A group of incarcerated transgender women and men have sued Georgia corrections officials, challenging a new law that prevents them from receiving gender-affirming medical care. The lawsuit, filed Friday morning, accuses the state of violating the Eighth Amendment, which prohibits cruel and unusual punishment.

Five transgender plaintiffs — two men and three women — brought the class action lawsuit on behalf of nearly 300 other people in Georgia state prisons, who argue that the state’s law will have “catastrophic consequences.” In some cases it is forcing trans people who have already received hormone replacement therapy and other services for years to detransition without their consent.

“We are very much in the thick of seeing policies like this be adopted,” said Chinyere Ezie, a senior staff attorney at the Center for Constitutional Rights, which brought the lawsuit with co-counsel Bondurant Mixson & Elmore LLP. “It’s really unfortunate, I think that it has and will cost people’s lives. I think that the plan is to really just eradicate trans people from public life, to really — contrary to medicine — make the treatment of gender dysphoria a culture war, as opposed to a serious medical need that requires treatment.”

In May, Gov. Brian Kemp, a Republican, signed SB 185, a bill passed by the state’s majority conservative legislature that prohibits the use of state funds or resources for surgery, hormone replacement therapy, cosmetic procedures and other treatments used to address gender dysphoria. The law states explicitly that incarcerated people may still receive treatments like hormone replacement therapy if they are medically necessary for conditions other than gender dysphoria. 

Ezie told The 19th that the bill’s sponsors indicated during hearings that incarcerated trans people would not be allowed to pay for treatment themselves, either. Her team has also heard this from their clients, she said. The 19th reached out to the Georgia Department of Corrections to confirm whether incarcerated trans people can pay for these procedures themselves.

“Senate Bill 185 prohibits the use of state funds or resources for the following treatments for state inmates: A. Sex reassignment surgeries or any other surgical procedures that are performed for the purpose of altering primary or secondary sexual characteristics; B. Hormone replacement therapies; and C. Cosmetic procedures or prosthetics intended to alter the appearance of primary or secondary sexual characteristics,” wrote Joan Heath, the department’s director of communications.

“Thus, the GDC cannot use state resources to transport an offender to be seen by a provider paid for at their own expense, nor allow a provider being paid by an offender to treat such offender at a GDC facility,” she continued.

The legal complaint filed by the Center for Constitutional Rights includes details about the plaintiffs who described the effects of being cut off from their gender-affirming medical care. One trans woman named Fantasia Horton, incarcerated in Phillips State Prison, had been receiving hormone therapy since 2019 but was completely cut off following the law, despite being told that her dosages would gradually decrease before ending, according to the Center for Constitutional Rights.

“Due to Defendants’ policies and actions in terminating her treatment, Ms. Horton is now at grave risk of physical and psychological harm,” the complaint stated. “Three years ago, after losing access to hormone therapy for just one week after her prison’s supply of hormone therapy was temporarily depleted, Ms. Horton’s mental health plummeted and her depressive symptoms returned.”

Gender dysphoria is a condition recognized by medical journals and professionals. It is defined as the sense of discomfort or anxiety a person feels when their physical gender feels out of sync with their gender identity. This can lead to long-term mental health effects, including periods of depression, thoughts or acts of self-harm. Forced detransition due to anti-trans legislation, coupled with the poor conditions and discrimination that incarcerated trans people often experience, can worsen these mental health consequences. From a physical standpoint, doctors recommend that any termination of hormone replacement therapy takes place gradually over three to six months, rather than cold turkey.

“Taking away individuals’ access to gender-affirming therapies while in prison constitutes cruel and unusual punishment and increases the likelihood of abuse and detrimental health consequences,” Jan T. Mooney, an Atlanta-based psychologist, and Mark Spencer, an Atlanta-area internal medicine physician, wrote in an April column about the Georgia bill. 

“Abrupt cessation or forced weaning of medically necessary, ongoing treatment is a health risk. Physical effects of hormone withdrawal are accompanied by psychological distress, which may manifest as anxiety, depression, and suicidality,” they continued.

The class action lawsuit comes 10 years after Ezie first sued over another ban on gender-affirming care in Georgia prisons. In that case Ashley Diamond, a Black transgender woman, sued the Georgia Department of Corrections in 2015 after being held in men’s prisons and denied hormone treatments. 

The case drew attention from the U.S. Department of Justice, which said at the time that blanket policies barring hormone therapy violate the Eighth Amendment “because they do not provide for individualized assessment and treatment.” Diamond won an undisclosed settlement in 2016, and her case prompted policy changes in Georgia meant to facilitate better treatment of incarcerated transgender people. But six years later, Diamond sued again, asserting that the state failed to provide her adequate health care or protect her from sexual assault after a second incarceration. Ultimately, Diamond dropped that lawsuit to protect her mental health, according to her lawyers.

To see the same issues come up again in 2025 feels like being “in a time machine going back in time,” said Ezie, who represented Diamond 10 years ago.

“I think that is a feeling that’s shared by many trans rights activists,” Ezie said. “It feels like, rather than seeing a forward march of progress when it comes to securing basic rights and basic dignity for transgender people, we are now fighting to hold on to very basic legal wins that you know we achieved, at times, decades ago.”

Ezie and the legal team at the Center for Constitutional Rights are hopeful that the courts will overturn Georgia’s law, as they have in other similar cases. For example, Wisconsin enacted a law in 2005 that barred prison doctors from providing hormone therapy or gender-affirming surgery to incarcerated transgender people in state custody. But a federal court ruled that denying this medical care constitutes cruel and unusual punishment. Another state-level class action lawsuit in Colorado resulted in a negotiated settlement agreement between the state and the Department of Corrections requiring an overhaul of how it houses incarcerated transgender women and provides medical care to all trans people behind bars.

If the Center for Constitutional Rights is successful in Georgia, Ezie anticipates that there will still be a long road ahead in the effort to challenge anti-trans legislation and policies.

“We’re going to continue to use the courts, we’re going to continue to organize, we’re going to continue to — as we did prior to the passage of this bill — lobby against bills like this that seek to cause so much preventable harm,” she said. “This is why we fight.”

Correction: An earlier version of this article misidentified the legal representation for Ashley Diamond in 2015.