Skip to content Skip to search

Republish This Story

* Please read before republishing *

We’re happy to make this story available to republish for free under an Attribution-NonCommercial-NoDerivatives Creative Commons license as long as you follow our republishing guidelines, which require that you credit The 19th and retain our pixel. See our full guidelines for more information.

To republish, simply copy the HTML at right, which includes our tracking pixel, all paragraph styles and hyperlinks, the author byline and credit to The 19th. Have questions? Please email [email protected].

— The Editors

Loading...

Modal Gallery

/
Sign up for our newsletter

Menu

  • Our Mission
  • Our Team
  • Latest Stories
  • Search
  • Upcoming Events
  • Contact Us
  • Newsletter
  • Donate
  • Work With Us
  • Fellowships
    • From the Collection

      Changing Child Care

      Illustration of a woman feeding a baby a bottle
      • Washington, D.C., offers financial relief to local child care workers

        Orion Rummler · September 20
      • As climate change worsens hurricane season in Louisiana, doulas are ensuring parents can safely feed their babies

        Jessica Kutz · May 5
      • Supreme Court Justice Samuel Alito argued abortion isn’t an economic issue. But is that true?

        Chabeli Carrazana · May 4
    • From the Collection

      Next-Gen GOP

      Illustration of a woman riding an elephant
      • Mayra Flores’ victory set a record for women in Congress. It also reflects the growing visibility of Republican Latinas

        Candice Norwood · June 21
      • A banner year for Republican women

        Amanda Becker · November 11
      • Republican women could double representation in the U.S. House

        Amanda Becker · November 4
    • From the Collection

      On The Rise

      Illustration of three women marching
      • Can Cheri Beasley build a winning coalition in North Carolina?

        Candice Norwood · October 11
      • Los Angeles has never elected a woman mayor. Karen Bass hopes to change that.

        Nadra Nittle · September 8
      • Judge J. Michelle Childs is confirmed to D.C. appeals court

        Candice Norwood · July 20
    • From the Collection

      Pandemic Within a Pandemic

      Illustration of four people marching for Black Lives Matter with coronavirus as the backdrop
      • The 19th Explains: Why the nursing shortage isn’t going away anytime soon

        Mariel Padilla · September 23
      • Some LGBTQ+ people worry that the COVID-19 vaccine will affect HIV medication. It won’t.

        Orion Rummler · November 23
      • Why are more men dying from COVID? It’s a complicated story of nature vs. nurture, researchers say

        Mariel Padilla · September 22
    • From the Collection

      Portraits of a Pandemic

      Illustration of a woman wearing a mask and holding up the coronavirus
      • For family caregivers, COVID is a mental health crisis in the making

        Shefali Luthra · October 8
      • A new database tracks COVID-19’s effects on sex and gender

        Shefali Luthra · September 15
      • Pregnant in a pandemic: The 'perfect storm for a crisis'

        Shefali Luthra · August 25
    • From the Collection

      The 19th Explains

      People walking from many articles to one article where they can get the context they need on an issue.
      • The 19th Explains: What we know about Brittney Griner’s case and what it took to get her home

        Candice Norwood, Katherine Gilyard · December 8
      • The 19th Explains: Why the Respect for Marriage Act doesn’t codify same-sex marriage rights

        Kate Sosin · December 8
      • The 19th Explains: Why baby formula is still hard to find months after the shortage

        Mariel Padilla · December 1
    • From the Collection

      The Electability Myth

      Illustration of three women speaking at podiums
      • Mayra Flores’ victory set a record for women in Congress. It also reflects the growing visibility of Republican Latinas

        Candice Norwood · June 21
      • Stepping in after tragedy: How political wives became widow lawmakers

        Mariel Padilla · May 24
      • Do term limits help women candidates? New York could be a new testing ground

        Barbara Rodriguez · January 11
    • From the Collection

      The Impact of Aging

      A number of older people walking down a path of information.
      • From ballroom dancing to bloodshed, the older AAPI community grapples with gun control

        Nadra Nittle, Mariel Padilla · January 27
      • 'I'm planning on working until the day I die': Older women voters are worried about the future

        Mariel Padilla · June 3
      • Climate change is forcing care workers to act as first responders

        Jessica Kutz · May 31
    • From the Collection

      Voting Rights

      A series of hands reaching for ballots.
      • Election workers believe in our system — and want everyone else to, too

        Barbara Rodriguez, Jennifer Gerson · November 8
      • Voter ID laws stand between transgender people, women and the ballot box

