Federal Appeals Court Upholds Contempt Order Against Corrections Corporation of America

ANCHORAGE – The American Civil Liberties Union (ACLU) of Alaska, with the ACLU National Prison Project, filed a class action lawsuit today against the Alaska Department of Corrections (DOC) challenging DOC’s inadequate, dangerous, and inhumane health care system. The federal court lawsuit, brought on behalf of incarcerated Alaskans, contends that the state’s failure to provide adequate health care is a violation of the Eighth and Fourteenth Amendments and has resulted in needless suffering, decline, and death. A years-long investigation into the inadequate physical, dental, and mental health care for thousands of incarcerated Alaskans demonstrates a critical need to fix DOC’s health care system immediately. “Thousands of Alaskans depend on DOC to take care of their most basic and essential health care needs. They have no other option once they are detained. But the care they’re receiving, if they receive it, often comes too late, and is woefully inadequate,” said Megan Edge, Prison Project Director for the ACLU of Alaska. “State officials have known for years about these unconstitutional, inhumane, and cruel conditions, but have failed to make meaningful changes. We are hopeful that the courts will mandate an overhaul of DOC’s medical processes. If they don’t, Alaskans will continue to suffer and die needlessly.” According to DOC, the cost of care for someone housed in an Alaska state jail or prison is $202 per day. However, this does not include medical care for chronic diseases, end-of-life, or emergency care. At the beginning of 2025, Alaska Governor Michael Dunleavy announced a proposed state budget that included $481 million for the DOC. DOC’s budget has continued to grow, without safer conditions or improved health care. “When it comes to health care, Alaska’s prisons showcase some of the worst conditions of confinement that we’ve seen anywhere in the country,” said Nancy Rosenbloom, Senior Litigation Advisor at the ACLU’s National Prison Project. “The Alaskans who we represent in this lawsuit have been subject to an egregious lack of medical care that is heartbreaking, inhumane, and violates their constitutional rights under the Eighth and Fourteenth Amendments.” Examples of the health care inadequacies include the following: Untreated diabetes led to a coma and time in the ICU. In July 2023, an incarcerated diabetic woman complained of severe low back pain and was diagnosed with muscle spasms. Her pain did not improve and became so excruciating that she could not walk to receive medical attention, eat meals, or use the bathroom without the assistance of other incarcerated people. Medical staff did not check her blood sugar levels even while she remained in her cell, incapacitated by pain. Approximately one week later, an officer noted that the woman had fallen out of bed and was unresponsive. Upon being transferred to the emergency room, she was found to be in a diabetic coma, a life-threatening complication of poorly controlled diabetes. She spent 6 days in the intensive care unit before returning to prison. A diagnosed chronic illness progressed to pre-stages of colon cancer. An incarcerated man was diagnosed with ulcerative colitis, a chronic inflammatory bowel disease in which abnormal reactions of the immune system cause inflammation and ulcers in the large intestine. Because of DOC’s failure to treat his disease appropriately during a previous incarceration, he suffered enormous pain and discomfort, and the colitis progressed to the advanced pre-stages of colon cancer. Untreated cataracts led to near blindness and the inability to care for other health problems. An incarcerated man’s cataracts worsened and advanced to the point where surgery was required. Because DOC failed to provide him with the needed procedure, his vision has become so impaired that he cannot clearly see the food on his plate or safely navigate the prison environment. Years after his diagnosis of bilateral “dense” cataracts and myopia (nearsightedness, with a visual acuity of 20/400 in both eyes), DOC has still failed to provide him surgery or eyeglasses. At the same time, he repeatedly asked the prison clinic for assistance, as he could not see well enough to care for his severe facial acne. He often bled from his face, at times soaking a napkin with blood. Untreated teeth lead to gross decay, oral wounds, and stitches. An incarcerated man suffered three fractured teeth, including one loose in the socket, and a knocked-out tooth. Despite requesting dental care in September 2021, he did not receive an appointment for four months, by which time he had pain and “gross decay.” DOC dental staff extracted two teeth and the patient required sutures to repair wounds in his mouth caused by the fractured teeth cutting his lips. He experienced further dental problems that were not addressed, leading to severe pain and further loss of teeth. DOC has a de facto “extraction only” policy, often offering extraction as the only treatment option, even for teeth that could be saved.

RICHMOND, Va. -- On Friday, February 28th, the ACLU of North Carolina joined the ACLU Disability Rights Program, Rights Behind Bars, Tycko & Zavareei LLP, and Kaplan & Grady LLC, in filing an appeal with the U.S. Court of Appeals for the Fourth Circuit on behalf of Tracey Edwards. While she was incarcerated in the North Carolina Correctional Institution for Women (NCCIW), prison officials abruptly cut off Ms. Edwards' medication for opioid use disorder (MOUD) after she gave birth, causing an extremely painful, dangerous, and unnecessary withdrawal. Prison officials also kept Ms. Edwards shackled during and after giving birth – in direct violation of the prison system’s own policy – causing severe pain and interfering with Ms. Edwards’ ability to bond with her newborn child. “People who are incarcerated deserve respect and dignity, as well as safe and responsive medical care,” said D Dangaran, Director of Gender Justice Rights Behind Bars. “By shackling Ms. Edwards during childbirth, keeping her shackled after she gave birth, and cutting off her medication, prison officials needlessly escalated the physical, mental, and emotional harm to Ms. Edwards during a time when she was already vulnerable.” “The use of shackles on Ms. Edwards and the denial of MOUD caused her pain and suffering, and greatly increased the risk of relapse, overdose, and death,” said Shana Khader, partner at Tycko and Zavareei LLP. “Defendants in this case violated medical standards of care as well as Ms. Edwards’ civil rights.” Ms. Edwards brought claims for damages under the Eighth Amendment and federal disability rights laws. The district court ruled against Ms. Edwards. In this appeal, Ms. Edwards seeks to have the district court’s decision reversed so a jury can decide her claims. “The treatment that Ms. Edwards experienced is both inhumane and unconstitutional,” said Joseph Longley, ACLU Disability Rights Program Staff Attorney. “This appeal is about accountability. No one, especially a new mother, should endure such cruel and degrading conditions. And no one should be denied access to their lifesaving medications for opioid use disorder, especially when tens of thousands of Americans are dying of an overdose every year. We are working to ensure Ms. Edwards gets her day in court and that this kind of mistreatment is never repeated.” The brief can be found here: https://www.acluofnorthcarolina.org/sites/default/files/field_documents/2025.02.28_appellants_opening_brief_4th_cir._dkt._23-1.pdf

