 Filed 01/31/18 Page 20 of 39 Page ID #20
IDOC perpetuates and tolerates myriad systemic deficiencies in treating gender dysphoria: lengthy and dangerous delays in evaluating, prescribing, and initiating appropriate treatment; significant delays in providing or continuing hormone treatment, coupled with inadequate hormone dosages, improper hormone regimens, and lack of or inadequate hormone level monitoring for prisoners who obtain hormone therapy; failure to accommodate social transition, including by mechanically assigning gender dysphoric prisoners to facilities that do not match their gender, allowing routine strip-searches of gender dysphoric women prisoners by male staff, referring to gender dysphoric prisoners by gender-inappropriate names and pronouns, and denying prisoners access to basic gender affirming clothing and grooming products, such as bras for transgender women and treatment and products for body hair and facial hair removal to achieve a more feminine appearance; failure to consider or to provide gender affirming surgery as is medically necessary for some patients with gender dysphoria; lack of medical personnel with knowledge of and qualifications to treat gender dysphoria, combined with a failure to refer prisoners to clinicians competent to treat gender dysphoria; and failure to provide appropriate psychotherapy to prisoners with gender dysphoria.
A. IDOC Fails to Evaluate Prisoners for Gender Dysphoria and Delays Treatment.
72. Transgender prisoners face significant delays before IDOC evaluates them for gender dysphoria and even longer delays before IDOC initiates medically necessary treatment. These delays are contrary to the Standards of Care, which indicate that patients “should receive prompt and attentive evaluation, with the goal of alleviating their gender dysphoria and providing them with appropriate medical services.”
73. IDOC fails to adequately evaluate prisoners for gender dysphoria during the intake process. Attempts to ask new prisoners about their transgender status or treatment for
20

Case 3:18-cv-00156-DRH-DGW Document 1 Filed 01/31/18 Page 21 of 39 Page ID #21
gender dysphoria are sporadic at best, and when a prisoner does indicate that they are transgender during an intake evaluation, the statement is routinely disregarded or ignored. Many transgender prisoners repeatedly request evaluation for gender dysphoria before receiving it, if they receive it at all, and once evaluated, many prisoners wait weeks, months, or even years before receiving medically necessary treatments including hormone therapy.
74. Lydia Vision identified as transgender to IDOC officials in December 2015. Her case was evaluated by the GID Committee in March 2016. Despite identifying as transgender and being diagnosed with gender dysphoria by IDOC mental health professionals, the GID Committee refused to provide Lydia proper treatment including hormone treatments and gender affirming clothing and grooming items. To date, Lydia still has not received any medical treatment for gender dysphoria beyond limited individual therapy sessions despite repeated requests.
75. Sasha Reed requested hormone treatment from IDOC in November 2015. Her mental health professional asked Sasha to fill out a questionnaire and told her that it would be sent to the GID Committee for review. In February 2016, the GID Committee responded and denied her hormones. Sasha was told that she needed to wait while doctors investigated her conceptualization of gender identity. Sasha waited sixteen months before finally being treated with hormone therapy in April 2017. Her treatment, however, is still inadequate for the reasons set forth below, leaving her depressed, anxious, and at serious risk of suicide or self-harm.
76. In some instances, IDOC does not respond to a prisoner’s need for treatment until their distress manifests in self-harm. Sora Kuykendall was forced to wait approximately four months before receiving treatment and her resulting distress from the delay in treatment manifested in Sora tying her testicles in order to stop the production of testosterone. It was only
21

Case 3:18-cv-00156-DRH-DGW Document 1 Filed 01/31/18 Page 22 of 39 Page ID #22
after Sora’s self-castration attempt that IDOC finally provided some treatment for her gender dysphoria. Her treatment, however, is still inadequate for the reasons set forth below, leaving her depressed, anxious, and distressed.
77. Similarly, Janiah Monroe requested treatment for gender dysphoria for approximately three years before she was finally approved for hormone treatments in April 2012. The distress associated with the delay resulted in Janiah attempting her own treatment by selfcastrating multiple times before she finally was provided care. Her treatment, however, is still inadequate for the reasons set forth below, leaving her depressed, anxious, and at risk of potential suicide or self-harm.
B. IDOC Fails to Provide Adequate Hormone Therapy Treatment to Prisoners with Gender Dysphoria.
78. IDOC inadequately provides hormone therapy to prisoners with gender dysphoria. Even once a prisoner obtains hormone therapy, IDOC routinely provides hormones that are not medically recommended or appropriate, fails to adequately monitor the prisoner’s hormone levels, and fails to ensure proper dosages.
79. The Standards of Care specify that “feminizing/masculinizing hormone therapy – the administration of exogenous endocrine agents to induce feminizing or masculinizing changes – is a medically necessary intervention for many transsexual, transgender, and gender nonconforming individuals with gender dysphoria.” The consequences of withdrawing hormone treatment or not providing hormone treatment when medically necessary “include a high likelihood of negative outcomes such as surgical self-treatment by autocastration, depressed mood, dysphoria, and/or suicidality.”
80. Despite the medical necessity of hormone treatment for some transgender prisoners, the GID Directive creates barriers that prevent prisoners from receiving hormone
22

Case 3:18-cv-00156-DRH-DGW Document 1 Filed 01/31/18 Page 23 of 39 Page ID #23
treatment, requiring approval of the Agency Medical Director. Thus, IDOC’s Medical Director, who does not have expertise in the treatment of persons with gender dysphoria and is not the prisoner’s treating medical provider, can deny hormone treatments despite a diagnosis for gender dysphoria and a prescription by the medical professional familiar with the prisoner’s case.
81. The GID Committee also can override the treating provider’s determination of whether a prisoner receives hormone treatments, despite its members’ lack of expertise in the treatment of gender dysphoria. Upon information and belief, IDOC has isolated no other medical condition for approval by the medical director and/or a committee comprised of personnel with no expertise in treating that condition before such treatment is administered.
82. These barriers result in unjustified outright denial or substantial delays in prisoners receiving hormone treatments. Lydia Vision has requested hormone treatments for over a year. She continues to be denied hormone therapy by the GID Committee despite ongoing requests and a diagnosis of gender dysphoria.
83. Marilyn Melendez received a gender dysphoria diagnosis around March 2015. Despite this, the GID Committee denied Marilyn’s request and forced her to wait before she could seek reevaluation. Marilyn was not approved for hormone treatment by the GID Committee until July 2015 and her treatment did not begin until August.
84. IDOC forced Ebony Stamps to choose between continued hormone treatment and isolation. Ebony opted to cease her hormone therapy after several weeks in “orientation” so that she would no longer be kept in isolation but could return to the general population, with social interaction, the denial of which was causing her physical and mental health to deteriorate rapidly. Ebony has undergone a period of extreme distress from the cessation of her hormones so she has
23

Case 3:18-cv-00156-DRH-DGW Document 1 Filed 01/31/18 Page 24 of 39 Page ID #24
requested that they be restarted, but months have passed and she still has not been able to restart that treatment resulting in severe depression, continuous anxiety, and extreme distress.
85. Even after a prisoner is approved for hormone treatments, IDOC routinely provides outdated hormones that are no longer recommended by the Endocrine Society, and provides inadequate hormone dosages and hormone level monitoring.
86. The type of hormones that should be provided to an individual depends on the gender of the individual seeking treatment as well as the individual’s gender assigned at birth. Individuals prescribed feminizing endocrine treatments, i.e., women who were assigned the gender of male at birth, who have not had their testicles surgically removed, require a dual course of hormone treatment: estrogen and testosterone blockers. Generally approved estrogen treatments include: oral doses of estradiol, transdermal doses of estradiol, or parenteral doses of estradiol valerate or cypionate. Accepted antiandrogens, or testosterone blockers, include Spironolactone or Cyproterone acetate. The Endocrine Society also recommends an injection of GnRH agonist taken monthly.
87. Instead of these accepted treatments, Marilyn Melendez and Sora Kuykendall have been prescribed a conjugated equine estrogen, which is not recommended by the Endocrine Society because it is also impossible to meaningfully measure estrogen levels in blood and therefore regulate appropriate doses.
88. Further, IDOC fails to adequately monitor prisoner hormone levels and other health markers for prisoners taking hormone therapy. Like many prescription medications, taking hormones can have side effects, especially when not properly monitored. The Standards of Care direct that “clinicians who prescribe hormone therapy . . . [p]rovide ongoing medical monitoring, including regular physical and laboratory examination to monitor hormone
24

Case 3:18-cv-00156-DRH-DGW Document 1 Filed 01/31/18 Page 25 of 39 Page ID #25
effectiveness and side effects.” Similarly, the Endocrine Society recommends “appropriate regular medical monitoring . . . for both [female to male] and [male to female] transsexual persons during the endocrine transition and periodically thereafter,” including patient evaluations every 2-3 months in the first year of hormone or endocrine treatment and then 1-2 times per year thereafter. The Endocrine Society recommends measuring serum testosterone and estradiol every three months, and that estrogen doses be adjusted according to the serum levels of estradiol.
89. Despite being on hormones in IDOC custody for more than two years, Marilyn Melendez has only once had her blood drawn to test her hormone levels. Similarly, Sora Kuykendall has not received regular monitoring of her hormone levels. Janiah Monroe’s hormone levels have not been regularly monitored since she was first prescribed hormone treatments in 2012.
90. Failing to monitor hormone levels could result in dangerous levels of estrogen: an increased risk for blood clots or strokes if the estrogen level is too high, or for osteoporosis if the estrogen levels are too low, among other potential complications. Accordingly, the Standards of Care dictate that “[m]onitoring for adverse events should include both clinical and laboratory evaluation.” Janiah’s most recent bloodwork revealed estrogen levels that would be considered post-menopausal. Such levels are inadequate to protect her from bone loss and may not be sufficient to treat her gender dysphoria. Despite this, Janiah’s hormone dosages have not been increased to provide therapeutically appropriate treatment.
91. Once a person has been provided with hormone therapy to treat gender dysphoria, there are significant risks of long-term harm if that person is no longer provided hormone therapy. Surgical care often reduces many risks related to hormone therapy.
25

Case 3:18-cv-00156-DRH-DGW Document 1 Filed 01/31/18 Page 26 of 39 Page ID #26
C. IDOC Fails to Permit, Accommodate, and Facilitate Social Transition Necessary to Treat Gender Dysphoria.
92. IDOC fails to permit, accommodate, and facilitate social transition—“living part time or full time in another gender role, consistent with one’s gender identity”—that is medically necessary treatment for gender dysphoria. Among other things, IDOC (i) mechanically places transgender women in facilities for male inmates, without considering whether a female facility would be more appropriate; (ii) routinely subjects transgender women to strip searches performed by male staff; (iii) mis-genders prisoners with gender dysphoria, failing to recognize and respect their gender identity; and (iv) denies transgender women access to gender affirming clothing and grooming items. These failures prevent, or seriously limit, gender dysphoric prisoners’ ability to live consistent with their gender identity, which in turn worsens their gender dysphoria.
93. IDOC fundamentally fails to accommodate social transition necessary to treat gender dysphoria by treating transgender women not as women but as men. This mis-gendering begins immediately upon arrival, when transgender women automatically are assigned to male facilities, and not considered for placement in a female facility. This IDOC policy disregards the National Standards to Prevent, Detect, and Respond to Prison Rape Under the Prison Rape Elimination Act (PREA), which state that “[i]n deciding whether to assign a transgender or intersex inmate to a facility for male or female inmates, and in making other housing and programming assignments, the agency shall consider on a case-by-case basis whether a placement would ensure the inmate’s health and safety, and whether the placement would present management or security problems.”
94. Once transgender women inevitably are placed in IDOC facilities for men, they then are routinely subjected to demeaning and harmful strip-searches by male staff. This, too,
26

Case 3:18-cv-00156-DRH-DGW Document 1 Filed 01/31/18 Page 27 of 39 Page ID #27
disregards PREA’s directive that a facility “shall not conduct cross-gender strip searches or cross-gender visual body cavity searches” except in exigent circumstances or when performed by medical practitioners. These women then routinely are referred to by staff and other inmates by the wrong name and gender, even after they request to be addressed by the correct name and gender.
95. Similarly, IDOC fails to provide gender affirming clothing and grooming items to prisoners with gender dysphoria. These clothing and grooming items can significantly enhance an individual’s ability to function healthily in their environment, and are an essential component of gender transition and treatment for gender dysphoria for many persons with the condition. In addition, many women in IDOC facilities who are transgender have developed breasts as a result of either past or current hormone treatment or past surgery. Without a bra, these women suffer pain and discomfort. Similarly, IDOC often denies access to grooming products such as shaving razors, hair removal products, or lotions to offset the dry skin that can result from taking spironolactone, an anti-androgen commonly used in feminizing hormone therapy.
96. Janiah Monroe has specifically requested that she be considered for placement in a female facility. Her request was denied because she has not completed gender affirming surgery—and her requests for gender affirming surgery likewise have been denied. Lydia Vision, Sora Kuykendall, and Sasha Reed have all repeatedly requested clothing and grooming items provided to non-transgender women. IDOC continues to deny each prisoner’s request. Marilyn Melendez and Janiah Monroe have both received bras from IDOC only after grieving IDOC’s repeated denials of this care. IDOC, however, continues to deny their requests for other gender affirming clothing and grooming items.
27

Case 3:18-cv-00156-DRH-DGW Document 1 Filed 01/31/18 Page 28 of 39 Page ID #28
D. IDOC Fails to Consider and/or Provide Surgery as Part of Medically Necessary Treatment for Gender Dysphoria.
97. IDOC refuses to consider or provide surgery to prisoners suffering from gender dysphoria despite medical research and evidence demonstrating that surgery may be necessary in some cases and is an effective treatment, effectively imposing a blanket ban on surgical treatment for gender dysphoria. Under the Standards of Care, gender affirming surgery can be an “essential and medically necessary” treatment for gender dysphoria. Hormone therapy alone for certain individuals is not sufficient:
While many transsexual, transgender, and gender-nonconforming individuals find comfort with their gender identity, role, and expression without surgery, for many others surgery is essential and medically necessary to alleviate their gender dysphoria. … For the latter group, relief from gender dysphoria cannot be achieved without modification of their primary and/or secondary sex characteristics to establish greater congruence with their gender identity. 98. Several of the Named Plaintiffs meet the criteria to be candidates for gender affirming surgery, having been on hormones and lived in their congruent gender role for at least a year. Those who do not meet these criteria would likely have done so if IDOC had provided medically necessary treatment on a timely basis. 99. The Standards of Care apply equally to prisoners and non-prisoners. The Standards of Care dictate that “[a]ll elements of assessment and treatment” can be provided in prisons, and that “access to medically necessary treatments should not be denied on the basis of institutionalization.” While “[r]easonable accommodations to the institutional environment can be made in the delivery of care consistent with the [Standards of Care],” “[d]enial of needed changes in gender role or access to treatments, including sex reassignment surgery, on the basis of residence in an institution are not reasonable accommodations ….”
28

Case 3:18-cv-00156-DRH-DGW Document 1 Filed 01/31/18 Page 29 of 39 Page ID #29
100. On information and belief, no IDOC prisoner is or ever has been approved for gender affirming surgery or has even been evaluated to determine whether they need gender affirming surgery to treat their gender dysphoria. Janiah Monroe has requested gender affirming surgery on multiple occasions and has been continually denied. Similarly, despite repeated requests from Marilyn Melendez, IDOC has taken no meaningful steps to evaluate her as a candidate for surgery. Sora Kuykendall first requested surgery in June 2015. IDOC has taken no steps to evaluate her as a candidate in the past two and a half years.
101. Instead, IDOC has a practice and a policy that it makes it a practical impossibility for prisoners to receive medically necessary surgical treatment. IDOC’s GID Directive mandates that “[t]he Department shall not perform or allow the performance of any surgery for the specific purpose of gender change, except in extraordinary circumstances as determined by the Director who has consulted with the Agency Medical Director.” In other words, under the GID Directives, IDOC’s Director, who is not competent to treat gender dysphoria, can refuse to provide a prisoner with a medically-necessary surgery, despite that prisoner meeting the criteria listed in the Standards of Care and receiving the required referrals from treating medical personnel.
E. IDOC Fails to Provide Access to Clinicians Competent to Treat Gender Dysphoria, Resulting in Misdiagnosis and Inappropriate Treatment.
102. IDOC’s medical professionals who treat prisoners with gender dysphoria do not have any meaningful knowledge of, experience with, or training regarding the Standards of Care, nor do they have any meaningful training or experience regarding the proper treatment of gender dysphoria. The Standards of Care specify that, at minimum, all mental health professionals working with gender dysphoric adults should (i) be knowledgeable about gender nonconforming identities and expressions; (ii) be knowledgeable about the treatment and assessment of gender
29

