Federal judge halts enforcement of Georgia law prohibiting gender-affirming care in state’s prisons

A federal judge granted a preliminary injunction Thursday, halting the enforcement of Georgia Senate Bill 185 in the state’s prison system, saying the “implementation of SB 185 was not a medical judgment, it was a policy judgment.”

“The state’s categorical ban on receiving hormone therapy is in tension with case law recognizing that, in appropriate circumstances, hormone therapy can be medically necessary for gender dysphoria,” said Victoria M Calvert, a judge of the U.S. District Court for the Northern District of Georgia. 

SB 185 was passed by the Georgia General Assembly and signed by Gov. Brian Kemp earlier this year. It went into effect on May 8. The bill prohibits the use of state funds or resources for gender-affirming care like hormone replacement therapy (HRT).

The Center for Constitutional Rights and Bondurant Mixson & Elmore LLP filed a class action lawsuit on behalf of Isis Benjamin, Fantasia Horton, Naeomi Madison, Brynn Wilson and a John Doe. All of the plaintiffs are incarcerated people in Georgia’s prison system who had been receiving or were previously approved for hormone replacement therapy before the Georgia Department of Corrections (GDC) implemented new policies on gender affirming care under SB 185. Judge Calvert’s ruling on Thursday also certified the lawsuit into two classes: the first includes all people incarcerated in Georgia’s prisons who had been receiving hormone replacement therapy by May 8, 2025, and the second includes any transgender people incarcerated in Georgia’s prisons who request hormone replacement therapy going forward. 

Before SB 185, people incarcerated in Georgia’s prisons could be prescribed gender-affirming care like HRT if it was deemed “medically necessary” by GDC’s medical and mental health directors. In July, however, GDC began notifying incarcerated individuals receiving HRT that it would no longer be providing that treatment. 

“On Tuesday, July 8, 2025, right after I received my biweekly hormone therapy shot, I was called in to a meeting with a GDC psychologist who I had never met before,” Fantasia Horton wrote in a statement to the court. “The psychologist told me that because of SB 185, I would no longer be able to receive hormone therapy, surgery, or any other gender dysphoria treatment from GDC. She also told me that instead of continuing hormone therapy, I would begin being detransitioned by GDC.”

Patients who were receiving that medical care were given a choice between stopping hormone therapy cold turkey or tapering down before ceasing. The plaintiffs were also informed that they could not get gender affirming treatment even if they paid out of pocket. The preliminary injunction orders the GDC to “immediately cease tapering hormone therapy doses” and assess the necessity of hormone replacement therapy to people suffering from gender dysphoria without concern for SB 185. 

According to the lawsuit, without treatment, the plaintiffs are at risk for gender dysphoria and with it “depression, anxiety, mood dysregulation, self-harm, self-surgery, or death by suicide.”

One of the plaintiff’s attorneys, Celine Siwan Zhu, justice fellow and staff attorney at the Center for Constitutional Rights, told the Atlanta Community Press Collective, “Fundamentally, our case is saying that denying health care to a specific group of people violates the Eighth Amendment prohibition on cruel and unusual punishment.”

While preliminary injunctions must be renewed every 90 days, Judge Calvert’s order said she is considering granting “permanent injunctive relief relating to hormone treatment.” She ordered both parties to file arguments in the matter within the next two weeks. 

“We’re heartened by this ruling, and excited to call our plaintiffs and let them know their medical care will resume,” Zhu said. “It’s important to remember that when legislatures experiment with unconstitutional laws withholding medical care like SB 185, the cost is always human suffering.”

Prison gender-affirming care bans overturned in other states

The ACLU of Idaho filed a similar class action lawsuit last year, challenging Idaho House Bill 668, which similarly prohibits the use of public funds for gender-affirming care. After HB 688 took effect, Centurion of Idaho—a subsidiary of Centurion Health, a private correctional healthcare company—began transitioning incarcerated people off hormone therapy. A federal judge granted a preliminary injunction that stopped Idaho from enforcing HB 688 against incarcerated people with gender dysphoria in December 2024 due to potential violations of the plaintiff’s Eighth Amendment rights.

“Where the Government shows ‘deliberate indifference’ to the serious medical needs of a prisoner by choosing a course of treatment that is medically unacceptable in conscious disregard of an excessive risk to the plaintiff’s health, the Government violates the Eighth Amendment rights of those prisoners,” the judge’s order said.

Another Centurion subsidiary, Centurion of Georgia, provides health care services for the GDC. Centurion of Georgia is a defendant in the SB 185 lawsuit.

The detransition model that GDC and Centurion are using in Georgia is based on the Centurion plan in Idaho. Zhu noted that Centurion of Georgia is “knowingly” implementing a detransition plan that had been previously blocked by a federal judge.

In 2023, Florida passed SB 254, which severely limited gender-affirming care for incarcerated minors in addition to adults. In Florida, unlike Idaho and Georgia, however, Centurion “continued providing care, and they just didn’t seek the state for reimbursement,” Zhu said.

A federal judge permanently blocked the enforcement of SB 254 in June 2024, but the Florida Department of Corrections instituted a policy that effectively mirrors SB 254 in September 2024. The ACLU of Florida filed a class action lawsuit over the policy the following month, but a judge rejected the plaintiff’s request for a preliminary injunction in December 2024.