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Bayse v. Doizer

United States District Court, M.D. Georgia, Macon Division

May 21, 2019

Commissioner GREGORY DOZIER, et al., Defendants.

         Proceedings Under 42 U.S.C. § 1983 Before the U.S. Magistrate Judge


          Charles H. Weigle, United States Magistrate Judge

         Before the Court is a motion for summary judgment filed by Defendants Gregory Dozier, Sharon Lewis, and Kenneth Sanford. (Doc. 48). Because Defendants are entitled to qualified immunity from Plaintiff Robbin Amanda Bayse's civil rights claims, it is RECOMMENDED that the motion for summary judgment be GRANTED.

         I. BACKGROUND

         Plaintiff Robbin Amanda Bayse, also known as Robert Bayse, is an inmate of the Georgia Department Corrections (“GDC”) and currently incarcerated at Valdosta State Prison. Plaintiff was born biologically male but has been living as a transgender female for at least the past twenty-seven years.[1] (Bayse Dep., Doc. 48-3, p. 41). Plaintiff was diagnosed with gender dysphoria in September 2015 (Id., p. 18) and has also been diagnosed with major depressive disorder and borderline personality disorder (Dr. Moody Decl., Doc. 48-7, ¶ 5). Plaintiff also experiences anxiety, sleeplessness, nightmares, and auditory hallucinations. (Id., ¶ 6); (Doc. 48-3, p. 19).

         The uncontested definition of gender dysphoria is outlined in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-5). See (Compl., Doc. 1, p. 10); (Ga. Dept. Corrs. SOP, Doc. 48-5, p. 2); cf. (Mot. Summ. J., Doc. 48-2, p. 13 n.2 (citing DSM-5)). The DSM-5 defines gender dysphoria as “[a] marked incongruence between one's experienced/expressed gender and assigned gender, of at least 6 months' duration, as manifested by at least two of the following:”

1. A marked incongruence between one's experienced/expressed gender and primary and/or secondary sex characteristics (or in young adolescents, the anticipated secondary sex characteristics).
2. A strong desire to be rid of one's primary and/or secondary sex characteristics because of a marked incongruence with one's experienced/expressed gender (or in young adolescents, a desire to prevent the development of the anticipated secondary sex characteristics).
3. A strong desire for the primary and/or secondary sex characteristics of the other gender.
4. A strong desire to be of the other gender (or some alternative gender different from one's assigned gender).
5. A strong desire to be treated as the other gender (or some alternative gender different from one's assigned gender).
6. A strong conviction that one has the typical feelings and reactions of the other gender (or some alternative gender different from one's assigned gender).

         Am. Psychiatric Ass'n, Diagnostic and Statistical Manual of Mental Disorders (DSM-5) 452-53 (5th ed. 2013); see also Gibson v. Collier, 920 F.3d 212, 217 (5th Cir. 2019) (discussing DSM-5's definition of gender dysphoria); Freeman v. Dunn, No. 2:06-CV-122-WKW, 2018 WL 3235794, at *87 n.245 (M.D. Ala. July 2, 2018) (same). The DSM-5 adds, “The condition is associated with clinically significant distress or impairment in social, occupational, or other important areas of functioning.” DSM-5, at 452-53.

         Plaintiff has a documented history of self-harm and attempted suicide, which predates her diagnosis of gender dysphoria and her incarceration. See, e.g., (Doc. 61-9); (Doc. 48-3, p. 70). Plaintiff first attempted suicide at seven years old, after witnessing an aunt kill herself and due to a perception that people were not “trying to understand who I was.” (Doc. 48-3, p. 70). Plaintiff has attempted self-castration three times, either by cutting or “tying” her genitals. (Doc. 61-9, pp. 2, 4, 8-9). One doctor noted, “[Plaintiff Bayse] described having had a long[-]time hatred of his male genitals and has struggled with the urge to castrate himself.” (Id., p. 7). On one occasion, Plaintiff cut her face in response to prison officials' alleged refusal to allow her to wear makeup. (Id., p. 10); see also (Doc. 48-3, p. 55).

         Plaintiff, as per GDC policy, is currently being treated for her gender dysphoria and other psychiatric disorders pursuant to a treatment plan. (Doc. 48-7, ¶¶ 4-5); (Treatment Plan, Doc. 54-4). GDC Standard Operating Procedure 507.04.68 provides, in relevant part, that gender dysphoric inmates “will receive thorough medical and mental health evaluations from appropriately licensed and qualified medical and mental health professionals, ” who will then develop a treatment plan “that promotes the physical and mental health of the patient” in accordance with “accepted standards of care.” (Doc. 1-3, p. 1). The treatment plan must be approved by the Statewide Medical Director and Statewide Mental Health Director before implementation, then regularly reviewed and updated as necessary. (Id., p. 2). In addition, gender dysphoric inmates are to “receive a current individual assessment and evaluation, ” and “[t]reatment options will not be precluded solely due to level of services received, or lack of services, prior to incarceration.” (Id.).

         Under the treatment plan, Plaintiff has received hormone therapy and other medications, such as Risperdal to treat her auditory hallucinations. (Doc. 48-7, ¶ 6). Plaintiff has also attended a trauma group and counseling sessions, expressed herself through art and journaling, and engaged in “mindful exercise.” (Docs. 54-4; 54-6, pp. 2- 8). Hormone therapy has caused Plaintiff to “develop[] breasts, soft skin and other female secondary sex characteristics.” (Bayse Decl., Doc. 8, ¶ 3). Plaintiff also wears traditionally feminine accessories, such as earrings and bracelets; applies makeup, eyeliner, and lip gloss; and colors her fingernails and toenails. (Doc. 48-3, pp. 96-98). Plaintiff testified that her earrings are made from a “candy wrapper and a hair comb tooth, ” her bracelet is made from “a little rope, ” and she colors her nails using colored pencils. (Id.); (Doc. 8, ¶ 10). Plaintiff was wearing these accessories during her deposition. (Doc. 48-3, pp. 96-98). She also wears her hair longer than the mandated hair-length limit of three inches. (Id., pp. 92-99); (Doc. 61-15). Plaintiff claims that she is barred from obtaining “gender-affirming clothing, grooming, or commissary items, ” such as colored pencils, which she claims are medically necessary to treat her gender dysphoria and ease the “mental anguish” she experiences at “being forced to live as a male.” (Doc. 8, ¶¶ 11-12).