WASHINGTON – Three transgender people currently incarcerated in federal custody have filed a class action lawsuit against the Trump Administration and the Federal Bureau of Prisons (BOP) challenging an Executive Order and new BOP policies prohibiting their access to gender-affirming care. The class action lawsuit was filed in federal court in Washington, D.C., on behalf of approximately 2,000 transgender people incarcerated in federal prisons across the United States. Following a January 20 executive order from President Trump that prohibited gender-affirming medical care for transgender people in federal prisons and immigration detention centers, the BOP instructed federal prisons to cease treatments like hormone replacement therapy previously prescribed by BOP medical providers. BOP also instructed officials to remove any transgender women held in women’s facilities and place them in men’s facilities, an issue under challenge in multiple separate lawsuits. BOP’s new policy also prohibits gender-affirming clothing and commissary items for transgender people, and requires that incorrect pronouns be used. Today’s lawsuit was filed on behalf of two transgender men and one transgender woman serving sentences in facilities in New Jersey, Minnesota, and Florida. All three were diagnosed with gender dysphoria by BOP medical providers and prescribed hormone therapy by health care staff, but have either had their treatments suspended or were told they will be suspended soon. The filing argues this policy violates the Eighth Amendment’s prohibition on “cruel and unusual punishments,” which federal courts have long held includes the denial of medically-necessary health care, including access to gender-affirming care. It also argues that the policy violates the equal protection requirement of the 5th Amendment, the Administrative Procedure Act, and the Rehabilitation Act. The case was filed on behalf of the three plaintiffs, and all other transgender people in federal prisons, by the ACLU, the ACLU of DC, and the Transgender Law Center. “Since his first day in office, President Trump has singled out transgender people for discrimination, persecution, and erasure from public life,” said Li Nowlin-Sohl, Senior Staff Attorney for the ACLU’s LGBTQ & HIV Project. “This policy injects politics into the provision of health care for people in custody, putting the ideology of the president over the best medical judgement of BOP’s own officials as well as the rights and lives of incarcerated transgender people themselves. Withholding medically-necessary care from anyone in custody is cruel and unusual, and we’re confident the courts will not abide this clear and transparent violation of that principle.” “Courts have held time and again that the Constitution requires that prisons provide incarcerated people with medical and mental health care. President Trump’s executive order categorically banning all gender-affirming care for transgender people in federal prisons is just as unconstitutional as categorically banning chemotherapy for incarcerated cancer patients or insulin for people with diabetes,” said Corene Kendrick, deputy director of the ACLU National Prison Project. “People of all backgrounds, races, and genders know that we all deserve the right to live as our most authentic selves,” said Shawn Meerkamper, Managing Attorney at Transgender Law Center. “This executive order endangers lives and is an attack on the rights and dignity of transgender people everywhere. Denying access to the life-saving health care prescribed by BOP doctors is yet another cruel attempt at further harming and discriminating against transgender people.” “The Trump administration's decision to deny gender-affirming care approved by its own doctors is unconstitutional and part of a broader campaign to push trans people out of public life,” said Michael Perloff, Senior Staff Attorney at ACLU-D.C. “Trans people aren’t pawns in an ideological battle—they’re people who deserve access to critical medical care like everyone else. The Trump administration has reportedly begun instructing BOP officials to ignore previous enforcement of the 2002 Prison Rape Elimination Act and unilaterally re-house transgender women into men’s prisons with the full knowledge of their risk for sexual violence and suicide, as well as confiscate clothing, commissary, items, or other personal items “inconsistent” their sex assigned at birth. A federal judge has since blocked that policy as-applied to the incarcerated transgender women who have brought separate challenges. Of the 155,000 people in federal prisons, just over 2,000 (or 1.2%) are transgender. In December 2024, the Supreme Court held oral arguments in U.S. v. Skrmetti, a landmark case challenging Tennessee’s categorical ban on gender-affirming hormonal therapies for transgender youth on the grounds the law violates the Equal Protection Clause of the U.S. Constitution by discriminating based on sex. The case began when an initial lawsuit was first filed by the American Civil Liberties Union, the ACLU of Tennessee, Lambda Legal, and Akin Gump Strauss Hauer & Feld LLP on behalf of three transgender adolescents and their families. A decision is expected in June 2025. Thee complaint filed today in Kingdom v. Trump can be found here.