Case 3:18-cv-00156-DRH-DGW Document 1 Filed 01/31/18 Page 30 of 39 Page ID #30
dysphoria including the DSM-5 and/or the International Classification of Diseases; and (iii) possess the ability to recognize and diagnose co-existing mental health concerns and to distinguish these from gender dysphoria. The Standards of Care also recommend that treating clinicians actively seek continuing education on the treatment and assessment of gender dysphoria, including through professional meetings, workshops, and/or seminars. Mental health professionals who are new to working with individuals with gender dysphoria “should work under the supervision of a mental health professional with established competence in the assessment and treatment of gender dysphoria.”
103. The Standards of Care explicitly state that in an institutional setting, “[i]f the inhouse expertise of health professionals … does not exist to assess and/or treat people with gender dysphoria, it is appropriate to obtain outside consultation from professionals who are knowledgeable about this specialized area of health care.” Multiple Named Plaintiffs have requested referrals to health professionals who are competent to treat gender dysphoria because of IDOC’s inadequate treatment.
104. IDOC’s treatment providers are not knowledgeable or experienced in gender dysphoria. Indeed, they display a profound and fundamental lack of understanding of the disorder by referring to it as “gender identity disorder”—despite a change in nomenclature in 2013—as well as “tg disorder,” “sex dysphoria,” and other incorrect and inaccurate descriptions. Treatment providers frequently refer to their own gender dysphoric patients with incorrect names and pronouns.
105. As a result of IDOC’s inadequate knowledge of and training provided to medical professionals regarding the treatment of gender dysphoria, those medical professionals misdiagnose prisoners who have gender dysphoria with other conditions. These misdiagnoses
30

Case 3:18-cv-00156-DRH-DGW Document 1 Filed 01/31/18 Page 31 of 39 Page ID #31
lead to inappropriate treatment that prolongs the suffering associated with gender dysphoria and delays medically appropriate and necessary treatments.
106. Prisoners with gender dysphoria commonly present with symptoms of depression or past psychotic episodes. These prisoners are often prescribed medications that fail to treat the underlying gender dysphoria, focusing instead on the individual symptoms. For example, Sasha Reed was diagnosed with schizophrenia and placed on antipsychotic medication prior to receiving treatment for her gender dysphoria. IDOC and the GID Committee repeatedly used Sasha’s history of psychiatric treatment as an excuse to deny her hormone treatment.
107. Janiah Monroe’s request for a bra and gender affirming surgery was presented to the GID Committee in February 2016. Rather than address her requests for medical treatment, the GID Committee decided that her chart should be reviewed by psychiatry to reassess her psychotropic medication regimen.
108. Similarly, Lydia Vision has been denied hormone therapy for medically unfounded and clinically inappropriate reasons. Despite a diagnosis of gender dysphoria, the GID Committee denied Lydia access to hormone therapy, instead recommending support, treatment, and monitoring for PTSD symptoms.
109. IDOC’s failure to employ or contract with clinicians competent to treat gender dysphoria has caused prisoners to withhold potentially useful information out of fear that it will lead to an incorrect diagnosis or treatment. For example, throughout the process of obtaining hormones, Marilyn Melendez was often afraid to tell IDOC medical professionals that she had suicidal thoughts out of a fear that she would be placed on suicide watch instead of receiving hormone therapy.
31

Case 3:18-cv-00156-DRH-DGW Document 1 Filed 01/31/18 Page 32 of 39 Page ID #32
F. IDOC Fails to Provide Necessary and Clinically Appropriate Psychotherapy to Treat Gender Dysphoria.
110. IDOC does not provide transgender prisoners with the necessary individual and group psychotherapy sessions. The Standards of Care recommend individual and group therapy in order for the individuals with gender dysphoria to “explor[e] gender identity, role, and expression; address[] the negative impact of gender dysphoria and stigma on mental health; alleviat[e] internalized transphobia; enhance[e] social and peer support; improve[e] body image; or promot[e] resilience.”
111. IDOC systematically fails to provide regular individual and group therapy to transgender prisoners and those with gender dysphoria. When IDOC provides such “therapy” at all, the programming is effectively a peer support group rather than a bona-fide therapeutic experience.
112. While some individuals may benefit from socialization, group support, and psychotherapy, none is a substitute for the medically-necessary medical and surgical interventions necessary to treat gender dysphoria.
CLASS CERTIFICATION ALLEGATIONS 113. All Plaintiffs bring this action on their own behalf and, pursuant to Rules 23(a), 23(b)(1), and 23(b)(2) of the Federal Rules of Civil Procedure, on behalf of a class of all prisoners in the custody of IDOC who have requested from IDOC evaluation or treatment for gender dysphoria, whether or not they used that specific term (collectively, the “Plaintiff Class”). 114. Numerosity. The class is so numerous that joinder of all members is impracticable. Fed. R. Civ. P. 23(a)(1). Further, the Plaintiff Class members are identifiable using records maintained in the ordinary course of business by IDOC.
32

Case 3:18-cv-00156-DRH-DGW Document 1 Filed 01/31/18 Page 33 of 39 Page ID #33
115. Commonality. There are questions of law and fact common to members of the class. Such questions include, but are not limited to:
a. Whether the Defendants have failed to establish and administer a medical care system that provides constitutionally adequate medical care for prisoners needing to be evaluated or provided treatment for gender dysphoria in violation of the cruel and unusual punishment clause of the Eighth Amendment;
b. Whether the Defendants are deliberately indifferent to the serious medical needs of class members with gender dysphoria;
c. Whether the Defendants have failed to employ clinicians competent to treat gender dysphoria to ensure the delivery of constitutionally adequate medical care for the condition;
d. Whether the Defendants have routinely and systemically failed to provide reasonably prompt medical care for gender dysphoria;
e. Whether the Defendants have routinely and systemically failed to adequately train medical treatment providers regarding the evaluation and treatment of gender dysphoria;
f. Whether the Defendants have routinely and systemically failed to identify and correct incompetent medical treatment providers and inadequate treatment for gender dysphoria;
g. Whether the Defendants have failed to promulgate and follow policies, practices and protocols reasonably necessary to ensure the delivery of constitutionally required medical care for gender dysphoria;
33

Case 3:18-cv-00156-DRH-DGW Document 1 Filed 01/31/18 Page 34 of 39 Page ID #34

h. Whether the Defendants have failed to ensure compliance with policies,

practices and protocols reasonably necessary to ensure the delivery of

constitutionally required medical care for gender dysphoria;

i.

Whether the GID Directive and Defendants’ actions pursuant to the GID

Directive fail to ensure the delivery of constitutionally required medical

care for gender dysphoria; and

j.

Whether Defendants Meeks and Hinton, in their role as members of the

GID Committee (charged under the GID Directive with evaluating “an

offender who presents with gender identity issues . . . to make final

recommendations’ regarding a prisoner’s “overall health-related treatment

plans” and “gender-related accommodation[s]”), have failed to establish

and administer a medical care system that provides constitutionally

adequate medical care for prisoners needing to be evaluated or provided

treatment for gender dysphoria in violation of the cruel and unusual

punishment clause of the Eighth Amendment.

116. Typicality. The claims of the Plaintiffs are typical of those of the Plaintiff Class.

Each of the named Plaintiffs is subject to the Defendants’ knowing failure to provide

constitutionally adequate medical care, and as such their claims arise from the same policies,

practices, or courses of conduct; and their claims are based on the same theory of law as the

class’s claims.

117. Adequacy. Plaintiffs are capable of fairly and adequately protecting the interest

of the Plaintiff Class and will diligently serve as class representatives. Plaintiffs do not have any

interests antagonistic to the class. Plaintiffs, as well as the Plaintiff Class members, seek to

34

Case 3:18-cv-00156-DRH-DGW Document 1 Filed 01/31/18 Page 35 of 39 Page ID #35
enjoin the unlawful acts and omissions of the Defendants. Finally, Plaintiffs are represented by counsel experienced in civil rights litigation, prisoners’ rights litigation, litigation on behalf of transgender people, and complex class action litigation, and have the resources necessary to fairly and adequately represent the class.
118. Rule 23(b)(1). This action is maintainable as a class action pursuant to Fed. R. Civ. P. 23(b)(1) because the prosecution of separate actions by individuals would create a risk of inconsistent and varying adjudications, which in turn would establish incompatible standards of conduct for the Defendants. Additionally, the prosecution of separate actions by individual members could result in adjudications with respect to individual members that, as a practical matter, would substantially impair the ability of other members to protect their interests.
119. Rule 23(b)(2). This action is maintainable as a class action pursuant to Fed. R. Civ. P. 23(b)(2) because the Defendants have acted, or failed to act, on grounds generally applicable to all members of the class, and because the Defendants’ policies, practices, actions, and omissions that form the basis of this complaint are common to and apply generally to all members of the class. The injunctive and declaratory relief sought is appropriate and will apply to all members of the class. All IDOC medical care policies relating to gender dysphoria are centrally promulgated, disseminated, and enforced, and the failure to address the systemic deficiencies is the result of policies and practices of IDOC, not any particular person. The injunctive and declaratory relief sought is appropriate and will apply to all members of the Plaintiff Class.
35

Case 3:18-cv-00156-DRH-DGW Document 1 Filed 01/31/18 Page 36 of 39 Page ID #36
CLAIM FOR RELIEF Cause of Action
(42 U.S.C. § 1983; Eighth Amendment) 120. By their policies and practices described herein, Defendants subject all Plaintiffs and the Plaintiff Class to a substantial risk of serious harm and injury from inadequate and delayed evaluation and treatment of gender dysphoria. These policies and practices have been and continue to be implemented by Defendants and their agents, officials, employees, and all persons acting in concert with the under color of state law, in their official capacities, and are the proximate cause of the Plaintiffs’ and the Plaintiff Class’s ongoing deprivation of rights secured by the United States Constitution under the Eighth Amendment. 121. Defendants have been and are aware of all of the deprivations complained of herein, and have condoned or been deliberately indifferent to such conduct. 122. Plaintiffs and the Plaintiff Class they represent have no adequate remedy at law to redress the wrongs suffered as set forth in this complaint. Plaintiffs have suffered and will continue to suffer irreparable injury as a result of the unlawful acts, omissions, policies, and practices of the Defendants, as alleged herein, unless Plaintiffs and the Plaintiff Class they represent are granted the relief they request. The need for relief is critical because the rights at issue are paramount under the United States Constitution and the laws of the United States.
PRAYER FOR RELIEF WHEREFORE, Plaintiffs respectfully requests that the Court enter judgment: a. Declare that the suit is maintainable as a class action pursuant to Federal Rule of
Civil Procedure 23(a) and 23(b)(1) and (b)(2); b. Adjudge and declare that the acts, omissions, policies, and practices of
Defendants, and their agents, employees, officials, and all persons acting in concert with them under color of state law or otherwise, described herein are in
36

Case 3:18-cv-00156-DRH-DGW Document 1 Filed 01/31/18 Page 37 of 39 Page ID #37
violation of the rights of Plaintiffs and the Plaintiff Class they represent under the Cruel and Unusual Punishments Clause of the Eighth Amendment, which grants constitutional protection to the Plaintiffs and the Plaintiff Class they represent; c. Preliminarily and permanently enjoin Defendants, their agents, employees, officials, and all persons acting in concert with them under color of state law, from subjecting Plaintiffs and the Plaintiff Class to the illegal and unconstitutional conditions, acts, omissions, policies, and practices set forth above. d. Order Defendants and their agents, employees, officials, and all persons acting in concert with them under color of state law, to develop and implement, as soon as practical, a plan to eliminate the substantial risk of serious harm that Plaintiffs and members of the Plaintiff Class suffer due to Defendants’ inadequate evaluation and treatment of gender dysphoria. At a minimum, this plan should include: (i) Prisoner access to clinicians to treat gender dysphoria who meets the competency requirements stated in the Standards of Care; (ii) Prompt evaluation for gender dysphoria upon request or clinical indication of the condition; (iii) Timely fulfillment of medically prescribed treatment for gender dysphoria, including, but not limited to, hormone therapy and gender affirming surgery; (iv) Accommodation of medically necessary social transition, including individualized placement determinations, avoidance of cross-gender strip searches, and access to gender affirming clothing and grooming items; and (v) Ceasing the practice whereby medical decisions regarding gender dysphoria are second-guessed and treatment is governed by the GID Committee.
37

Case 3:18-cv-00156-DRH-DGW Document 1 Filed 01/31/18 Page 38 of 39 Page ID #38 e. Award Plaintiffs the costs of this suit, and reasonable attorneys’ fees and litigation expenses pursuant to 42 U.S.C. § 1988, and other applicable law; f. Retain jurisdiction of this case until Defendants have fully complied with the orders of this Court, and there is a reasonable assurance that Defendants will continue to comply in the future absent continuing jurisdiction; and g. Grant any other relief as the Court may deem just and proper under the circumstances. [Remainder of Page Intentionally Left Blank]
38

Case 3:18-cv-00156-DRH-DGW Document 1 Filed 01/31/18 Page 39 of 39 Page ID #39

Dated: January 31, 2018

Respectfully submitted,
By: /s/ Jordan M. Heinz John A. Knight Ghirlandi Guidetti ROGER BALDWIN FOUNDATION OF ACLU, INC. 180 North Michigan Avenue, Suite 2300 Chicago, Illinois 60601 Telephone: (312) 201-9740 Facsimile: (312) 201-9760 jknight@ACLU-il.org gguidetti@ACLU-il.org
Catherine L. Fitzpatrick Jordan M. Heinz Erica B. Zolner Megan M. New Scott Lerner KIRKLAND & ELLIS LLP 300 North LaSalle Street Chicago, Illinois 60654 Telephone: (312) 862-2000 Facsimile: (312) 862-2200 catherine.fitzpatrick@kirkland.com jordan.heinz@kirkland.com erica.zolner@kirkland.com megan.new@kirkland.com scott.lerner@kirkland.com
Attorneys for Plaintiffs

39

 
 Case 3:18-cv-00156-NJR Document 96 Filed 11/30/18 Page 1 of 9 Page ID #293



IN THE UNITED STATES DISTRICT COURT

FOR THE SOUTHERN DISTRICT OF ILLINOIS

JANIAH MONROE, MARILYN MELENDEZ EBONY STAMPS, LYDIA HELENA VISION, SORA KUYKENDALL, and SASHA REED,

Plaintiffs,

v.

No. 18-0156-DRH

BRUCE RAUNER, JOHN BALDWIN, STEVE MEEKS, and MELVIN HINTON,

Defendants.

MEMORANDUM and ORDER

HERNDON, District Judge:

Introduction and Background

Pending before the Court is a November 9, 2018 Report and

Recommendation (“the Report”) recommending that the Court grant defendant

Bruce Rauner’s motion to dismiss and deny as moot a motion to stay discovery

(Doc. 91). Specifically, the Report recommends that the Court grant the motion to

dismiss, that Governor Rauner be dismissed with prejudice and the motion to stay

discovery be denied as moot. On November 20, 2018, plaintiffs filed objections to

the Report (Doc. 95). Based on the following, the Court rules as follows.