         Plaintiff has contested the adequacy of her treatment plan and consistently demanded sex reassignment surgery (“SRS”) throughout her incarceration, see, e.g., (Docs. 54-6, p. 17; 61-2, p. 8; 61-5, pp. 5, 9; 61-6, pp. 10-12; 61-12, p. 6), stating that she feels “trapped in the wrong body” (Doc. 8, ¶ 3). She claims that her several requests to see a “qu[a]lified physician, psychiatrist or psychologist” for treatment have been “futile.” (Bayse Decl., Doc. 22, ¶¶ 3, 7). The perceived inadequacy of her treatment has caused her to develop an eating disorder and “placed [her] at increased risk of suicide, self-mutilation and self-castration.” (Id., ¶¶ 8-9). One psychologist, Dr. Kelly Hern, noted that Plaintiff had exhibited an “obsessive ‘need' for reassignment surgery.” (Doc. 61-6, p. 9). In response to her persistent requests for SRS, medical staff have challenged Plaintiff's perception that SRS would cure her mental disorders. Dr. Hern, for example, informed Plaintiff about research against the surgery. (Id., p. 5). Dr. Hern also dismissed the idea that that the prescribed medication was to “cover up” her problems and told Plaintiff that SRS “is not an option as yet.” (Id.). Madia West, the Mental Health Director at Johnson State Prison, also “challenged ideation that gender reassignment would end all problems” and continued to discuss “gender relevant issues” with Plaintiff. (Doc. 54-6, p. 31).


         Plaintiff claims that Defendants, in violation of the Eighth Amendment, acted with deliberate indifference to her gender dysphoria by refusing to provide her with SRS and by only allowing her access to unqualified medical and mental health professionals. Plaintiff also contends that the GDC has a policy prohibiting physicians from recommending and providing SRS.

         Plaintiff has also brought a claim under the Fourteenth Amendment's equal protection clause, arguing that the GDC has a policy prohibiting male-to-female transgender inmates from obtaining a vaginoplasty but allowing inmates born biologically female to undergo the procedure.

         In relief, Plaintiff requests an injunction for adequate medical care, including SRS; an injunction to “enjoin[] Defendants from interfering with the discretion” of Plaintiff's treating physicians and mental health staff; a declaration that the GDC's policy against SRS and the treatment of transgender inmates is unconstitutional; $450, 000 in compensatory damages, jointly and severally; $250, 000 in punitive damages, jointly and severally; and attorneys fees and costs. (Doc. 1, p. 7). Plaintiff sues Defendants in both their individual and official capacities. (Id.).


         Plaintiff filed her complaint on January 26, 2018. (Doc. 1). On screening, the Court ordered Plaintiff's deliberate indifference claims under the Eighth Amendment and equal protection claims under the Fourteenth Amendment to proceed for further factual development. (Doc. 12). On June 24, 2018, Plaintiff moved for a preliminary injunction and temporary restraining order, seeking SRS and other treatments she considered to be medically necessary to treat her gender dysphoria. (Doc. 19). The Court denied Plaintiff's motion on the grounds that she had not shown a substantial likelihood of success on the merits, as she could not show that the treatments were medically necessary to treat her condition. (Doc. 43, adopting Doc. 35). On January 25, 2019, Defendants moved for summary judgment. (Doc. 48).

         Throughout this action, Plaintiff, in addition to several motions and responsive filings, has filed several affidavits and declarations, each discussing, and often repeating, specific details regarding her treatment, alleged deprivations, and her life experiences in general. See (Docs. 8, 9, 22, 29, 46, 47, 58, 63). Each of these affidavits and declarations has been reviewed and considered for purposes of this recommendation.


         A party is entitled to summary judgment “if the movant shows that there is no genuine dispute as to any material fact and that the movant is entitled to judgment as a matter of law.” Fed.R.Civ.P. 56(a). “An issue of fact is ‘material' if it is a legal element of the claim under the applicable substantive law which might affect the outcome of the case.” Allen v. Tyson Foods, Inc., 121 F.3d 642, 646 (11th Cir. 1997) (citing Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 248 (1986)). A factual dispute is genuine if the evidence is such that a reasonable jury could return a verdict for the nonmoving party; however, “the mere existence of a scintilla of evidence in support of the position will be insufficient.” Johnson v. Bd. of Regents of Univ. of Georgia, 263 F.3d 1234, 1243 (11th Cir. 2001) (quoting City of Delray Beach v. Agricultural Ins. Co., 85 F.3d 1527, 1530 (11th Cir. 1996)).

         The party moving for summary judgment bears the burden of informing the Court of the basis for its motion, and of citing “the pleadings, depositions, answers to interrogatories, and admissions on file, together with the affidavits, if any, ” that support summary judgment. Celotex Corp. v. Catrett, 477 U.S. 317, 322-24 (1986). In resolving motions for summary judgment, the Court must view the evidence in the light most favorable to the nonmoving party. Tolan v. Cotton, 572 U.S. 650, 657 (2014). “The evidence of the non-movant is to be believed, and all justifiable inferences are to be drawn in his favor.” Anderson, 477 U.S. at 255.

         V. ...

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