        Barbara Rodriguez · October 14
      • Emily’s List expands focus on diverse candidates and voting rights ahead of midterm elections

        Errin Haines · August 30

    View all collections

  • Explore by Topic

    • 19th Polling
    • Abortion
    • Business & Economy
    • Caregiving
    • Coronavirus
    • Education
    • Election 2020
    • Election 2022
    • Environment & Climate
    • Health
    • Immigration
    • Inside The 19th
    • Justice
    • LGBTQ+
    • Politics
    • Press Release
    • Race
    • Sports
    • Technology

    View All Topics

Home
  • Our Mission
  • Our Team
  • Latest Stories
  • Search
  • Upcoming Events
  • Contact Us
  • Newsletter
  • Donate
  • Work With Us
  • Fellowships

We’re an independent, nonprofit newsroom reporting on gender, politics and policy. Read our story.

The 19th News(letter)

News from reporters who represent you and your communities.

You have been subscribed!

Submitting...

Uh-oh! Something went wrong. Please try again later.

Become a member

The 19th thanks our sponsors. Become one.

A woman lies down as she reads a book at a prison infirmary.
Treatment of transgender people in state and federal prisons has come under intense scrutiny in recent years. (Photo by SANDY HUFFAKER/AFP/Getty Images)

Justice

‘They couldn’t understand me’: One woman’s plea for transgender surgery in prison

Kanautica Zayre-Brown’s case in North Carolina highlights the tensions between LGBTQ+ advocates and the Biden administration as trans people behind bars are being denied what experts agree is medically necessary care.

Kate Sosin

LGBTQ+ reporter

Kate Sosin portrait

Published

2021-11-19 05:00
5:00
November 19, 2021
am

Share

  • Twitter
  • Facebook
  • Email

It’s been nearly 10 years since Kanautica Zayre-Brown started taking estrogen. Her birth certificate and ID say “female.” She legally changed her name. 

If it were up to her, her transition would already be complete. But at 40, Zayre-Brown, an incarcerated woman in North Carolina, is fighting for something that experts agree is a basic medical necessity for transgender people: gender-affirming medical care. Her case highlights the tensions between LGBTQ+ advocates and the Biden administration as trans people behind bars are being denied what experts agree is medically necessary care. 

Zayre-Brown has a diagnosis of gender dysphoria, when a person’s gender does not align with their sex assigned at birth. Two years ago — with orders from a doctor — she began petitioning Anson Correctional Institution to provide her surgery that would help complete her transition. Her attorney, Jaclyn Maffetore with the ACLU, argues that Anson has a legal obligation to provide it. 

The 19th thanks our sponsors. Become one.

“What the law requires is an individualized determination for each individual person for the medical care that they need,” Maffetore said. “The step that she’s seeking to take now is a step that has been in her plan of care for her gender dysphoria before she was incarcerated. And methods to alleviate her gender dysphoria [like hormone replacement therapy and affirming clothing] have just not been effective.”

Kanautica Zayre-Brown poses for a photo.
Kanautica Zayre-Brown in 2017. (Courtesy of Kanautica Zayre-Brown)

“I just felt like they just didn’t care because they couldn’t understand me,” Zayre-Brown said. “When I take my clothes off, I don’t feel like the woman that I am.” 

Maffetore said she can’t get a clear answer from the state on why her client does not meet the criteria for gender-affirming surgery. She also added that her client has been misgendered by prison staff.

“She is a woman. She has been living as a woman for the majority of her life,” Maffetore said. “That obviously seems like a failure on the part of [the state Department of Public Safety] to ensure that their staff is adequately trained and following their policies.” 

Maffetore alleges DPS has been slow to provide explanations for the delay, blaming procedural delays and the pandemic. Now, Maffetore says the ACLU is prepared to file suit.

“Kanautica is in mental anguish, dealing with her gender dysphoria that has not been released through any other means and feeling like DPS has forgotten about her,” she said. 

John Bull, a spokesperson for the North Carolina DPS, provided The 19th a copy with the department’s policy for caring for transgender people, which mandates that requests for surgery be fielded by a committee made up of health care and administration prison officials. 

He added that health privacy laws prevent the state from commenting on Zayre-Brown’s specific case. 

It also requires staff to use affirming names and pronouns for transgender staff, something that many staff members have neglected to do, Zayre-Brown claims. Although her name is legally changed, her  “deadname,” a term trans people use to refer to a former name, still appears in searches on the state’s database of incarcerated people.  