On January 31, 2018, Janiah Monroe, Marilyn Melndez, Ebony Stamps,

Lydia Helena Vision, Sora Kuykendall, and Sasha Reed filed suit against Bruce

Rauner, John Baldwin, Steve Meeks and Melvin Hinton (Doc. 1). Ruaner is the Page 1 of 9

Case 3:18-cv-00156-NJR Document 96 Filed 11/30/18 Page 2 of 9 Page ID #294
current governor of Illinois, Meeks is the medical director for the Illinois Department of Corrections (“IDOC”), Hinton is the Chief of Mental Health Services for IDOC and Baldwin is the Acting Director of the IDOC. Plaintiffs are prisoners in the custody of the IDOC. Represented by counsel, they bring this civil rights action pursuant to 42 U.S.C. § 1983, on behalf of themselves and other similarly situated inmates. Plaintiffs are currently in various institutions both within and outside the Southern District of Illinois; those located in this District are Kuykendall (Menard Correctional Center), and Reed (Lawrence Correctional Center). Plaintiffs identify themselves as transgender women, and have sought evaluation and/or treatment for gender dysphoria during their IDOC custody. They allege that the IDOC has denied and/or delayed evaluation and medically necessary treatment and accommodations for their gender dysphoria, causing them to suffer physical and psychological distress, including self-harm and suicide attempts. They contend that incarceration under these conditions violates their Eighth Amendment rights. They seek class action certification, and declaratory and injunctive relief. On February 1, 2018, the undersigned conducted its review of the complaint under 28 U.S.C. § 1915A and referred the matter to Magistrate Judge Donald G. Wilkerson (Doc. 4).
Thereafter on March 27, 2018, defendant Bruce Rauner filed a motion to dismiss (Doc. 41). In the motion, Rauner argues that he should be dismissed from this case as he is not the proper party for carrying out any of plaintiffs’ requested
Page 2 of 9

Case 3:18-cv-00156-NJR Document 96 Filed 11/30/18 Page 3 of 9 Page ID #295
injunctive relief (Doc. 41). Raunder maintains that the proper defendants are the
named IDOC officials who would have the responsibility for complying with any
injunction that the Court may enter in this case. Plaintiffs filed an opposition to
the motion countering that Governor Rauner is a proper defendant because he has
the constitutional authority as the executive of the State of Illinois and plaintiffs
allege that he bears responsibility for ensuring the provision of constitutionally
adequate medical care for IDOC prisons (Doc. 55). On November 9, 2018,
Magistrate Judge Wilkerson issued the Report finding:
However, the person with authority to effect change already has been named in this suit, namely the Director of the IDOC. As such, the Complaint fails to set forth what the Governor could conceivably do to remedy the alleged constitutional violations above and beyond the other named parties. His inclusion in the lawsuit appears superfluous.
(Doc. 91, p. 4).
Legal Standards The Court’s review of the Report is governed by 28 U.S.C. § 636(b)(1), which
provides in part:
A judge of the court shall make a de novo determination of those portions of the report or specified proposed findings or recommendations to which objection is made. A judge of the court may accept, reject, or modify, in whole or in part, the findings or recommendations made by the magistrate judge. The judge may also receive further evidence or recommit the matter to the magistrate judge with instructions. Fed. R. Civ. P. 72(b) also directs that the Court must only make a de
novo determination of those portions of the report and recommendation to
Page 3 of 9

Case 3:18-cv-00156-NJR Document 96 Filed 11/30/18 Page 4 of 9 Page ID #296
which specific written objection has been made. Johnson v. Zema Sys. Corp., 170 F.3d 734, 739 (7th Cir. 1999). If no objection or only a partial objection is made, the Court reviews those unobjected portions for clear error. Id. In addition, failure to file objections with the district court “waives appellate review of both factual and legal questions.” Id. Under the clear error standard, the Court can only overturn a Magistrate Judge's ruling if the Court is left with “the definite and firm conviction that a mistake has been made.” Weeks v. Samsung Heavy Indus. Co., Ltd., 126 F.3d 926, 943 (7th Cir. 1997).
Rule 8(a)(2) of the Federal Rules of Civil Procedure requires only “a short and plain statement of the claim showing that the pleader is entitled to relief,” in order to “ ‘give the defendant fair notice of what the ... claim is and the grounds upon which it rests.’ ” Bell Atlantic Corp. v. Twombly, 550 U.S. 544, 555 (2007) (quoting Conley v. Gibson, 355 U.S. 41, 47 (1957) ); see also Windy City Metal Fabricators & Supply, Inc. v. CIT Tech. Fin. Servs., Inc., 536 F.3d 663, 667 (7th Cir. 2008).
When considering whether to dismiss a complaint for failure to state a claim upon which relief can be granted, the Court assumes all factual allegations in the complaint to be true, viewing all facts—as well as any inferences reasonably drawn therefrom—in the light most favorable to the plaintiff. Bell Atlantic Corp., 550 U.S. at 563 (citing Swierkiewicz v. Sorema N.A., 534 U.S. 506, 514 (2002) ); Parish v. City of Elkhart, 614 F.3d 677, 679 (7th Cir. 2010). A well-pleaded complaint may
Page 4 of 9

Case 3:18-cv-00156-NJR Document 96 Filed 11/30/18 Page 5 of 9 Page ID #297
proceed even if it appears “that actual proof of those facts is improbable, and that a recovery is very remote and unlikely.” Bell Atlantic Corp., 550 U.S. at 556.
Nevertheless, the factual allegations in the complaint must be enough to raise a right to relief above the speculative level. Id. at 555. While a complaint does not need detailed factual allegations, a plaintiff’s obligation to provide the grounds of his entitlement to relief requires more than mere labels and conclusions, and a formulaic recitation of the elements of a cause of action will not do. Id. (citations omitted). The Court “need not accept as true legal conclusions, or threadbare recitals of the elements of a cause of action, supported by mere conclusory statements.” Brooks v. Ross, 578 F.3d 574, 581 (7th Cir. 2009) (quoting Ashcroft v. Iqbal, 556 U.S. 662, 678 (2009) ). “The complaint must contain sufficient factual matter, accepted as true, to state a claim to relief that is plausible on its face.” Bonte v. U.S. Bank, N.A., 624 F.3d 461, 463 (7th Cir. 2010) (citing Iqbal, 556 U.S. at 678).
To assess whether a complaint states a plausible claim of relief, the Supreme Court articulated a two-pronged approach in which a court (1) first identifies the well-pleaded factual allegations by discarding the pleadings that are “no more than conclusions” and (2) then determines whether the remaining well-pleaded factual allegations “plausibly give rise to an entitlement of relief.” Iqbal, 556 U.S. at 679. A plaintiff is not required to plead facts in the complaint to anticipate and defeat affirmative defenses. Independent Trust Corp. v. Stewart Info. Serv. Corp., 665
Page 5 of 9

Case 3:18-cv-00156-NJR Document 96 Filed 11/30/18 Page 6 of 9 Page ID #298
F.3d 930, 935 (7th Cir. 2012). However, a plaintiff can plead himself or herself out of court by pleading facts that undermine the allegations set forth in the complaint. See, e.g., Whitlock v. Brown, 596 F.3d 406, 412 (7th Cir. 2010) (citations omitted) (“A judicial admission trumps evidence. This is the basis of the principle that a plaintiff can plead himself out of court.”).
Analysis Here, plaintiffs object to the Report’s recommendation that the motion to dismiss be granted and to the extent that it is granted that dismissal should be without prejudice; object to the Report’s finding of fact that characterizes plaintiffs’ opposition as “Plaintiff opposes the motion, arguing that he is the very person who can provide the full relief they seek” and object to the Report’s conclusion of law that “Plaintiff[s]’ allegations against the Governor are not robust or detailed enough to push them over the line from possibility to plausibility,” and that ”Plaintiffs allege systemic problems with delivery of care to transgender inmates but do not tie such relief to the Governor’s office,” and that “the Complaint fails to set forth what the Governor could conceivably do to remedy the alleged constitutional violations above and beyond the other named parties,” such that “[h]is inclusion in this lawsuit appears superfluous.” In addition, plaintiffs reiterate their prior arguments countering the motion to dismiss. The Court rejects plaintiffs’ objections and arguments with the exception that dismissal will be without prejudice instead of with prejudice.
Page 6 of 9

Case 3:18-cv-00156-NJR Document 96 Filed 11/30/18 Page 7 of 9 Page ID #299
The Eighth Amendment “imposes a duty on government officials to provide medical care to prisoners.” Townsend v. Cooper, 759 F.3d 678, 689 (7th Cir. 2014) (citing Estelle v. Gamble, 429 U.S. 97, 104-05 (1976)). Prison officials violate the Eighth Amendment when they are deliberately indifferent to a prisoner’s serious medical needs.Arnett v. Webster, 658 F.3d 742, 750 (7th Cir. 2011) (citing Estelle, 429 U.S. at 104). To state a claim, a prisoner must demonstrate that his medical condition is sufficiently serious (i.e., the objective standard). Greeno v. Daley, 414 F.3d 645, 653 (7th Cir. 2005) (quoting Farmer v. Brennan, 511 U.S. 825, 834 (1970)). He also must demonstrate that each defendant responded to his serious medical need with deliberate indifference (i.e., the subjective standard). Id.
A medical condition is considered objectively serious if it has been diagnosed by a physician as requiring treatment or would be obvious to a layperson. See Pyles v. Fahim, 771 F.3d 403, 409 (7th Cir. 2014) (citing Knight v. Wiseman, 590 F.3d 458, 463 (7th Cir. 2009)). The allegations must also suggest that each defendant responded to plaintiffs’ serious medical needs with deliberate indifference. A prison official acts with deliberate indifference when he “know[s] of and disregard[s] an excessive risk to inmate health.” Greeno, 411 F.3d at 653.
In order to seek injunctive relief on a claim that a policy/practice/custom led to a constitutional violation, plaintiffs are required to name the proper party in their official capacity. Thus, no personal involvement is required to be subjected to the equitable jurisdiction of the Court (for prospective injunctive relief). See Ex
Page 7 of 9

Case 3:18-cv-00156-NJR Document 96 Filed 11/30/18 Page 8 of 9 Page ID #300
Parte Young, 209 U.S. 123, 157 (1908); Ogden v. United States, 758 F.2d 1168, 1177 (7th Cir. 1985). A proper party for injunctive relief is the person who “would be responsible for ensuring that any injunctive relief is carried out.” Gonzalez v. Feinerman, 663 F.3d 311, 315 (7th Cir. 2011).
As to the specific allegations against Rauner, plaintiffs’ compliant contains the following:
46. Defendant Bruce Rauner is the Governor of the State of Illinois. He is sued in his official capacity. The Governor is the Chief Executive Office of the State of Illinois. He is responsible for ensuring the provision of constitutionally adequate medical care for all prisoners in the custody of IDOC, including those who have requested evaluation or treatment for gender dysphoria. In all his actions described in this Complaint, Defendant Governor Rauner is acting under color of state law and in the course of his employment.
(Doc. 1, p. 12, ¶ 46). There are no allegations suggesting that Governor Rauner personally
participated in any decision to deny plaintiffs medical care or, for that matter, implemented any policy or custom, or practice that resulted in a constitutional deprivation. Plaintiffs offer nothing more than conclusory allegations that Ruaner has been aware and are aware of all the deprivations complained of and have condoned or been deliberately indifferent to such conduct. (See Doc. 1, ¶ 121). Such allegations do not satisfy the Twombly standard. Aschcroft v. Iqbal, 556 U.S. at 680 (citing Twombly v. Bell Atlantic Corp., 550 U.S. 544 (2007)(courts are not required to assume that conclusory allegations are true, even early in
Page 8 of 9

Case 3:18-cv-00156-NJR Document 96 Filed 11/30/18 Page 9 of 9 Page ID #301

litigation)). Plaintiffs offer no other allegations suggesting that Rauner was on

notice that a particular policy, custom, or widespread practice resulted in plaintiffs’

denial of care or that Rauner exhibited deliberate indifference toward them.

Further, the Court finds that the complaint does not establish that Rauner would

have any involvement in carrying out any injunctive relief that is ultimately ordered.

See Gonzalez, 663 F.3d at 315. Put simply, plaintiffs have not “nudged [their]

claims…across the line from conceivable to plausible.” Id. at 680. Thus, the

Court grants the motion to dismiss.

Conclusion

Accordingly, the Court ADOPTS in part the Report (Doc. 91), GRANTS

defendant Rauner’s motion to dismiss (Doc. 41), and DENIES as moot the motion

to stay discovery (Doc. 80). The Court DISMISSES with prejudice defendant

Bruce Rauner. Clerk to enter judgment at the close of the entire case.

IT IS SO ORDERED.

Judge Herndon 2018.11.29 16:05:13 -06'00'
United States District Judge

Page 9 of 9

 
 Case 3:18-cv-00156-NJR Document 186 Filed 12/19/19 Page 1 of 39 Page ID #2320

IN THE UNITED STATES DISTRICT COURT FOR THE SOUTHERN DISTRICT OF ILLINOIS

JANIAH MONROE, MARILYN MELENDEZ, EBONY STAMPS, LYDIA HELENA VISION, SORA KUYKENDALL, and SASHA REED,

Plaintiffs,

v.

Case No. 18-CV-00156-NJR-MAB

JOHN BALDWIN, STEVE MEEKS, and MELVIN HINTON,

Defendants.

MEMORANDUM AND ORDER
ROSENSTENGEL, Chief Judge: Janiah Monroe, Marilyn Melendez, Ebony Stamps, Lydia Helena Vision, Sora
Kuykendall, and Sasha Reed are transgender women in the custody of the Illinois Department of Corrections (“IDOC”) (Doc. 1). They filed this putative class action under 42 U.S.C. § 1983, alleging IDOC provides transgender inmates inadequate treatment for gender dysphoria, in violation of the Eighth Amendment (Id.). Plaintiffs bring this suit against the IDOC Director, Chief of Health Services, and Mental Health Supervisor in their official capacities (Id.).
THE COMPLAINT According to the Complaint, IDOC utilizes a committee of unqualified officials to oversee the security, placement, and treatment of transgender inmates (“the Transgender Committee”) (Doc. 1). Through the Transgender Committee and other flawed policies,
Page 1 of 39

Case 3:18-cv-00156-NJR Document 186 Filed 12/19/19 Page 2 of 39 Page ID #2321
IDOC often delays or denies hormone therapy for reasons not recognized by the medical community; fails to provide adequate hormone therapy and hormone monitoring; fails to consider and provide surgery as part of medically necessary treatment for gender dysphoria; prevents and fails to permit, accommodate, and facilitate social transition necessary to treat gender dysphoria; and fails to provide access to clinicians competent to treat gender dysphoria, resulting in misdiagnosis and inappropriate treatment.
Plaintiffs seek a preliminary injunction directing Defendants to: (1) cease the policy and practice of allowing the Transgender Committee to make the medical decisions regarding gender dysphoria resulting in denials and delays of treatment; (2) cease the policy and practice of denying and delaying hormone therapy for reasons that are not recognized as contraindications to treatment; (3) cease IDOC’s policy and practice of refusing to evaluate and provide surgery to treat gender dysphoria; and (4) cease the policy and practice of depriving gender dysphoric prisoners of medically necessary social transition, including by mechanically assigning housing based on genitalia.
Plaintiffs also seek medically necessary treatment for Plaintiffs and the putative class members, including: (1) access to clinicians who meet the competency requirements stated in the Standards of Care to treat gender dysphoria; (2) evaluation for gender dysphoria upon request or clinical indications of the condition; (3) timely medically prescribed treatment for gender dysphoria, including, but not limited to, hormone therapy and monitoring and gender-affirming surgery; (4) medically necessary social transition, including individualized placement determinations, avoidance of cross-
Page 2 of 39

Case 3:18-cv-00156-NJR Document 186 Filed 12/19/19 Page 3 of 39 Page ID #2322
gender strip searches, and access to gender-affirming clothing and grooming items; and (5) training for IDOC staff on the importance of social transition, including using proper names and pronouns for transgender inmates. Finally, Plaintiffs request the Court appoint a medical expert in gender dysphoria to oversee IDOC’s implementation of the above-referenced relief.
The Court held a two-day hearing on the motion for preliminary injunction and now makes the following findings of facts and conclusions of law (Docs. 155 & 156).
FACTS Treatment of Gender Dysphoria
Gender dysphoria refers to a condition in which a person experiences clinically significant distress stemming from incongruence between one’s experienced or expressed gender and one’s assigned gender (Doc. 157, p. 95; Doc. 158, p. 14). Gender dysphoria is considered a medical condition and has been removed from the mental and behavioral disorders in the World Health Organization Classification of Diseases and the Diagnostic Statistical Manual of Mental Disorders (Doc. 158, p. 95). The World Professional Association for Transgender Health (“WPATH”) is a professional association dedicated to understanding and treating gender dysphoria (Doc. 157, p. 98). WPATH dictates medically-accepted Standards of Care for treating gender dysphoria (Id. at p. 7). According to WPATH, its Standards of Care are “the highest standards of health care” for transgender people (Doc. 123, Ex. 13, p. 8). IDOC purports to follow the Standards of Care and has updated its mental health standards operating procedure manual to incorporate them (Doc. 143, Ex. 4, pp. 4, 10). According to WPATH, treatment options for
Page 3 of 39

