United States Court of Appeals 

For the Seventh Circuit 

Chicago, Illinois 60604 

Submitted September 17, 2019*

Decided September 20, 2019 

Before 

FRANK H. EASTERBROOK, Circuit Judge 

ILANA DIAMOND ROVNER, Circuit Judge 

AMY C. BARRETT, Circuit Judge

No. 19-1619 

JOHN H. BALSEWICZ, 

Plaintiff-Appellant, 

v. 

CRAIG BLUMER, et al., 

 Defendants-Appellees.

 Appeal from the United States District 

Court for the Eastern District of Wisconsin. 

No. 17-CV-360-JPS 

J. P. Stadtmueller, 

Judge. 

O R D E R 

 John Balsewicz, also known as Melissa, is a transgender prisoner who has been 

diagnosed with gender dysphoria and depression. She sued various prison healthcare 

providers under 42 U.S.C. § 1983, alleging that they unconstitutionally delayed 

hormone treatment, inadequately addressed her suicidal ideation, and retaliated against 

her for complaining about sexual harassment. We affirm the district court’s entry of 

summary judgment for the defendants. 

 

*

 We have agreed to decide this case without oral argument because the briefs 

and record adequately present the facts and legal arguments, and oral argument would 

not significantly aid the court. FED. R. APP. P. 34(a)(2)(C). 

NONPRECEDENTIAL DISPOSITION 

To be cited only in accordance with Fed. R. App. P. 32.1 
No. 19-1619 Page 2 

We review the evidence in the light most favorable to Balsewicz. See Rosario v. 

Brawn, 670 F.3d 816, 820 (7th Cir. 2012). In April 2016, while housed at the Waupun 

Correctional Institution, Balsewicz underwent an assessment for gender dysphoria. A 

doctor should have forwarded the results to the Wisconsin Department of Corrections’s 

Transgender Committee for consideration of the proper accommodations and 

treatment, but he failed to do so. 

A short time later, Balsewicz was transferred to the Wisconsin Resource Center 

to receive mental health treatment. She reported that she thought constantly about 

suicide and had been depressed her whole life; she was diagnosed with major 

depressive disorder and borderline personality disorder. The Resource Center assigned 

her to a depression support group and to Dialectical Behavioral Therapy (“DBT”)— 

specialized group treatment for inmates with personality disorders who have thoughts 

of self-harm. 

In September, Balsewicz asked about the status of her gender dysphoria 

assessment. A Resource Center doctor discovered that her assessment had not been 

forwarded to the Committee and immediately sent it. The Committee determined that 

Balsewicz was an appropriate candidate to see the gender dysphoria consultant. An 

appointment was scheduled for the next available opening, roughly five months later. 

Over time, members of Balsewicz’s DBT treatment team observed that she was 

more focused on her gender dysphoria than on being treated for her thoughts of selfharm—the reason for which she was placed in the DBT group. Balsewicz voiced her 

desire to be treated for her gender dysphoria and stated that her depression stemmed 

from not being treated. In early December, her treatment team agreed to discontinue the 

DBT; she remained in group therapy for her depression. Throughout this time, 

Balsewicz reported that, while she still had thoughts of self-harm and was depressed, 

she had no intent to attempt self-harm. 

Later in December, however, Balsewicz was placed in clinical observation after 

she told a social worker that she intended to kill herself by overdosing on pills or 

cutting her wrists. Inmates under observation are checked every fifteen minutes, and 

cameras in the cells assist with monitoring. Additionally, inmates are allowed only 

property that staff believe will not pose a safety risk. At first, Balsewicz was allowed 

only a security smock, mattress, and safety blanket. After treatment staff met with her, 

assessed her condition, and determined that she was calm and cooperative, they 

allowed her to wear her regular clothing. Two days later, however, Balsewicz tried to 
No. 19-1619 Page 3 

hang herself by making a ligature out of her clothes. She was sent to the hospital for 

evaluation, deemed stable, and returned to observation. 

A few days later, a doctor and a social worker met with Balsewicz for therapy. At 

the end of the session, Balsewicz grabbed scissors from a table. She made no attempt to 

harm anyone. Instead, the staff believed that she was trying to be helpful by letting 

them know that there was a possible weapon sitting out. But given Balsewicz’s history 

of violence and her decision to grab the scissors, staff also reported their concern that 

she had made an indirect threat. So, they issued her a conduct report and moved her to 

the high management unit for more monitoring. The next day, Balsewicz used the lens 

of her eyeglasses to cut her arm; staff assessed her and put her back on observation. A 

week later, she called for help and, when a technician arrived, she swallowed a handful 

of lithium pills that she had been hoarding. Staff sent her to the hospital, where tests 

showed that her lithium levels were elevated but still within the normal range. 