Stories by experienced reporters you can trust and relate to.

Delivered directly to your inbox every weekday.

You have been subscribed!

Submitting…

Uh-oh! Something went wrong. Please try again later.

Treatment of transgender people in state and federal prisons has come under intense scrutiny in recent years. In courting the LGBTQ+ vote, then-candidate Joe Biden promised that if elected president, he would bolster protections for transgender people behind bars. 

Among those promises was enforcement of the Prison Rape Elimination Act, a law passed unanimously by Congress in 2003 and implemented in 2012 that, in part, required prisons to house transgender people on a case-by-case basis, with an emphasis on where they would be safest. An NBC News investigation in 2020 found that in nearly in 5,000 transgender prison placements, just 15 transgender prisoners were housed according their lived genders.

On his campaign website, Biden also pledged to “ensure all transgender inmates in federal correctional facilities have access to appropriate doctors and medical care—including OBGYNs and hormone therapy.”

The Department of Justice, which enforces PREA in state prisons, would not comment on how far the administration has come in developing policy toward those goals. In an email to The 19th, the department pointed to its investigation into conditions facing trans people in Georgia. 

In April, the DOJ filed a statement of interest in the case of Ashley Diamond, a transgender woman incarcerated in Georgia who alleged that the state failed to provide her gender-affirming medical care. The statement argues that constituted cruel and unusual punishment and that the U.S. government has an obligation under the Constitution to protect against it. 

“By taking action in this case, the Justice Department is reminding departments of corrections that prison officials have the obligation to assess and treat gender dysphoria just as they would any other medical or mental health condition,” said Associate Attorney General Vanita Gupta in a statement at the time.

LGBTQ+ advocates celebrated the Justice Department’s filing in the Georgia case as potentially landmark for the future of trans rights. The case remains pending. 

When I take my clothes off, I don’t feel like the woman that I am.

Kanautica Zayre-Brown

Two years ago, the 9th U.S. Circuit Court of Appeals ruled that Idaho must provide gender-affirming care to Adree Edmo, who had repeatedly been denied surgery while serving a 10-year sentence for a sex crime. 

Gov. Brad Little wrote in a statement at the time that “hardworking taxpayers of Idaho should not be forced to pay for a convicted sex offender’s gender reassignment surgeries.” Emdo’s attorneys countered that her right to care had nothing to do with her crime. 

Under the Trump administration, the Justice Department did not enforce the part of PREA  governing the placement of incarcerated transgender people. While PREA does not directly mandate surgery, access to both often go hand in hand. According to Project for Incarcerated Transgender Survivors at American University, many prisons won’t transfer transgender people who have not had surgery. Conversely, those who petition for surgery from men’s prisons are almost always denied, court records show.  

A spokesperson for the Justice Department said states must comply with the PREA rules, placing transgender people on a case-by-case basis and certifying that they are in compliance, or risk losing 5 percent of their funding. 

LGBTQ+ advocates have been eager to see if the Biden administration might enforce health care protections for trans people behind bars in state and federal prisons and​​ revise changes made the federal Bureau of Prisons Manual under the Trump administration that removed transgender PREA protections.

In the interim, people like Zayre-Brown are waiting. She doesn’t know how much longer she can hold out, she said. Her last emergency grievance, in which she threatened self-mutilation, was denied. She also volunteered to pay for her own surgery and recover at home under home monitoring. 

“I really, really, really understand now how trans individuals, trans sisters, and brothers have passed away,” she said. “I totally understand how they feel from not having access to adequate care. I never thought I would understand it. I understand it now.”

Share

  • Twitter
  • Facebook
  • Email

Help sustain what we started

Your monthly investment is critical to our sustainability as a nonprofit newsroom.

Donate Today

Become a member

Up Next

People strand by the water looking at the Olympic Rings in Tokyo.

Sports

Olympic officials nudge sports federations toward greater inclusion for transgender and nonbinary athletes

The International Olympic Committee issued nonbinding guidelines, including one on testosterone testing, that would allow more athletes to participate.

Read the Story

The 19th
The 19th is a 501(c)(3) tax-exempt organization. Our stories are free to republish in accordance with these guidelines.

  • Donate
  • Newsletter
  • Events
  • Search
  • Jobs
  • Fellowships
  • Contact Us
  • About Us
  • Community Guidelines
  • Membership
  • Membership FAQ
  • Major Gifts
  • Sponsorship
  • Privacy
  • Twitter
  • Facebook
  • Instagram