Case 3:18-cv-00156-NJR Document 186 Filed 12/19/19 Page 4 of 39 Page ID #2323
gender dysphoria include social role transition, cross-sex hormone therapy, psychotherapy, and surgery (Doc. 158, p. 14).
WPATH lists the minimum qualifications a mental health professional must attain in order to assess and treat gender dysphoria (Id. at p. 25). Specifically, a person must: hold a master’s degree in behavioral science; be familiar with the Diagnostic Statistical Manual of Mental Disorders or the International Classification of Diseases; have documented supervision in psychotherapy; understand the variations of gender identities and gender expressions; have continuing education in the assessment and treatment of gender dysphoria; have cultural competence; and be aware of the growing body of literature in the area (Id. at pp. 25-26). Individuals who are new to the field should work under the supervision of someone with competence who is regarded as an expert in gender dysphoria (Id. at p. 26).
Social Role Transition Social role transition is living in the role congruent to one’s affirmed identity. For instance, in the case of a transgender woman, social transition would include wearing a female hairstyle, female clothing, and makeup, and using a feminine name, female toiletries, and a female bathroom (Doc. 158, p. 16). In a prison setting, social transition would require a transgender woman be afforded the same canteen items that female prisoners can access, have means to safe and effective hair removal, be referred to by a female name, and be permitted to wear makeup or clothing that affirms her gender (Id. at p. 17). Psychotherapy
Page 4 of 39

Case 3:18-cv-00156-NJR Document 186 Filed 12/19/19 Page 5 of 39 Page ID #2324
Psychotherapy helps individuals become more resilient, deal with stigma, manage family situations, and cope with the social problems that are attendant to gender dysphoria (Id. at p. 14).
Surgery There are different surgical options for transgender individuals, including reconstruction of the genitalia, also known as gender-affirming surgery (Id. at pp. 20, 90). Reconstruction eliminates the major source of hormones that contribute to and cause gender dysphoria (Id. at pp. 20-21). After reconstruction, the urogenital organs function and appear the same as one’s peers (Id.). In 2014, Medicare declared gender-affirming surgery to be medically necessary and safe (Id. at p. 88). Studies indicate that less than one percent of patients who undergo gender-affirming surgery around the world experience regret (Id. at p. 90). Other studies show suicide and self-harm dramatically decrease following reconstruction surgery (Id.). Other surgical options include removal of the breasts and chest reconstruction (Id. at p. 21). Cross-Sex Hormone Therapy Cross-sex hormone therapy involves taking hormones to masculinize or feminize the body (Id. at p. 14). An individual should not begin hormone therapy unless he or she has well-documented gender dysphoria above the age of majority and has no significant mental health concerns that prevent him or her from giving informed consent (Id. at p. 19). Hormone therapy is often a necessary component of treating gender dysphoria (Id. at p. 156). The Endocrine Society Guidelines are internationally recognized baseline
Page 5 of 39

Case 3:18-cv-00156-NJR Document 186 Filed 12/19/19 Page 6 of 39 Page ID #2325
guidelines for the adequate treatment of gender dysphoria (Doc. 157, p. 91). Hormone therapy that falls below the Guidelines is considered less-than-adequate treatment (Id. at pp. 98-99). The Guidelines state that once a person begins hormone therapy, they should undergo baseline lab testing to monitor hormone levels (Id. at p. 102). Hormone levels need to be checked every two to three months for the first year of treatment, and dosages should be adjusted accordingly until a target hormone level is achieved (Id.). After this period, hormone levels should be checked once or twice each year (Id.). An individual who suddenly stops taking hormones is at risk for serious medical or mental health complications (Id. at p. 103).
Spironolactone and Estradiol are the two main agents involved in hormone therapy for transgender women (Id. at pp. 103-04). Spironolactone is a testosteroneblocker, and Estradiol is estrogen (Id. at pp. 104, 109). Estradiol is administered at a starting dose of two milligrams and titrated to four or six milligrams (Id. at p. 104). Four milligrams typically results in target concentrations (Id. at p. 105). For transgender men, hormone treatment involves testosterone injections (Id. at p. 106).
Spironolactone is a diuretic that can elevate potassium levels and cause heart arrhythmias, kidney failure, and death (Id. at p. 107). Estradiol enlarges the pituitary gland, which can cause blindness if the gland gets too big (Id. at pp. 107-08). Thus, monitoring hormone levels is important for efficacy and safety (Id. at p. 108).
There are other forms of estrogen besides Estradiol, but the Endocrine Society Guidelines do not recommend them because they are very difficult to monitor (Id. at pp. 109-110). For example, Premarin and Menest, which are conjugated estrogens, are not
Page 6 of 39

Case 3:18-cv-00156-NJR Document 186 Filed 12/19/19 Page 7 of 39 Page ID #2326
naturally produced by the body; they come from pregnant horse urine (Id. at p. 110). Transgender people may receive hormone therapy but still experience symptoms
of gender dysphoria because their body does not match their gender identity (Id. at p. 109). Hormone therapy does not shrink genitals or make them disappear (Id.). IDOC’s Policies on Transgender Inmates
IDOC’s Administrative Directive 04.03.104, “Evaluation of Offenders with Gender Identity Disorders,” sets forth the policies and procedures for evaluating and treating inmates with gender dysphoria (“the GID Directive”) (Doc. 1, p. 17; Doc. 123, Ex. 10). The GID Directive creates the Transgender Committee, which is a group of IDOC officials who are responsible for reviewing placements, security concerns, and overall healthrelated treatment plans for transgender prisoners with gender dysphoria, as well as overseeing gender-related accommodations (Doc. 61, p. 29). The Transgender Committee has five voting members: IDOC’s Chief of Psychiatry, Chief of Health Services, Chief of Mental Health Services, Chief of Operations, and Transfer Coordinator (Doc. 158, pp. 102, 146-52; Doc. 61, pp. 20-21). None of these individuals meets WPATH’s minimum qualifications for treating transgender people and two have no medical training (Doc. 158, pp. 146-51).
The Committee meets once each month to review inmates’ treatment and care (Id. at p. 105). The Committee reviews approximately twenty cases at each meeting and goes over treatment plans and inmate requests (Id.). IDOC’s therapists present issues to the Transgender Committee on behalf of the inmate (Id. at pp. 111-13). The Committee reviews information about each inmate, including the inmate’s treatment plan, but does
Page 7 of 39

Case 3:18-cv-00156-NJR Document 186 Filed 12/19/19 Page 8 of 39 Page ID #2327
not review an inmate’s complete medical records (Id. at pp. 113, 163). The Committee generally allots six minutes to hear an inmate’s case (Id. at p. 162). The Committee decides issues based on a majority vote of its five members, but nonmedical members do not vote on medical issues (Id. at pp. 157, 187). After the Committee renders a decision, the inmate’s therapist or physician is responsible for carrying out the plan (Id. at p. 113). There is no formal appeals process for challenging the Committee’s decisions (Id. at pp. 160-61).
Dr. William Puga Dr. William Puga is a physician who specializes in psychiatry (Doc. 158, p. 102). He has served as IDOC’s Chief of Psychiatry since March 2018 (Doc. 158, pp. 102, 135). He oversees the psychiatric treatment at all thirty-one facilities and is the chairman of the Transgender Committee (Id. at p. 104). Since he began working with the Committee, Dr. Puga has become familiar with the Standards of Care, has read about endocrinology and surgical issues, and has studied how other states work with transgender offenders (Id. at p. 109). Dr. Puga also authors a newsletter for the psychiatric staff that discusses psychiatrists’ role in treating and evaluating transgender inmates (Id.). The Committee considers whether or not an inmate should begin hormone therapy (Id. at p. 114). Dr. Puga estimates that about seventy IDOC inmates are on hormones (Id.). According to Dr. Puga, if an inmate was taking hormones prior to incarceration, the Committee generally approves the continuation of hormone therapy without much scrutiny (Id.). But if an inmate wants to begin hormone therapy for the first time, the Committee conducts a review to determine whether therapy is appropriate and
Page 8 of 39

Case 3:18-cv-00156-NJR Document 186 Filed 12/19/19 Page 9 of 39 Page ID #2328
safe (Id.). Periodically, the Committee denies requests to begin hormone therapy if the inmate is psychiatrically unstable or if hormone therapy is contraindicated due to an inmate’s medical history of conditions like embolisms, liver disease, or cardiac issues (Id. at pp. 114-15). If the Committee approves hormone therapy, the inmate’s physician administers the hormones (Id. at p. 121).
Hormone therapy can cause complications (Id. at p. 117). For instance, in April 2019, a transgender inmate had a stroke that left her partially paralyzed and affected her speech (Id.). IDOC concluded that the hormones caused the stroke (Id. at pp. 117-18).
IDOC has raised the issue of misgendering (calling transgender people by the wrong pronouns) with its employees and has provided education and training for correctional officers on dealing with transgender inmates (Id. at p. 125). IDOC also encourages facilities to call inmates by their preferred name and has terminated employees who are verbally abusive to transgender inmates (Id. at pp. 126-27).
Dr. Puga testified the Committee will entertain requests for gender-affirming surgery but it has not actually evaluated a specific inmate as a surgical candidate (Id. at p. 120). Also, the Committee addresses social transition issues, but the therapists and the facilities make many decisions such as showering accommodations and access to commissary items (Id. at pp. 123-24).
The Committee reviews transfer requests from transgender female inmates who want to reside at female facilities (Id. at p. 128). Dr. Puga contacts the inmate’s current facility, reviews disciplinary and medical records, speaks with the inmate’s therapist, and gathers as much relevant information as he can to present to the Committee (Id. at
Page 9 of 39

Case 3:18-cv-00156-NJR Document 186 Filed 12/19/19 Page 10 of 39 Page ID #2329
pp. 128-29, 132). Dr. Puga believes a total of two transgender females have transferred to a female facility (Id.). Dr. Puga testified that one of the inmates was “fairly successful” at the female facility (Id.). The other inmate, Janiah Monroe, stopped taking her hormones and was sexually active (Id.). Dr. Puga talked to the warden and mental health staff at the female facility, who reported the transgender women were not well received (Id. at p. 129). Dr. Puga stated that many women in IDOC’s care have been exposed to domestic, physical, or emotional violence, and transgender women sometimes scare the other women (Id. at p. 130). Dr. Puga received information that Monroe threatened staff and other inmates (Id. at pp. 134-35). Women at the facility filed complaints against Monroe under the Prison Rape Elimination Act; some were false but many were legitimate (Id. at p. 130). The female facility eventually placed Monroe in segregation for her own safety (Id. at pp. 135-36). According to Dr. Puga, these difficulties have not deterred the Committee from considering transfer requests on an individual basis (Id.).
Dr. Puga does not recall learning about gender dysphoria in medical school (Id. at p. 139). He treated two transgender patients while in private practice, three transgender patients while working at a hospital, and three transgender patients while working as a consultant to a school district (Id.). Dr. Puga did not serve as these individuals’ primary provider for gender dysphoria (Id. at p. 141). Dr. Puga has never treated a transgender individual under the supervision of a WPATH-certified physician, prescribed hormones to a transgender patient, been involved in monitoring hormone levels of a transgender patient, approved surgery for a transgender patient, or presided over the social transition of a transgender patient (Id. at pp. 144-45). He is unaware of any standards for prescribing
Page 10 of 39

Case 3:18-cv-00156-NJR Document 186 Filed 12/19/19 Page 11 of 39 Page ID #2330
hormones and testified, “For psychiatry I have guidelines for medications that we prescribe but I don’t know how medicine works, frankly” (Id. at p. 175). He stated, “Dr. Reister has probably the most experience out of everybody [on the Committee] as far as working with [transgender patients]” (Doc. 158, p. 103).
Dr. Shane Reister Dr. Shane Reister is the southern regional psychologist for IDOC who consults the Transgender Committee (Doc. 143, Ex. 3, pp. 6-7). He has a doctorate in psychology and his experience includes a practicum at an LGBT specialty site (Id. at p. 5). Dr. Reister worked at a correctional facility in Rushville, Illinois, where he organized an LGBT group therapy program (Id.). He also attended a WPATH conference a couple of years ago and is scheduled to attend a second conference this year (Id. at pp. 5-6). He has been a member of WPATH for five years (Id.). Dr. Reister developed sensitivity training for IDOC staff, which is designed to help employees interact appropriately with transgender inmates (Id. at p. 7). Dr. Reister does not prescribe hormones; he defers to Dr. Puga for medical treatment of patients with gender dysphoria because these decisions are outside Dr. Reister’s competency (Id. at p. 16). Expert Testimony Dr. Vin Tangpricha Dr. Vin Tangpricha testified on behalf of Plaintiffs (Id. at p. 88). He is boardcertified in endocrinology and specializes in treating transgender individuals (Id.). Dr. Tangpricha holds a medical degree from Tufts University and a Ph.D. from Boston University (Id.). He estimates he has treated more than 360 transgender patients and has
Page 11 of 39

Case 3:18-cv-00156-NJR Document 186 Filed 12/19/19 Page 12 of 39 Page ID #2331
published thirty peer-reviewed articles related to gender dysphoria, including the WPATH Standards of Care (Id. at pp. 90-91). Dr. Tangpricha was also involved in creating the Endocrine Society Guidelines (Id. at p. 91). The first version of the Guidelines was published in 2008, and an updated version was published in 2017 (Id. at p. 145). Dr. Tangpricha is the president of WPATH, on the board of directors for the American Association for Clinical Endocrinologists (“AACE”), and chairs AACE’s national education committee (Id. at p. 92).
Dr. Tangpricha testified that gender dysphoria is a serious medical condition and that failure to properly treat the condition can result in anxiety, depression, self-harm, and suicide (Id. at p. 95). Dr. Tangpricha reviewed the record in this case and is familiar with the Transgender Committee (Id. at p. 11). He does not believe any of the voting members on the Committee are qualified to make decisions about hormone therapy (Id.). Dr. Tangpricha reviewed an IDOC medical record where the Committee denied an inmate’s request for an increased dosage of estrogen and a bra without providing a medical reason or completing a blood test to determine hormone levels (Id. at pp. 115-16). In another record, the Committee denied a request for an increased dosage of estrogen because the inmate was not “stable” (Id. at pp. 117-18). But the remarks under the mental health section of the document state “Currently stable. Attending all programming. Working full-time in inmate commissary” (Id.). Dr. Tangpricha could not find any medical rationale for the denial of the request (Id.). He reviewed other similar documents and noted the Committee was denying requests for increased hormones without testing hormone levels (Id.). The Committee also denied requests for injections without a
Page 12 of 39

Case 3:18-cv-00156-NJR Document 186 Filed 12/19/19 Page 13 of 39 Page ID #2332
reasoned basis; injections can be necessary when someone’s body does not absorb the hormone pills (Id. at p. 119-20).
Dr. Tangpricha reviewed Plaintiffs’ medical records and determined IDOC’s treatment for each woman failed to comply with the Endocrine Society Guidelines. For instance, IDOC prescribed Plaintiffs Menest and Premarin (Id. at pp. 124), delayed hormone therapy for Plaintiffs without medical justification (Id. at p. 126-27), and failed to monitor Plaintiffs’ hormone levels (Id. at pp. 124-28). The few times IDOC conducted blood tests on Plaintiffs, their hormone levels were below therapeutic levels (Id. at pp. 121-28). Dr. Tangpricha reviewed medical records from other transgender inmates in IDOC’s custody and found the same deficiencies in treatment (Id. at pp. 129-38). In one circumstance, an inmate was prescribed Spironolactone but no Estradiol, so the estrogen had little effect (Id. at pp. 140-41). In a psychiatry record in the inmate’s file, the mental health professional refers to “gender identity disorder,” which is an outdated and offensive term (Id. at p. 139). The professional also referred to the inmate with male pronouns and called her gender dysphoria a delusion:
He is cooperative in a very limited sense, his judgment and inside rapport, but he knows he’s still a male. He tries to show that he is female. He is in some kind of a delusion that he is female, and once his voice starts getting a high pitch, he will start talking. (Id.). Dr. Tangpricha also noted there are records of inmates on hormone therapy with elevated potassium, prolactin, and creatinine levels, which place these individuals at risk for complications (Id. at p. 142). Of all the records Dr. Tangpricha reviewed, IDOC did not monitor ninety percent of the inmates in accordance with the Endocrine Society
Page 13 of 39