Balsewicz filed a grievance in January, alleging that, at a therapy session back in 

early November, a social worker had sexually harassed her by initiating sexually 

explicit conversations and providing her with a pair of women’s underwear. She stated 

that she had immediately reported the incident but was not taken seriously. The 

Resource Center investigated her claims and found that no staff member had 

committed a sexual harassment violation. 

Balsewicz eventually saw the gender dysphoria consultant in February 2017. The 

consultant recommended against hormone treatment due to Balsewicz’s psychological 

instability. The consultant reevaluated Balsewicz about a year later and determined that 

she could start hormone treatment, which began in September 2018. 

In the meantime, Balsewicz had sued numerous doctors and members of her 

mental health treatment team, alleging that they had been deliberately indifferent to her 

gender dysphoria and risk of suicide. She further claimed that the defendants removed 

her from treatment in retaliation for her oral complaint about sexual harassment. The 

district court granted the defendants’ motion for summary judgment. 

On appeal, Balsewicz first contends that she submitted sufficient evidence to 

create a factual issue about whether members of her treatment team were indifferent to 

her risk of suicide by allowing her to have her regular clothing while on observation. 

But nothing in the record suggests that any defendant intentionally or recklessly 

disregarded her risk of suicide, such as by failing to take reasonable steps to prevent her 
No. 19-1619 Page 4 

suicide attempts. See Farmer v. Brennan, 511 U.S. 825, 832 (1994); Rosario, 670 F.3d at 821–

22. Here, the defendants began frequent monitoring of Balsewicz from the moment that 

she threatened to attempt suicide. She was placed on observation, checked every fifteen 

minutes, and given limited access to clothing and other items. Although the defendants 

allowed her to wear clothes that she then used to try to hang herself, that decision was 

made only after the treatment team assessed her and deemed it safe. They were wrong, 

but a reasonable jury could not conclude that allowing Balsewicz to wear her regular 

clothes, while still under observation, was such a departure from professional judgment 

that it constituted deliberate indifference. See Youngberg v. Romeo, 457 U.S. 307, 323 

(1982); McGee v. Adams, 721 F.3d 474, 481 (7th Cir. 2013). 

We reach the same conclusion about Balsewicz’s two other suicide attempts. 

Balsewicz had told her treatment team that she could attempt suicide by cutting her 

wrists or overdosing on pills. But allowing her to keep her glasses while in the high 

management unit demonstrates, at worst, negligence; the deliberate-indifference 

standard presents a higher bar. See Farmer, 511 U.S. at 836. Further, the defendants were 

unaware that Balsewicz was hoarding her lithium pills; she reported that she was 

taking the pills and that they were improving her mood. Even if the defendants could 

have done more to ensure that she took her pills every day—her observation cell was 

searched weekly—deliberate indifference requires more than a showing of negligence. 

See Farmer, 511 U.S. at 836. 

 

As for Balsewicz’s argument that the defendants unlawfully delayed her 

hormonal treatment, the delay did not rise to the level of deliberate indifference. 

Inexplicable delays in treatment can, in some cases, constitute deliberate indifference. 

See Petties v. Carter, 836 F.3d 722, 730 (7th Cir. 2016) (en banc). Here, there was a fivemonth delay in forwarding her gender dysphoria assessment to the Committee for 

consideration. But the doctor responsible attested that he had accidentally overlooked 

sending the assessment—he had sent another patient’s file at the same time. Balsewicz 

has presented no evidence to contest this. The second doctor attested that he sent the 

assessment immediately upon discovering it, and Balsewicz has no evidence to support 

her speculation that he knew about the assessment sooner. 

Finally, Balsewicz contends that the district court erred in entering summary 

judgment for the defendants on her claim that they retaliated against her for her “verbal 

complaint” of staff misconduct by removing her from DBT treatment a month after her 

complaint and ignoring her threats of self-harm. But the only evidence of retaliation 

that Balsewicz presents is what she believes is suspicious timing, which by itself is not 
No. 19-1619 Page 5 

enough to establish retaliatory motive. See Gracia v. SigmaTron Int’l, Inc., 842 F.3d 1010, 

1021 (7th Cir. 2016). She presents no evidence to refute the defendants’ stated reasons 

for their decision to remove her from treatment (her disruptive behavior and a lack of 

commitment to treatment). And we already have concluded that her risk of suicide was 

not ignored but handled within a permissible range of professional judgment. 

We have considered Balsewicz’s remaining arguments, and none has merit. 

AFFIRMED