Case 3:18-cv-00156-NJR Document 186 Filed 12/19/19 Page 14 of 39 Page ID #2333
Guidelines (Id. at p. 143). Approximately twenty-five to fifty percent of the inmates were not monitored at all (Id. at p. 144). Also, over ninety percent of the inmates who IDOC did monitor had hormone levels that fell below the therapeutic range (Id. at p. 143).
Dr. Randi Ettner Dr. Randi Ettner is a clinical and forensic psychologist with a specialty in the assessment and treatment of gender dysphoria (Doc. 158, p. 5). She received a Ph.D. from Northwestern University and has been licensed as a psychologist since 1980 (Id.). She has authored over thirty peer-reviewed publications on transgender health and “seen” over 3,000 individuals with gender incongruity (Id. at pp. 6-7). Dr. Ettner has consulted surgeons and mental health professionals on transgender health and chairs the WPATH’s committee for incarcerated people (Id. at pp. 7-8). Dr. Ettner reviewed Plaintiffs’ medical records and grievances; analyzed the Committee reports; and interviewed and administered psychodiagnostics testing to Plaintiffs (Id. at p. 9). She concluded Plaintiffs have severe gender dysphoria and IDOC provides inadequate and inappropriate care by delaying hormone therapy, failing to facilitate social transition, and not assessing anyone for surgical intervention (Id. at pp. 910, 38). Dr. Ettner reviewed the records of other transgender IDOC inmates and observed the same pattern of inadequate treatment (Id. at pp. 10-12, 37-38). She stated that individuals with gender dysphoria who do not have access to treatment typically engage in self-treatment (auto-castration or auto-penectomy), experience psychological decompensation, or commit suicide (Id. at pp. 26-27, 58).
Page 14 of 39

Case 3:18-cv-00156-NJR Document 186 Filed 12/19/19 Page 15 of 39 Page ID #2334
Dr. Ettner testified that the Committee has denied inmates’ requests for hormone therapy for a number of reasons that are not medically justified (Id. at pp. 34-44). For instance, the Committee denied hormone therapy because inmates suffered from PTSD, did not have social support, were “faking” gender dysphoria, had unresolved trauma, and/or needed to show more stability (Id.; Pls. Exs. 11-16).
Dr. Ettner does not believe any of the members of the Transgender Committee are competent to treat gender dysphoria (Doc. 158, p. 50). Based on her review of the Committee’s decisions and inmates’ medical records, Dr. Ettner concluded the Committee is making decisions that fall below the Standards of Care and place inmates at risk (Id. at p. 51). Also, Dr. Ettner believes IDOC’s mental health staff, in general, is incompetent to treat gender dysphoria based on records of misgendering inmates and conflating sexual identity with gender identity (Id. at pp. 55-56).
Dr. Ettner reviewed the minutes from IDOC’s Suicide Task Force Committee meeting held on October 14, 2015 (Id. at pp. 56-58; Pl. Ex. 20). The note states a transgender woman committed suicide on May 31, 2015 (Id.). The inmate had requested hormone therapy in May 2014 and was evaluated for gender dysphoria in April 2015 but was never prescribed hormones (Id.). One of the members of the Suicide Task Force Committee stated, “[L]apse in presentation to Transgender Committee could have been a reason for the suicide” (Id.). Prior to her death, however, the inmate had been in segregation for one year and had an “encounter with a staff member” just two days before (Id.).
Dr. Ettner testified that transgender inmates are still at risk for self-harm, psychological decompensation, and suicide because there is no evidence they are
Page 15 of 39

Case 3:18-cv-00156-NJR Document 186 Filed 12/19/19 Page 16 of 39 Page ID #2335
receiving necessary medical treatment for gender dysphoria in a timely manner (Id. at pp. 58-59). She stated these problems can be addressed by qualified individuals who conduct in-person assessments of inmates and generate a treatment plan (Id. at p. 58). According to Dr. Ettner, there are prison systems that send inmates with gender dysphoria to meet with a trained expert for evaluation (Id.). Thus, IDOC would not necessarily have to hire an expert for every facility (Id.). Also, IDOC staff could go through the training to receive certification in treating gender dysphoria, but this involves classes, mentoring, testing, and participating in clinical cases (Id. at p. 59).
Dr. Ettner has evaluated over forty inmates for gender dysphoria throughout the country (Id. at p. 84). All of these evaluations were for litigation purposes and on behalf of plaintiffs (Id. at p. 85). She concluded that three of the inmates she evaluated were receiving adequate care (Id. at pp. 85-86). Dr. Ettner opined that the named Plaintiffs in this case should be evaluated for surgery (Id. at p. 99). The Plaintiffs
Janiah Monroe Janiah Monroe has been in IDOC custody since 2008; at the time of the evidentiary hearing, she resided at Logan Correctional Center (“Logan”), a female facility (Doc. 157, pp. 184-85).1 Monroe was assigned male at birth and grew up in Chicago and New York with a very religious family (Id. at p. 185). Monroe knew from a young age that she was a female; she told her parents on her third birthday that she wanted to be their daughter
1 The Court notes that according to filings after the hearing in this case, there have been a number of issues concerning Monroe’s placement and her health. Thus, the Court requests an update on these matters from Plaintiffs’ counsel.
Page 16 of 39

Case 3:18-cv-00156-NJR Document 186 Filed 12/19/19 Page 17 of 39 Page ID #2336
(Id.). In her youth, Monroe enjoyed playing with her female cousins, playing jump rope, and fixing her hair (Id. at p. 186). She wore both male and female clothing (Id. at p. 187). When Monroe would exhibit feminine characteristics, her father beat her (Id. at p. 185).
Monroe began taking hormones and birth control pills when she was about eleven years old (Id. at p. 188). Monroe hated being perceived as a male and felt anxiety and shame; she felt hatred toward herself, her body, and the way she sounded (Id. at p. 189). Monroe’s struggles with gender dysphoria drove her to attempt suicide (Id.).
When Monroe was first incarcerated in 2008, she informed IDOC she was transgender and requested gender reassignment surgery, hormone therapy, and electrolysis (Id. at pp. 191-92). IDOC told her it would not provide hormone therapy to inmates unless they were legally on hormones prior to incarceration (Id. at p. 192). The denial of treatment was “[e]xcruciatingly painful” for Monroe (Id. at p. 193). She attempted self-castration, chewed through the arteries in both of her arms, chewed out a vein, carved a swastika in her wrist to symbolize self-hate, and hung herself (Id.).
For the first decade of her incarceration, Monroe was housed in male facilities, where she was subjected to verbal harassment, physical assaults, and sexual abuse at the hands of other inmates and correctional officers (Id. at pp. 194-96). Monroe described living in male facilities as “terrifying” (Id. at p. 196). When she stood up for herself, the correctional officers would purposely place her in a cell with a sexually violent inmate and laugh at her when she called for help (Id. at p. 197). During pat-downs, male officers commented on Monroe’s body and inappropriately groped her (Id. at p. 204). Monroe filed grievances over the mistreatment but rarely received a response (Id. at p. 198).
Page 17 of 39

Case 3:18-cv-00156-NJR Document 186 Filed 12/19/19 Page 18 of 39 Page ID #2337
IDOC did not diagnose Monroe with gender dysphoria until 2012—four years after she was first incarcerated (Id. at p. 199). After multiple unsuccessful requests for treatment, Monroe began hormone therapy in April 2012 (Id. at p. 200). Hormone therapy helps Monroe’s gender dysphoria to some extent, but she describes it as “putting a BandAid on a wound that needs stitches” (Id. at p. 202). Monroe believes her hormone dosages are inadequate (Id. at p. 202). Monroe has cut her penis and scrotum so many times that she cannot recall each instance; she hopes her genitals become infected so IDOC is forced to remove them (Id. at pp. 201-02). Monroe believes she needs breast implants, vaginoplasty, and clitoroplasty, so her “mind and [] body can be one” (Id. at p. 213). She has made countless requests and filed at least ten grievances asking for surgery, but has never been evaluated as a surgical candidate (Id. at pp. 213-14).
At the female facility, Monroe has access to female undergarments, makeup, brushes, combs, and beauty shops, and is searched by female officers (Id. at pp. 203-04). At male facilities, transgender inmates only have access to a bra (Id.). After transferring to the female facility, Monroe became involved in a sexual relationship with a female inmate (Id. at pp. 210-12). Consensual sexual encounters among inmates at the female facility are not uncommon (Id. at p. 212). The woman Monroe was involved with accused Monroe of sexual assault, but IDOC determined the allegations were false (Id. at pp. 21112, 221). Monroe believes her accuser was jealous of her friendship with another woman (Id.). Monroe testified her penis is not fully functioning and has not functioned at any time since she was transferred to Logan (Id. at p. 222).
Page 18 of 39

Case 3:18-cv-00156-NJR Document 186 Filed 12/19/19 Page 19 of 39 Page ID #2338
Marilyn Melendez Marilyn Melendez is an inmate in IDOC custody who, at the time of the evidentiary hearing, was housed at Pontiac Correctional Center (“Pontiac”), a male facility (Id. at p. 13). Melendez was assigned male at birth but, at a young age, her mother explained that she was a girl born in a boy’s body (Id. at p. 14). When Melendez was eight or nine years old, her mother started her on hormones, testosterone blockers, and estrogen (Id. at p. 15). Melendez developed breasts, but when she was thirteen, her mother could no longer afford the treatment (Id. at pp. 15-16, 40). Melendez went through male puberty; she grew taller, her shoulders broadened, she developed muscles, her voice deepened, and she began experiencing erections (Id. at p. 16). Melendez “felt like a monster” and her peers made fun of her (Id.). She was involved in a lot of fights and started doing drugs, which led to her incarceration (Id.). Melendez came under IDOC’s custody in 2012 and was initially housed at Stateville Correctional Center (“Stateville”) (Id.). She immediately told Stateville she was transgender, but she was never evaluated for gender dysphoria (Id.). Two weeks later, Melendez was transferred to Menard Correctional Center (“Menard”) (Id. at pp. 16-17). She reiterated to the chaplain, a grievance counselor, and the mental health department that she was transgender and requested hormone therapy (Id. at pp. 17-18). Melendez was denied hormone therapy and never evaluated for gender dysphoria (Id.). Melendez was transferred to Pontiac one year later and told the facility she was transgender (Id. at p. 18). Pontiac officials told Melendez she was a cross dresser and just seeking attention (Id.). In 2015, Melendez was transferred back to Stateville (Id. at pp. 18-19). She was
Page 19 of 39

Case 3:18-cv-00156-NJR Document 186 Filed 12/19/19 Page 20 of 39 Page ID #2339
evaluated for gender dysphoria but told she needed additional counseling before a she could receive a final diagnosis (Id. at p. 19). Melendez was finally diagnosed with gender dysphoria in March 2015 (Id. at p. 20).
The Transgender Committee initially denied Melendez’s request for hormone therapy because it believed she needed further counseling (Id. at p. 21). Melendez was approved for hormone therapy in 2015 and began treatment in July or August 2015 (Id. at p. 22). But Melendez testified IDOC has not addressed her needs for hormone therapy (Id. at p. 23). IDOC started Melendez on the lowest dosage of hormones for a ninety-day period to see if she would experience any complications, and IDOC was supposed to conduct blood tests after the ninety days to determine an appropriate dosage (Id.). After the ninety days, Melendez was still growing excess facial and body hair, she was experiencing erections, her skin was oily, and she did not develop any breast tissue (Id.). Melendez was transferred to Pontiac, where she told the medical director she was unsatisfied with the dosage (Id. at p. 24). The physician told Melendez he did not “really know anything about transgender health” (Id.). Melendez filed grievances, and IDOC increased her dosage (Id.). Melendez is still unsatisfied with her hormone therapy as she has frequent erections, her testicles have not shrunk, and she grows excess hair (Id. at p. 25).
Melendez requested gender-affirming surgery but was told IDOC does not pay for sexual reassignment surgery (Id. at p. 26). Melendez believes she needs penile inversion surgery or the removal of her genitals, hair removal surgery, liposuction, breast augmentation, brow shaving, chin shaving, and cartilage shaving (Id. at p. 28). Living
Page 20 of 39

Case 3:18-cv-00156-NJR Document 186 Filed 12/19/19 Page 21 of 39 Page ID #2340
without surgery is “upsetting” and “depressing,” and brings Melendez “disgust and discomfort” (Id. at p. 27). Using the restroom and showering makes her feel like a “freak” (Id.).
IDOC denied Melendez’s request for hair removal because inmates are already allowed accessed to Magic Shave (hair-removal cream) and razors (Id. at pp. 29, 48). Melendez testified that hormones make skin softer and more sensitive, so the Magic Shave makes her skin peel and blister (Id. at p. 48). Melendez wants access to all of the products that inmates in the female facilities can access (Id. at p. 33). Melendez testified that living without feminine products is depressing (Id. at pp. 33-34). She has dry skin and, for an entire year, brushed her hair with her fingers and a spork (Id. at p. 34). She is forced to use men’s soap and aftershave (Id.).
Melendez requested a bra in 2015 and received one in 2017 (Id. at p. 32). She wants additional gender-affirming clothes and undergarments (Id. at p. 33). Melendez requested gender-affirming clothes from health care, mental health, commissary, and the warden, but is still waiting for an answer (Id. at pp. 29-30, 36). The lack of genderaffirming clothing has negatively impacted her social transition (Id. at p. 35).
Melendez has never been housed in a female facility (Id. at p. 36). Melendez is strip-searched by men in front of male inmates, and the correctional officers laugh at her (Id. at p. 52). Correctional officers have verbally harassed and groped Melendez and she is often misgendered (Id. at pp. 37-38). IDOC staff has called Melendez “him,” “dude,” “it,” and “he-she” (Id. at p. 38). Melendez requested to be moved to a female facility in the past, but has not recently requested a transfer because she heard transgender women
Page 21 of 39

Case 3:18-cv-00156-NJR Document 186 Filed 12/19/19 Page 22 of 39 Page ID #2341
in female facilities are segregated (Id. at p. 86). Melendez has contemplated suicide in the past year and testified that if her current
treatment persists, she will kill herself or put herself in a position where someone else kills her (Id. at pp. 38-39).
Sasha Reed Sasha Reed is a transgender woman who, at the time of the evidentiary hearing, was incarcerated at Lawrence Correctional Center (“Lawrence”), a male facility (Id. at pp. 54, 71). When Reed was three years old, she was placed in her aunt’s care and sexually and physically abused (Id.). Reed first understood she is female when she was eight years old (Id.). Her caretakers in the Department of Child and Family Services were not supportive of her female gender identity (Id. at p. 55). She felt “horrible” when people treated her as a male, and she felt stressed and depressed (Id. at p. 56). When Reed was seventeen, she began wearing female clothing (Id. at p. 55). Prior to her incarceration, Reed never received any type of treatment for gender dysphoria (Id. at p. 56). When Reed came under IDOC’s care in July 2013, she alerted officials at Stateville that she was transgender and requested to speak to a mental health professional (Id. at pp. 56-57, 60). Reed never met with anyone on the Transgender Committee, spoke with any mental health professionals, or received any treatment for gender dysphoria while she was at Stateville (Id. at pp. 57-58). Reed was depressed, anxious, and suicidal (Id. at p. 58). She attempted suicide because IDOC was not treating her gender dysphoria (Id.). Reed was transferred to Pontiac for a year and a half and told a nurse that she was transgender (Id. at p. 59). Reed never received any sort of treatment for gender dysphoria
Page 22 of 39

Case 3:18-cv-00156-NJR Document 186 Filed 12/19/19 Page 23 of 39 Page ID #2342
while at Pontiac (Id.). Reed was transferred to Menard, and in 2015, she alerted officials she was transgender (Id. at p. 60). She was diagnosed with gender dysphoria and began receiving treatment in November 2015 (Id.).
Reed started hormone therapy in March 2017 and is still taking hormones today (Id. at p. 61). Prior to starting therapy, Reed had to submit a survey to the Transgender Committee (Id.). The Committee met with Reed a month or two later and denied her request for hormone therapy (Id. at p. 62). The Committee told Reed she had to stop taking her medication for schizophrenia for six weeks before taking hormones (Id.). Reed complied, but the Committee still denied therapy (Id. at p. 63). Reed was attending mental health sessions every two weeks during this period and told her doctor she was depressed, anxious, and had thoughts of self-harm (Id. at p. 63). Reed was eventually prescribed hormones in March 2017 (Id. at p. 64).
In 2016, Reed filed a grievance requesting female clothing, soap, deodorant, shampoo, and body wash, and a transfer to a female facility; her request was denied (Id. at pp. 64-65). She filed another grievance in 2016, which was also denied (Id. at p. 65). Along with filing grievances, Reed requested female grooming items from mental health professionals and the warden (Id.). The warden told Reed, “[T]his is a man [sic] facility, we don’t do that” (Id. at p. 66). Reed also requested a bra in 2016 and 2017, but her grievances were denied because the facility stated a bra was not medically necessary (Id. at pp. 66-67). Reed finally received a bra in 2017 (Id. at p. 67). Reed wants access to female grooming products because she does not feel comfortable using products created for men (Id. at pp. 81-82).
Page 23 of 39

Case 3:18-cv-00156-NJR Document 186 Filed 12/19/19 Page 24 of 39 Page ID #2343
In 2016 and 2017, Reed filed grievances for gender-affirming surgery, but IDOC denied the requests (Id. at pp. 68-69). She testified she is a woman and does not feel comfortable having male “parts” (Id. at p. 68). Reed felt suicidal after IDOC denied her grievances and without surgery she does not feel hopeful about her future (Id.). Reed’s mental health professional told her IDOC is not permitting any surgeries (Id.).
Reed does not feel safe at a male facility (Id. at p. 71). IDOC staff and fellow inmates verbally harass Reed because of her gender identity (Id. at pp. 71-72). Men try to get her to show them her breasts or they try to grope her (Id. at p. 72). Reed filed a complaint about the harassment but has not received a response (Id. at pp. 72-73). Male correctional officers strip-search Reed, which makes her feel violated (Id. at p. 73). Reed has requested that female officers perform the searches, but the facility told her there is no policy about having females search transgender inmates in male facilities (Id. at p. 74). When Reed told IDOC she was transgender, she was never evaluated for a transfer to a female facility (Id. at pp. 74-75).
When Reed was first incarcerated, she told mental health professionals she heard voices in her head that instructed her to cut herself (Id. at p. 76). In July 2013, IDOC staff found Reed in her cell with a sheet around her neck, giving the thumbs up sign (Id.). Reed admitted she suffers from symptoms that cause depression and self-harm aside from gender dysphoria (Id. at pp. 79-80). Reed attends group therapy but is still upset that she is not receiving the right treatment for gender dysphoria (Id. at pp. 83-84). Sometimes she is suicidal (Id. at p. 84). Reed brings up her feelings to mental health staff, but they do not listen to her (Id.).
Page 24 of 39

Case 3:18-cv-00156-NJR Document 186 Filed 12/19/19 Page 25 of 39 Page ID #2344
IDOC classifies Reed as a “vulnerable” inmate and restricts her housing assignments and jobs (Id. at p. 82). As a vulnerable inmate, Reed is permitted to shower separately from other inmates, in private (Id. at pp. 81-82).
Sora Kuykendall Sora Kuykendall first identified as a female when she was about five years old (Doc. 123, Ex. 6, p. 1). Kuykendall’s family did not support her gender identity, so she was never evaluated for gender dysphoria (Id.). Kuykendall experienced extreme depression when she went through male puberty (Id. at pp. 1-2). When she was a teenager, she attempted suicide because of the despair she felt from being trapped in a man’s body (Id. at p. 2). Kuykendall came under IDOC’s care in November 2014 and, at the time of the evidentiary hearing, was housed in a male facility (Id. at pp. 2, 4). She requested hormone therapy within a week, but IDOC denied her request and refused to evaluate her for gender dysphoria (Id. at p. 2). IDOC eventually evaluated her for gender dysphoria after she attempted self-castration in 2015 (Id.). Kuykendall began taking Spironolactone and Menest in February 2015 (Id.). She has repeatedly requested IDOC officials conduct blood and laboratory tests to monitor her hormone levels, but as of April 2019, her hormone levels had never been monitored (Id.). Kuykendall has developed breasts and she requested a bra in June 2015; however, she did not receive a bra until six months later (Id.). Kuykendall has repeatedly requested feminine grooming and cosmetic products by filing formal grievances, but IDOC has denied or ignored her requests (Id. at pp. 2-3). Kuykendall still suffers from gender dysphoria (Id. at p. 3). She is disturbed by her
Page 25 of 39

Case 3:18-cv-00156-NJR Document 186 Filed 12/19/19 Page 26 of 39 Page ID #2345
genitals and body hair (Id.). She has continuously requested gender-affirming surgery since June 2015, but IDOC has not evaluated her for surgery (Id.). Kuykendall feels extremely depressed and anxious, and she has frequent thoughts of self-harm (Id.).
Kuykendall is strip-searched by male officers and in the presence of other males, which makes her feel humiliated and violated (Id.). She filed a grievance in March 2017 requesting to be strip-searched by females, but has not received a response (Id.). Kuykendall testified that IDOC staff, including mental health professionals, are consistently disrespectful and refer to her with male pronouns and call her “it” (Id. at p. 4). She feels unsafe and is verbally harassed on a daily basis (Id.).
Lydia Helena Vision Lydia Helena Vision knew from a young age that she was female (Doc. 123, Ex. 5, p. 1). She entered IDOC custody in June 2004 and, at the time of the evidentiary hearing, was housed at Danville Correctional Center (“Danville”) (Id.). Vision told IDOC personnel she was transgender in 2015 and was diagnosed with gender dysphoria in March 2016 (Id.). Since her diagnosis, Vision has requested hormone therapy, female clothing, and gender-affirming grooming items, but IDOC repeatedly denied her requests (Id. at pp. 1-2). IDOC told Vision she had to attend sessions for PTSD before beginning hormone therapy (Id. at p. 2). In July 2016, IDOC referred Vision to a psychiatrist who evaluated her via Skype and confirmed the diagnosis of gender dysphoria (Id.). Vision stated the psychiatrist confirmed that the lack of hormone therapy was causing Vision extreme distress and recommended she discuss hormone therapy with a physician (Id.). IDOC still refused to
Page 26 of 39

Case 3:18-cv-00156-NJR Document 186 Filed 12/19/19 Page 27 of 39 Page ID #2346
provide Vision hormone therapy; her treatment plan consisted of monthly counseling sessions with counselors who misgendered her and were unfamiliar with transgender issues (Id.).
Vision was forced to continue showering in general population for several months after her diagnosis (Id.). She had panic attacks while showering (Id.). At some point, Danville organized a transgender group, and Vision began attending sessions (Id. at p. 3). She also attended regular therapy sessions and requested more material on gender dysphoria (Id.). She joined an outside LGBTQ organization and wrote to other transgender people (Id.). Vision tried to take measures to feminize her appearance, such as following a special weightlifting program to enhance her breast size (Id.). Nonetheless, she felt increasingly depressed and anxious without access to hormone treatment and feminine products (Id.). Vision quit her job in the laundry room because of depression (Id. at p. 4).
Vision filed several grievances throughout her incarceration requesting hormones, gender-affirming clothes, grooming products, and placement in a cell with another transgender inmate (Id. at p. 3). IDOC eventually gave Vision a bra in 2017 but denied her remaining requests (Id.).
A psychiatrist evaluated Vision in October 2017 and recommended IDOC consider her for hormone therapy (Id.). IDOC still failed to start Vision on hormones (Id.). Another psychiatrist evaluated Vision in January 2018 and confirmed her diagnosis of gender dysphoria (Id.). Again, IDOC did not prescribe Vision hormones (Id.). Vision was transferred to Graham Correctional Center in May 2018 (Id.). In June 2018, yet another
Page 27 of 39

Case 3:18-cv-00156-NJR Document 186 Filed 12/19/19 Page 28 of 39 Page ID #2347
psychiatrist evaluated Vision and confirmed her diagnosis of gender dysphoria (Id. at p. 5). Vision was becoming more anxious and depressed and had trouble eating and sleeping (Id.). In late 2018, thirty-two months after her original diagnosis of gender dysphoria, Vision finally began hormone therapy (Id.).
Vision is still “terrified” she will never receive the treatment she needs (Id.). She has trouble accessing information about treatment and has had problems with prescription changes and hormone dosages (Id.). Also, Vison wants to be housed at a female facility (Id. at p. 6).
LEGAL STANDARDS Preliminary injunctions are extraordinary and drastic remedies that should not be granted unless the movant makes a clear showing that it has carried its burden of persuasion. Mazurek v. Armstrong, 520 U.S. 968, 972 (1997). Under Federal Rule of Civil Procedure (“Rule”) 65, the party moving for an injunction has the burden of showing that it has some likelihood of succeeding on the merits, that no adequate remedy at law exists, and that it will suffer irreparable harm in the interim period prior to final resolution of its claims. Girl Scouts of Manitou Council, Inc. v. Girl Scouts of U.S. of America, Inc., 549 F.3d 1079, 1086 (7th Cir. 2008). If the movant establishes these elements, the Court must then balance the potential harm to the movant if the preliminary injunction were wrongfully denied, against the potential harm to the non-movant if the injunction were wrongfully granted. Cooper v. Salazar, 196 F.3d 809, 813 (7th Cir. 1999). The Court should also take into consideration the effect that granting or denying the injunction will have on the public. Girl Scouts, 549 F.3d at 1086.
Page 28 of 39

Case 3:18-cv-00156-NJR Document 186 Filed 12/19/19 Page 29 of 39 Page ID #2348
The Prison Litigation Reform Act (“PLRA”) applies to suits filed by incarcerated people and limits the equitable relief a district court can order. 42 U.S.C. § 1997e & 18 U.S.C. § 3626. “The PLRA states that no prospective relief shall issue with respect to prison conditions unless it is narrowly drawn, extends no further than necessary to correct the violation of a federal right, and is the least intrusive means necessary to correct the violation.” Brown v. Plata, 563 U.S. 493, 530 (2011) (citing 18 U.S.C. § 3626(a). “When determining whether these requirements are met, courts must give substantial weight to any adverse impact on public safety or the operation of a criminal justice system.” Id. (internal quotations omitted).
Here, Plaintiffs allege IDOC is deliberately indifferent in its treatment of transgender inmates. “Prison officials violate the Eighth Amendment’s proscription against cruel and unusual punishment when they display deliberate indifference to serious medical needs of prisoners.” Fields v. Smith, 653 F.3d 550, 554 (7th Cir. 2011) (internal quotations and citations omitted). The deliberate indifference inquiry has two parts. The Court examines (1) whether a plaintiff suffered from an objectively serious medical condition and (2) whether the defendants were deliberately indifferent to that condition. Campbell v. Kallas, 936 F.3d 536, 545 (7th Cir. 2019). “To prove deliberate indifference, ‘mere negligence is not enough . . . [A] plaintiff must provide evidence that an official actually knew of and disregarded a substantial risk of harm.’” Id. (quoting Petties, 836 F.3d at 728).
DISCUSSION The parties agree that gender dysphoria is an objectively serious medical
Page 29 of 39

Case 3:18-cv-00156-NJR Document 186 Filed 12/19/19 Page 30 of 39 Page ID #2349
condition. See Campbell, 936 F.3d at 545. The parties differ, however, on what constitutes constitutionally adequate treatment. Plaintiffs contend IDOC puts transgender prisoners’ health and lives at risk by delaying the evaluation and treatment of gender dysphoria; permitting the Transgender Committee to make medical decisions for transgender inmates; improperly administering hormone treatment; denying transgender inmates the ability to socially transition; and failing to provide gender-affirming surgery to inmates. The linchpin of Plaintiffs’ arguments seems to be that IDOC does not comport with WPATH’s Standards of Care.
Plaintiffs’ experts, Dr. Ettner and Dr. Tangpricha, both relied on the Standards of Care and the Endocrine Society Guidelines to conclude that IDOC provides inadequate treatment to transgender inmates. But Defendants argue the Standards of Care delineate the highest level of care, rather than the constitutionally adequate care IDOC must provide. After all, it is well-settled that prisoners are not “entitled to demand specific care” or “the best care possible.” See Forbes v. Edgar, 112 F.3d 262, 267 (7th Cir. 1997). Along the same lines, Defendants assert the Court should discount the opinions of Dr. Ettner and Dr. Tangpricha as biased and unreliable.
Defendants discredit Dr. Ettner and Dr. Tangpricha because of their involvement in WPATH and their experience testifying for plaintiffs in cases involving gender dysphoria. “Rule 702’s reliability elements require the [Court] to determine only that the expert is providing testimony that is based on a correct application of a [valid] methodology and that the expert considered sufficient data to employ the methodology.” Stollings v. Ryobi Techs., Inc., 725 F.3d 753, 766 (7th Cir. 2013). “The focus, therefore, ‘must
Page 30 of 39

Case 3:18-cv-00156-NJR Document 186 Filed 12/19/19 Page 31 of 39 Page ID #2350
be solely on principles and methodology, not on the conclusions that they generate.’” Gopalratnam v. Hewlett-Packard Co., 877 F.3d 771, 781 (7th Cir. 2017) (quoting Daubert v. Merrell Pharm., Inc., 509 U.S. 570, 595 (1993)).
Here, Dr. Ettner and Dr. Tangpricha based their testimony on WPATH’s Standards of Care, which are endorsed as the standards for treating gender dysphoria by the World Health Organization, the American Medical Association, the American Psychiatric Association, the American Psychological Association, the American Family Practice Association, the Endocrine Society, and the National Commission on Correctional Health (Doc. 158, p. 24). Dr. Tangpricha testified the Standards of Care are the “floor” for treating gender dysphoria (Doc. 157, p. 98). Defendants’ own witness, Dr. Puga, testified he was not familiar with any other association that rivals WPATH’s level of universal acceptance in the transgender health field (Doc. 158, p. 142). Moreover, Defendants have not put forth a single expert to contest the Standards of Care or offer an opinion about the appropriate level of care for transgender inmates. Thus, this Court joins many other courts who agree the Standards of Care are the appropriate benchmark for treating gender dysphoria. Edmo v. Corizon, Inc., 935 F.3d 757, 769 (9th Cir. 2019) (and cases cited therein).
Also, Dr. Ettner and Dr. Tangpricha’s involvement with WPATH does not overshadow their qualifications as experts in transgender health. Together, they have treated thousands of individuals with gender issues, authored roughly sixty peerreviewed articles on transgender health, and earned a medical degree and Ph.Ds.
Defendants point out Dr. Tangpricha testified he did not recall seeing any medical Page 31 of 39

Case 3:18-cv-00156-NJR Document 186 Filed 12/19/19 Page 32 of 39 Page ID #2351
records where an inmate refused hormone therapy (Doc. 157, p. 157). At the hearing, however, Defendants confronted Dr. Tangpricha with records where an inmate refused to take hormones on several occasions (Id. at pp. 176-79). Defendants indicated they were going to move to admit the records into evidence, but did not do so. Thus, it is impossible to infer how the records affect Dr. Tangpricha’s reliability. Even so, Dr. Tangpricha’s unfamiliarity with a few pages of medical documents out of the thousands in this case does not weigh on his credibility. In sum, the opinions of Dr. Tangpricha and Dr. Ettner are based on well-recognized scientific and medical standards and they have established themselves as experts in the field of transgender health.
Likelihood of Success on the Merits For purposes of a preliminary injunction, Plaintiffs must demonstrate a likelihood of success on the merits, i.e., that they have a “better than negligible” chance of proving their claims. Ty, Inc. v. Jones Group, Inc., 237 F.3d 891, 897 (7th Cir. 2001). Because the parties agree that gender dysphoria constitutes an objectively serious medical condition, Plaintiffs must show IDOC consciously disregarded a known and substantial risk of harm associated with gender dysphoria. Greeno v. Daley, 414 F.3d 645, 653 (7th Cir. 2005). IDOC is well-aware that transgender inmates are at a high risk of suffering from mental health issues and resorting to self-harm. Plaintiffs’ grievances and medical records document a pattern of genital mutilation and suicide attempts among the transgender population (Pl. Exs. 4, 9, 10, 12, 14, 15, 16, 17). Unfortunately, a transgender inmate successfully committed suicide while in IDOC’s care in May 2015 (Pl. Ex. 20). Despite these known risks, there is evidence that IDOC denies and delays the
Page 32 of 39

Case 3:18-cv-00156-NJR Document 186 Filed 12/19/19 Page 33 of 39 Page ID #2352
diagnosis and treatment of gender dysphoria without a medical basis or penological purpose. For instance, Monroe was not diagnosed with gender dysphoria until four years after she first sought treatment from IDOC, Melendez had to wait three years to receive a diagnosis and treatment, and Kuykendall and Reed waited almost two years. During these periods, Reed attempted suicide and Kuykendall attempted self-castration. Medical records of the putative class members demonstrate the same pattern of delaying hormone therapy with no medical justification. Also, IDOC denies inmate requests to increase dosages of hormones without testing hormone levels or providing a medical basis. In cases where IDOC did test hormone levels, they were below the therapeutic range.
Moreover, Plaintiffs’ experts testified surgery can be medically necessary to treat gender dysphoria, but IDOC has not evaluated a single transgender inmate for surgery. Failing to provide care for a non-medical reason or inexplicably delaying treatment with no penological purpose can amount to deliberate indifference. Mitchell v. Kallas, 895 F.3d 492, 498 (7th Cir. 2018). Also, “[r]efusing to provide effective treatment for a serious medical condition serves no valid penological purpose and amounts to torture.” Fields v. Smith, 653 F.3d 550, 556 (7th Cir. 2011).
In addition, IDOC is aware of the serious side effects of the hormones it administers to transgender inmates. Dr. Puga testified hormones caused a transgender inmate to have a stroke that left her partially paralyzed and impaired her speech. Spironolactone and Estradiol, the two agents involved in hormone therapy for transgender women, can cause heart arrhythmias, kidney failure, blindness, and death. Despite these potentially lethal side effects, IDOC does not monitor inmates who take
Page 33 of 39

Case 3:18-cv-00156-NJR Document 186 Filed 12/19/19 Page 34 of 39 Page ID #2353
hormones in accordance with the Endocrine Society Guidelines. Dr. Tangpricha reviewed relevant medical records from all putative class members and testified IDOC did not monitor ninety percent of those inmates in accordance with the Endocrine Society Guidelines and did not monitor approximately twenty-five to fifty percent of the inmates at all. For instance, IDOC did not monitor Kuykendall’s hormone levels until two years after she started hormone therapy.
Plaintiffs also have put forth evidence that the Transgender Committee is unqualified to make medical decisions for transgender inmates. Dr. Puga is the Chair of the Committee but has never treated a patient primarily for gender dysphoria and is not familiar with the Endocrine Society Guidelines. Dr. Meeks, a medical doctor on the Committee, has never prescribed hormones to a patient (Doc. 123, Ex. 11). Although the Committee consults with Dr. Reister, he testified he defers medical decisions to Dr. Puga, and he is not familiar with the Guidelines. Dr. Puga testified, however, that Dr. Reister has the most experience with transgender health. Dr. Ettner testified the Committee’s uninformed decisions place transgender inmates at risk. “The Eighth Amendment protects a [prisoner] not only from deliberate indifference to his or her current serious health problems, but also from deliberate indifference to conditions posing an unreasonable risk of serious damage to future health.” Board v. Farnham, 394 F.3d 469, 479 (7th Cir. 2005) (emphasis in original).
There is also evidence that IDOC prevents Plaintiffs’ social transitions by misgendering inmates and denying them access to female commissary items. Social transition is “an important component of medical treatment” and misgendering someone
Page 34 of 39

Case 3:18-cv-00156-NJR Document 186 Filed 12/19/19 Page 35 of 39 Page ID #2354
with gender dysphoria is “traumatic” (Doc. 158 pp. 15, 18). Here, Plaintiffs have repeatedly requested access to commissary items like lotion, makeup, hair brushes, and female undergarments. IDOC often denies or fails to respond to these requests. At best, IDOC provides a bra to transgender inmates residing at male facilities. Also, Plaintiffs testified IDOC staff members call transgender inmates “him,” “dude,” “it,” and “he-she” (Doc. 157, p. 38). IDOC’s denial and/or delay of necessary social transition items has exacerbated Plaintiffs’ deteriorating mental states. Based on the above, Plaintiffs have met their burden of showing a likelihood of success on the merits for purposes of a preliminary injunction.
Irreparable Harm and Inadequate Remedy at Law The party moving for a preliminary injunction must demonstrate he or she will likely suffer irreparable harm absent the injunctive relief. Whitaker By Whitake v. Kenosha Unified School district No. 1 Board of Education, 858 F.3d 1034, 1044 (7th Cir. 2017). “This requires more than a mere possibility of harm” but “does not, however, require that the harm actually occur before injunctive relief is warranted.” Id. Also, the moving party must demonstrate there is no adequate remedy at law because “any award would be seriously deficient as compared to the harm suffered.” Id. at 1046 (internal quotations omitted). Here, Plaintiffs testified that the lack of proper treatment for gender dysphoria has caused them serious mental health issues. Kuykendall stated, “Every day my requests for gender-affirming surgery, hormone monitoring, gender-affirming clothing, and being able to be myself in a women’s facility go ignored, I feel myself slipping into a deeper
Page 35 of 39

Case 3:18-cv-00156-NJR Document 186 Filed 12/19/19 Page 36 of 39 Page ID #2355
depression. I am struggling with constant thoughts of self-harm.” Melendez stated her inability to socially transition is “extremely upsetting” and she has experienced thoughts of suicide in the recent past. Monroe has already attempted suicide because of her gender dysphoria and has mutilated her genitals on several occasions. Moreover, Dr. Ettner and Dr. Tangpricha testified that untreated gender dysphoria can lead to anxiety, depression, self-harm, and suicide. In this case, there is no doubt that Plaintiffs face irreparable harms that cannot be compensated by monetary damages. See Whitaker, 858 F.3d at 1045-46 (suicide and diminished well-being do not have an adequate remedy at law and are irreparable harms).
Balance of Harms and Public Interest “Once a moving party has met its burden of establishing the threshold requirements for a preliminary injunction, the court must balance the harms faced by both parties and the public as a whole.” Id. at 1053. The balance of harm substantially weighs in favor of granting injunctive relief. Plaintiffs continue to suffer physical and mental anguish on a daily basis and are at risk of self-mutilation and death. In contrast, Defendants have not identified any harm they will suffer if an injunction were granted. Moreover, the public has the “highest” interest in preventing the violation of a party’s constitutional rights. See United States v. Raines, 362 U.S. 17, 27 (1960) (“[T]here is the highest public interest in the due observance of all the constitutional guarantees.”). Also, “[t]he public has a strong interest in the provision of constitutionally-adequate health care to prisoners.” Flynn v. Doyle, 630 F.Supp.2d 987, 993 (E.D. Wis. Apr. 24, 2009). Accordingly, Plaintiffs have met their burden in moving for a preliminary injunction.
Page 36 of 39

Case 3:18-cv-00156-NJR Document 186 Filed 12/19/19 Page 37 of 39 Page ID #2356
Ongoing Violations Defendants argue Plaintiffs are not entitled to injunctive relief because they cite medical records from several years ago and do not put forth recent evidence to establish an ongoing violation. But Plaintiffs have provided plenty of evidence that IDOC continuously fails to provide adequate treatment to inmates with gender dysphoria. Melendez stated her hormone dosage is ineffective (Doc. 157, pp. 23-24); Reed and Melendez testified they do not have access to female commissary items that would facilitate their social transitions (Id. at pp. 33-24, 81-82); the Transgender Committee has never evaluated a single inmate for surgical intervention (Doc. 158, p. 120); and the medical records suggest IDOC fails to adequately monitor inmates’ hormones (Doc. 123, Ex. 6, p. 2).
INJUNCTIVE RELIEF For the reasons set forth above, the Court GRANTS Plaintiffs’ request for preliminary injunctive relief (Doc. 123). The Court ORDERS Defendants to immediately: 1. cease the policy and practice of allowing the Transgender Committee to make the medical decisions regarding gender dysphoria and develop a policy to ensure that decisions about treatment for gender dysphoria are made by medical professionals who are qualified to treat gender dysphoria; 2. cease the policy and practice of denying and delaying hormone therapy for reasons that are not recognized as contraindications to treatment, ensure timely hormone therapy is provided when necessary, and perform routine monitoring of hormone levels; and 3. cease the policy and practice of depriving gender dysphoric prisoners of medically necessary social transition, including by mechanically assigning housing based on genitalia and/or physical size or appearance.
Page 37 of 39

Case 3:18-cv-00156-NJR Document 186 Filed 12/19/19 Page 38 of 39 Page ID #2357
The Court FURTHER ORDERS Defendants to: 1. develop policies and procedures which allow transgender inmates access
to clinicians who meet the competency requirements stated in the WPATH Standards of Care to treat gender dysphoria; 2. allow inmates to obtain evaluations for gender dysphoria upon request or clinical indications of the condition; 3. develop a policy to allow transgender inmates medically necessary social transition, including individualized placement determinations, avoidance of cross-gender strip searches, and access to gender-affirming clothing and grooming items; and 4. advise the Court what steps, if any, IDOC has taken to train all correctional staff on transgender issues, including the harms caused by misgendering and harassment—by both IDOC staff and other inmates. As an additional point, the Court notes that no IDOC representative attended any portion of the two-day preliminary injunction hearing. Because the Court is concerned that IDOC is not taking Plaintiffs’ allegations in this lawsuit seriously, the Court ORDERS that each named Defendant shall read the transcript of the evidentiary hearing held on July 31-August 1, 2019 (see Docs. 157, 158) and certify to the Court, on or before January 6, 2020, that he has done so. The Court recognizes that these changes will take time, but it in light of the serious deficiencies in IDOC’s treatment of transgender inmates set forth above, the undersigned seeks assurance that progress is underway. There is a long way to go, and the issue must be promptly addressed. Thus, on or before January 22, 2020, Defendants SHALL notify the Court in writing what actions they have taken to implement the directives of this Order. The Court will at that point address Plaintiffs’ request for a court-appointed medical expert to oversee implementation of the preliminary injunctive relief in this
Page 38 of 39

Case 3:18-cv-00156-NJR Document 186 Filed 12/19/19 Page 39 of 39 Page ID #2358
Order. In light of its rulings above, the Court DENIES at this time Plaintiffs’ motions for
leave to supplement the record (Docs. 166, 175). Plaintiffs will be given an opportunity to respond to IDOC’s compliance with the Court’s Order. As set forth in footnote 1, Plaintiffs’ counsel shall advise the Court in writing concerning Ms. Monroe’s current condition on or before January 6, 2020.
Finally, the Court DENIES the recently filed motion for status conference (Doc. 185). A status conference will be set after Defendants have an opportunity to respond to the Court’s Order.
Pursuant to MillerCoors LLC v. Anheuser-Busch Companies, LLC, 940 F.3d 922 (7th Cir. 2019), the Court will enter the terms of the preliminary injunctive relief set forth above in a separate document.
IT IS SO ORDERED. DATED: December 19, 2019
____________________________ NANCY J. ROSENSTENGEL Chief U.S. District Judge
Page 39 of 39

 
 Case 3:18-cv-00156-NJR Document 212 Filed 03/04/20 Page 1 of 2 Page ID #2529

IN THE UNITED STATES DISTRICT COURT FOR THE SOUTHERN DISTRICT OF ILLINOIS

JANIAH MONROE, MARILYN MELENDEZ, EBONY STAMPS, LYDIA HELÉNA VISION, SORA KUYKENDALL, and SASHA REED,

Plaintiffs,

v.

Case No. 18-cv-00156-NJR

STEVE MEEKS, MELVIN HINTON, and ROB JEFFREYS,

Defendants.

AMENDED PRELIMINARY INJUNCTION

ROSENSTENGEL, Chief Judge:

Pursuant to Rule 65(d)(1)(C) of the Federal Rules of Civil Procedure and

MillerCoors LLC v. Anheuser-Busch Companies, LLC, 940 F.3d 922 (7th Cir. 2019), the Court

issues the following preliminary injunctive relief.

The Court ORDERS Defendants to immediately:

1. cease the policy and practice of allowing the Transgender Committee to make the medical decisions regarding gender dysphoria and develop a policy to ensure that decisions about treatment for gender dysphoria are made by medical professionals who are qualified to treat gender dysphoria;

2. ensure that timely hormone therapy is provided when medically necessary, including the administration of hormone dosage adjustments, and to perform routine monitoring of hormone levels; and

3. cease the policy and practice of depriving gender dysphoric prisoners of medically necessary social transition, including by mechanically assigning housing based on genitalia and/or physical size or

Page 1 of 2

Case 3:18-cv-00156-NJR Document 212 Filed 03/04/20 Page 2 of 2 Page ID #2530 appearance.
The Court FURTHER ORDERS Defendants to: 1. develop policies and procedures which allow transgender inmates access to clinicians who meet the competency requirements stated in the WPATH Standards of Care to treat gender dysphoria; 2. allow inmates to obtain evaluations for gender dysphoria upon request or clinical indications of the condition; 3. develop a policy to allow transgender inmates medically necessary social transition, including individualized placement determinations, avoidance of cross-gender strip searches, and access to gender-affirming clothing and grooming items; and 4. advise the Court what steps, if any, IDOC has taken to train all correctional staff on transgender issues, including the harms caused by misgendering and harassment—by both IDOC staff and other inmates. IT IS SO ORDERED. DATED: March 4, 2020
____________________________ NANCY J. ROSENSTENGEL Chief U.S. District Judge
Page 2 of 2

 
 Case 3:18-cv-00156-NJR Document 213 Filed 03/04/20 Page 1 of 11 Page ID #2531

IN THE UNITED STATES DISTRICT COURT FOR THE SOUTHERN DISTRICT OF ILLINOIS

JANIAH MONROE, MARILYN MELENDEZ, EBONY STAMPS, LYDIA HELÉNA VISION, SORA KUYKENDALL, and SASHA REED,

Plaintiffs,

v.

Case No. 18-cv-00156-NJR

STEVE MEEKS, MELVIN HINTON, and ROB JEFFREYS,

Defendants.

MEMORANDUM AND ORDER

ROSENSTENGEL, Chief Judge:

This matter is before the Court on the motion for class certification brought by

Plaintiffs Janiah Monroe, Marilyn Melendez, Ebony Stamps,1 Lydia Heléna Vision, Sora

Kuykendall, and Sasha Reed pursuant to Federal Rule of Civil Procedure 23(b)(2). (Doc. 124).

Defendants opposed the motion for class certification in a response filed on June 14, 2019.

(Doc. 145). Plaintiffs then filed a reply brief. (Doc. 149). For the following reasons, the motion

is granted.

INTRODUCTION

Plaintiffs, transgender women currently incarcerated in the Illinois Department of

Corrections (“IDOC”) facilities, bring this civil action pursuant to 42 U.S.C. § 1983 for

1 Plaintiffs state that Ebony Stamps is no longer in IDOC custody. (Doc. 124, p. 7). Because an individual “who [is] no longer incarcerated [does] not have a legally cognizable interest in enjoining IDOC’s future behavior” and does “not have standing to assert the class claims” Ebony Stamps will be dismissed from this case. Holmes v. Godinez, 311 F.R.D. 177, 213 (N.D. Ill. Oct. 8, 2015).
Page 1 of 11

Case 3:18-cv-00156-NJR Document 213 Filed 03/04/20 Page 2 of 11 Page ID #2532
violations of their constitutional rights. Plaintiffs claim that IDOC fails to provide constitutionally adequate medical treatment for inmates seeking evaluation and treatment for gender dysphoria in violation of the Eighth Amendment. (Doc. 1, p. 3; Doc. 124, p. 7). Plaintiffs seek declaratory and injunctive relief, asking the Court to compel Defendants to develop and implement a plan to eliminate the substantial risk of serious harm that Plaintiffs and members of the putative class suffer due to Defendants’ inadequate evaluation and treatment of gender dysphoria. (Doc. 1, p. 37; Doc. 124, p. 7). Plaintiffs also have moved for the certification of a class action under Federal Rule of Civil Procedure 23(b)(2). (Doc. 124, p. 7). As defined in the motion and memorandum in support of class certification, the proposed class includes, “all prisoners in the custody of IDOC who have requested evaluation or treatment for gender dysphoria.” (Doc. 124, pp. 8, 38).
DISCUSSION I. LEGAL STANDARD FOR CLASS CERTIFICATION
A plaintiff seeking to certify a class must satisfy the four requirements of Federal Rule of Civil Procedure 23(a): numerosity, commonality, typicality, and adequacy of representation. See, e.g., Harper v. Sheriff of Cook Cty., 581 F.3d 511, 513 (7th Cir. 2009). In addition to meeting the threshold requirements of Rule 23(a), a plaintiff also must satisfy the requirements of at least one subsection of Rule 23(b). Here, Plaintiffs seek to certify a class under Rule 23(b)(2), and therefore they must show that “a single injunction or declaratory judgment would provide relief to each member of the class.” Wal-Mart Stores, Inc. v. Dukes, 564 U.S. 338, 621 (2011). Finally, the Seventh Circuit has “long recognized an implicit requirement under Rule 23” that a class must be ascertainable, meaning “the class must be defined clearly and that membership be defined by objective criteria.” Mullins v. Direct
Page 2 of 11

Case 3:18-cv-00156-NJR Document 213 Filed 03/04/20 Page 3 of 11 Page ID #2533
Digital, LLC, 795 F.3d 654, 657 (7th Cir. 2015).2 “Plaintiffs bear the burden of showing that a proposed class satisfies the Rule 23
requirements, but they need not make that showing to a degree of absolute certainty.” Messner v. Northshore Univ. Health Sys., 669 F.3d 802, 811 (7th Cir. 2012) (internal citation omitted). “It is sufficient if each disputed requirement has been proven by a preponderance of evidence.” Messner, 669 F.3d at 811 (citing Teamsters Local 445 Freight Div. Pension Fund v. Bombardier Inc., 546 F.3d 196, 202 (2d Cir. 2008)). II. RULE 23(A) REQUIREMENTS
A. Numerosity The first requirement of Rule 23(a) is that the proposed class “be so numerous that joinder of all members is impracticable.” FED. R. CIV. P. 23(a)(1). “Although there is no ‘bright line’ test for numerosity, a class of forty is generally sufficient.” McCabe v. Crawford & Co., 210 F.R.D. 631, 643 (N.D. Ill. 2002) (citations omitted). See also Mulvania v. Sheriff of Rock Island Cty., 850 F.3d 849, 859 (7th Cir. 2017). A plaintiff is not required to specify the exact number of persons in the class, nor is a plaintiff required to establish the exact identity of the class members. See Marcial v. Coronet Ins. Co., 880 F.2d 954, 957 (7th Cir. 1989) (citation omitted). In addition to class size, courts consider “the geographic dispersion of the class members, the type of relief sought, and the practicability of relitigating the common core issue, when determining whether joinder would be practicable. Murry v. E*Trade Fin. Corp., 240 F.R.D. 392, 396 (N.D. Ill. 2006) (citations omitted). Plaintiffs state that as of July 28, 2018, IDOC records indicate that there are one hundred thirteen transgender prisoners across twenty-one different IDOC facilities.
2 Because Defendants do not dispute that the class is ascertainable or raise objections to the proposed class definition, the Court finds that Plaintiffs have satisfied this requirement.
Page 3 of 11

Case 3:18-cv-00156-NJR Document 213 Filed 03/04/20 Page 4 of 11 Page ID #2534
(Doc. 124, pp. 8, 10-11; Doc. 127-3, p. 2). According to more recent numbers presented by Defendants, the proposed class consists of one hundred fifteen transgender inmates at twenty-eight different facilities as of March 2019. (Doc. 145-1, p. 1). Defendants argue that seventy inmates of the one hundred fifteen were receiving hormone treatment, and so the proposed class would only be the remaining inmates who could challenge a continuing denial of prescription hormones. (Doc. 145, p. 8). The Court finds, however, that Plaintiffs claim they and the proposed class have been denied constitutionally adequate care for gender dysphoria due to system-wide policies, which is not limited to, but includes, denial or delay of hormone therapy and routine follow up. Therefore, class membership could include as many as one hundred fifteen inmates who “would have legitimate claims.” Marcial, 880 F. 2d at 957. Accordingly, the Court finds that Plaintiffs have successfully demonstrated numerosity.
B. Commonality The second requirement of Rule 23(a) is that there is at least one question of law or fact common to the class. FED. R. CIV. P. 23(a)(2). “Although a court need only find a single common question of law or fact, the mere occurrence of all plaintiffs suffering as a result of a violation of the same provision of law is not enough. The claim must depend upon a common contention that is capable of class-wide resolution.” Chi. Teachers Union, Local No. 1 v. Bd. of Educ. of City of Chi., 797 F.3d 426, 434 (7th Cir. 2015) (citations omitted). “Where the same conduct or practice by the same defendant gives rise to the same kind of claims from all class members, there is a common question.” Lippert v. Baldwin, No. 10-c-4603, 2017 WL 1545672 at *2 (N.D. Ill. Apr. 28, 2017) (quoting Suchanek v. Sturm Foods, Inc., 764 F.3d 750, 756 (7th Cir. 2014)). Plaintiffs state that Defendants’ system-wide policies and practices have deprived all
Page 4 of 11

Case 3:18-cv-00156-NJR Document 213 Filed 03/04/20 Page 5 of 11 Page ID #2535
proposed class members, who are seeking treatment of the same medical condition, of constitutionally adequate medical care. (Doc. 124, p. 12). These policies and practices: (1) allow under qualified medical professionals and non-medical prison staff to evaluate and design treatment plans for prisoners seeking treatment for gender dysphoria through the use of the Transgender Committee; (2) deny or delay hormone treatments for reasons that are not recognized as contraindications to treatment; (3) fail to prescribe or administer appropriate hormones and dosages and monitor prisoners’ health while receiving hormone treatment; (4) do not evaluate and consider gender confirmation surgeries as a treatment option; and (5) deprive prisoners of medically necessary social transition. (See Id. at pp. 13-24). While gender dysphoria treatment must be tailored to each individual’s needs, IDOC’s systemic policies and practices do not comply with established standards and guidelines defining appropriate treatment, and so the treatment provided to all members of the proposed class share the same inadequacies. (Id. at p. 13).
'HIHQGDQWV DUJXH WKDW 3ODLQWLIIV· FODLPV IRFXV RQ GHOD\ RI WUHDWPHQW Ɇ “delays in receiving hormone therapy, delays in receiving gender affirming clothing, etc.” (Doc. 145, p. 5). These allegations of delay can vary depending on an individual’s circumstances and must be determined on an individual basis. Each claim of delay in treatment might not be sufficient alone to rise to the level of an Eighth Amendment violation. (Id.). Defendants state that it has not been established that there is one correct manner of treatment for gender dysphoria, and treatment involves matters that are individualized and specific to each Plaintiff and proposed class member. Even though an “illegal policy might provide the ‘glue’ necessary to litigate otherwise highly individualized claims as a class[,]” an illegal policy is different from complaints of systemic failures, and there is no illegal policy in place. (Id. at p. 7) (citing Phillips v. Sheriff of Cook Cty., 828 F. 3d 541, 551 (7th Cir. 2016) (citations omitted)). Thus, this
Page 5 of 11

Case 3:18-cv-00156-NJR Document 213 Filed 03/04/20 Page 6 of 11 Page ID #2536
suit is not appropriate for class certification. The Court finds that Plaintiffs have repeatedly identified IDOC policies and practices
that have allegedly resulted in inadequate medical treatment for Plaintiffs and apply to all those in the proposed class. Because they claim that the Transgender Committee is responsible for the overall treatment plans for transgender prisoners with gender dysphoria, they are ultimately arguing that the Committee functions as “a common mode of exercising discretion that pervades the entire” IDOC system. Wal-Mart Stores, Inc., 564 U.S. at 356. Plaintiffs do not solely argue that a delay in care has caused constitutional deprivations, but that multiple practices and policies, including delay of care for non-medical reasons, have all contributed to misdiagnoses and inappropriate treatment for Plaintiffs. Therefore, the common question applicable to all Plaintiffs and the proposed class is whether IDOC policies and practices resulted in inadequate medical treatment in violation of the Eighth Amendment. See Lippert, 2017 WL 1545672 at *4 (holding that that the common question of whether “policies and practices do in fact put inmates with serious medical conditions at risk” satisfies the commonality requirement) (citing Parsons v. Ryan, 754 F.3d 657, 678, 681 (9th Cir. 2014)). “[A]ny dissimilarities among the proposed class members will not impede the generation of common answers in this case.” Lacy v. Cook Cty. Ill. 897 F.3d 847, 865 (7th Cir. 2018). Thus, Plaintiffs have met the commonality requirement.
C. Typicality The third requirement of Rule 23(a) is that the claims of the presentative parties are typical of the claims of the class. FED. R. CIV. P. 23(a)(3). The typicality requirement is meant to ensure that there is “enough congruence between the named representative’s claim and that of the unnamed members of the class to justify allowing the named party to litigate on behalf of the group.” Spano v. The Boeing Co., 633 F.3d 574, 586 (7th Cir. 2011). In other words,
Page 6 of 11

Case 3:18-cv-00156-NJR Document 213 Filed 03/04/20 Page 7 of 11 Page ID #2537
the named representative’s claims must have “the same essential characteristics as the claims of the class at large.” Oshana v. Coca-Cola Co., 472 F.3d 506, 514 (7th Cir. 2006) (quoting De La Fuente v. Stokely-Van Camp, Inc., 713 F.2d 225, 232 (7th Cir. 1983)). It is well-established that typicality is satisfied if the named representative’s claim “arises from the same event or practice or course of conduct that gives rise to the claims of other class members and . . . [the] claims are based on the same legal theory.” Oshana, 472 F.3d at 514 (quoting Rosario v. Livaditis, 963 F.2d 1013, 1018 (7th Cir. 1992)); De La Fuente, 713 F.2d at 232.
Because Plaintiffs and proposed class members are subjected to Defendants’ centralized policies, procedures, and practices, Plaintiffs assert that their claims are typical of the proposed class as a whole. Additionally, medical care for all inmates with gender dysphoria is guided and overseen by a single body, the Transgender Committee. (Doc. 124, p. 25). Plaintiffs and the proposed class members have experienced the same harm and seek the same injunctive reliefɆUeform of the systemic deficiencies in the provision of healthcare to individuals suffering from gender dysphoria. (Id., at p. 34). Differences in the precise details of the named Plaintiffs’ injuries and those of the proposed class are irrelevant to the determination of typicality, as the harm already incurred and the risk of future injury arises from the same system-wide policies and practices. (Id.).
Defendants claim that while the named Plaintiffs appear to have shared experiences, that does not mean that their background or treatment within IDOC is typical of that of all IDOC prisoners. (Doc. 145, p. 9). The evidence submitted by Plaintiffs lacks the type of specificity needed to establish that these Plaintiffs have suffered experiences typical of the proposed class. Plaintiffs make only generalizations about proposed class members without specific data to compare the typicality of their claims. It cannot be assumed that every inmate diagnosed with, or otherwise falling under the definition of, gender dysphoria wants to have
Page 7 of 11

Case 3:18-cv-00156-NJR Document 213 Filed 03/04/20 Page 8 of 11 Page ID #2538
sex reassignment surgery or the other items sought, and so Plaintiffs cannot show that their claims are typical of the group at large. (Id.).
Here, the Court finds that Plaintiffs’ claim that they and the class members have been exposed to Defendants’ same treatment policies and practices meets the typicality requirement. While there may be distinctions between claims of the named Plaintiffs and those of other class members, “the alleged harm arises from the same course of conduct on the part of IDOC.” Rasho v. Walker, No. 7-cv-01298-MMM, Doc. 252, p. 5 (C.D. Ill., Aug. 14, 2015); see also De La Fuente, 713 F.2d at 232. If Plaintiffs succeed in demonstrating that IDOC policies have resulted in constitutionally inadequate medical care for transgender prisoners with gender dysphoria, then the resulting injunctive relief would likely benefit [P]laintiffs as well as other similarly-afflicted IDOC prisoners.” Lippert, 2017 WL 1545672 at *6. Accordingly, Plaintiffs have established typicality.
D. Adequacy The final Rule 23(a) requirement for class certification is that “the representative parties will fairly and adequately protect the interests of the class.” FED. R. CIV. P. 23(a)(4). Defendants do not challenge the adequacy of class counsel (see Doc. 145, p. 10), and the Court has no reason to believe they are not qualified. Therefore, the Court will only analyze whether the named Plaintiffs are adequate representatives of the class. Plaintiffs argue that, as transgender prisoners with gender dysphoria, their interests directly align with those of the purposed class. (Doc. 124, p. 35). If Plaintiffs achieve the relief requested, for Defendants to implement constitutionally adequate medical care for prisoners with gender dysphoria, the injunctive relief would also benefit all proposed class members. (Id.; Doc. 149, p. 11). Defendants argue that Plaintiffs could proceed as a group, but they do not represent
Page 8 of 11

Case 3:18-cv-00156-NJR Document 213 Filed 03/04/20 Page 9 of 11 Page ID #2539
the views of all potential class members. (Doc. 145, p. 10). In the Motion for Class Certification, Plaintiffs are compared to each other, not to other putative class members, ignoring a wide range of variation between prisoners with gender dysphoria. Defendants further argue that Plaintiffs completely disregard and have no named representative for a member who was born female but identifies as male or a member who has gender dysphoria but chooses not to receive hormone treatment. As such, Defendants argue that Plaintiffs cannot adequately protect the interests of all prisoners in the custody of IDOC who have requested from IDOC evaluation or treatment for gender dysphoria. (Id.).
The Court finds that Plaintiffs and the proposed class members have the same interest in receiving constitutionally adequate care for the treatment of gender dysphoria. The Court does not see how a variation in medical treatment between different prisoners with gender dysphoria would result in conflicting interests or inadequate representation, as all transgender inmates with gender dysphoria have allegedly been harmed by the same policies and practices implemented throughout IDOC system. As such, the purposed class meets the adequacy requirement. IV. Rule 23(b)(2) Requirements
Plaintiffs seek to certify a class under Rule 23(b)(2), which allows for certification upon a finding that “the party opposing the class has acted or refused to act on grounds that apply generally to the class, so that final injunctive relief or corresponding declaratory relief is appropriate respecting the class as a whole[.]” “Rule 23(b)(2) applies only when a single injunction or declaratory judgment would provide relief to each member of the class. It does not authorize class certification when each individual class member would be entitled to a different injunction or declaratory judgment against the defendant.” Wal-Mart Stores, Inc., 564 U.S. at 360.
Page 9 of 11

Case 3:18-cv-00156-NJR Document 213 Filed 03/04/20 Page 10 of 11 Page ID #2540 Plaintiffs state that Defendants’ conduct applies to the class generally by depriving
Plaintiffs and proposed class members of constitutionally adequate medical treatment for gender dysphoria through IDOC’s system-wide policies and practices. The request for injunctive relief to address systemic failures in treatment would apply to and benefit all members of the proposed class. (Doc. 124, p. 38).
Defendants argue, first, that there is no basis for injunctive relief because there is no unlawful act by Defendants. (Doc. 145, p. 10). Additionally, there is not an injunctive remedy that could be imposed that would be final to the whole class and provide relief to each class member due to the individualized nature of the claims that could be presented. (Id., at p. 11). Because medical decisions cannot be made through a generic remedy and necessitate individualized relief, Plaintiffs’ claims are not amenable to class-wide injunctive relief. (Id.).
Here, although each Plaintiff has included specific allegations regarding her unconstitutional care, Plaintiffs’ main argument is that they have suffered serious harm and are at risk of further harm as a result of IDOC policies, procedures, and practices that deny evaluation and medically necessary treatment of gender dysphoria. Furthermore, they seek injunctive relief regarding Defendants’ conduct and IDOC policies that would “apply generally to the class...” FED. R. CIV. P. 23(b)(2). “When members of a putative class seek uniform injunctive or declaratory relief from policies or practices that are generally applicable to the class as a whole[,]” the requirements of Rule 23(b) are deemed satisfied. Lippert, 2017 WL 154672 at *9 (quoting Parsons, 754 F.3d at 688). Therefore, the Court grants class certification under Rule 23(b)(2).
Page 10 of 11

Case 3:18-cv-00156-NJR Document 213 Filed 03/04/20 Page 11 of 11 Page ID #2541 DISPOSITION
For the reasons set forth above, the Court GRANTS Plaintiffs’ Motion for Class Certification (Doc. 124) and CERTIFIES a class defined as “all prisoners in the custody of IDOC who have requested evaluation or treatment for gender dysphoria.”
IT IS SO ORDERED. DATED: March 4, 2020
____________________________ NANCY J. ROSENSTENGEL Chief U.S. District Judge
Page 11 of 11