United States District Court, E.D. Louisiana
REPORT AND RECOMMENDATION
VAN MEERVELD UNITED STATES MAGISTRATE JUDGE.
Williams a/k/a Serenity Izabel Williams, a state prisoner,
filed this federal civil action pursuant to 42 U.S.C. §
1983 against the following defendants: Beverly Kelly, the
Assistant Warden of the Rayburn Correctional Center
(“Rayburn”); Chris Polk, Rayburn's Assistant
Director of Nursing; Robert Tanner, Rayburn's Warden; and
James M. LeBlanc, the Secretary of the Louisiana Department
of Public Safety and Corrections. Plaintiff later filed an
amended complaint to add two new defendants: Teresa Knight,
Rayburn's Director of Nursing; and Dr. Robert Cleveland,
the physician at Rayburn. In this lawsuit, plaintiff claims that
the defendants have been deliberately indifferent to her need
for medical treatment for gender dysphoria and have violated
her right to equal protection.
motions are currently pending before the Court. Plaintiff has
filed motions for a preliminary injunction and default
judgment. The defendants have filed a motion to
dismiss, which plaintiff has opposed.
original complaint, plaintiff made the following
Serenity Izabel Williams is an anatomical male who is
suffering from Gender Dysphoria. This is a rare psychiatric
disorder in which she feels persistently uncomfortable about
her anatomical sex, and who typically seek medical treatment,
including sexual reassignment surgery. Gender Dysphoria is a
serious medical condition recognized by the medical community
as a serious condition.
All Defendants are all in deliberate indifference by imposing
a substantial risk of serious harm to Plaintiff Williams'
present and future health.
Plaintiff avers that she's on feminizing hormone therapy.
The final step of Williams' treatment is sexual
reassignment surgery, which would bring her primary and
secondary sex characteristics into conformity with her female
gender identity and therefore treat the severe mental anguish
she experiences as a result of her gender dysphoria.
Plaintiff avers that all of the defendants has been informed
that she have been and still is suffering with a serious
medical condition which is known as “Gender
Dysphoria” and have been denied serious medical
treatment such as sex reassignment surgery and be transfer to
an all female's prison.
All defendants not only being aware of the facts that by
denying Williams a sexual reassignment surgery; they have
caused her extreme anxiety, and depression that she go to
sleep crying and wake up crying knowing that she don't
feel comfortable as she is in life. She also thought of
All defendants have disregard the risk that Williams'
gender dysphoria will cause her to do upon herself, by
failing to take reasonable measures to abate these risks.
Plaintiff avers that defendants acted with an intent and/or
purpose to discriminate again her based upon membership in a
protected class. The essence of the Equal Protection Clause
is a requirement that similarly situated persons be treated
In support of her Equal Protection Clause claim under 42
U.S.C. § 1983, Williams alleges that all of the
defendants acted with an intent and/or purpose to
discriminate against her based upon her membership in a
protected class. Specifically, she alleges that defendants
intentionally treat her differently than non-transgender
female inmates seeking vaginoplasty due to her gender and
transgender status by barring her from such treatment or, at
a minimum, holding her to more onerous standard, and that
Defendants discriminated against her by refusing to have her
transfer to an all female's prison.
The Plaintiff further contends that none of the above
provided her with a legitimate penological reasoning of
denying her sex reassignment surgery. There are no
institution policy nor Department or State's policies and
regulations barring the plaintiff vaginoplasty surgery. If
there are statutes and regulations that bar her from getting
sex reassignment surgery; then it is facially discriminatory
because it explicitly distinguishes between treatment for
transsexual woman that is designated as presumptively
“not medically necessary” (i.e. castration and
vaginoplasty for treatment of gender dysphoria) and the same
treatments for non-transgender woman (i.e. vaginoplasty for
treatment of cystocele or rectocele), which are explicitly
exempted from this bar.
Here, Williams has alleged that each Defendants discriminated
against her on the basis of her transgender status. She
alleges that, in considering her need for medically necessary
surgery, and vaginoplasty in particular, Defendants treated
her differently from a similarly situated non-transgender
woman in need of medically necessary surgery. They articulate
no important governmental interest, much less describe how
their gender classification - which makes it more difficult
for a transgender person to receive gender reassignment
surgery than it is for a cisgender woman - is substantially
related to that interest.
amended complaint, plaintiff added the following additional
1. Plaintiff has been living as a female since adolescence in
the early 2000s;
2. She has been in custody since on or about October 16,
3. In 2016, a prison psychiatrist, Dr. Matthew Gamble,
diagnosed her as suffering from gender dysphoria;
4. She began feminizing hormone therapy on June 29, 2017; 5.
She is classified in the prison system as transgender
“based on her sexual preference and her mental health
status”; 6. She requested sex reassignment surgery on
“numerous occasions” with no success;
7. She filed an administrative grievance which was denied at
the final step by defendant LeBlanc;
8. Defendants are aware that she has attempted suicide on
“numerous occasions since childhood, ” and their
refusal to provide sex reassignment surgery poses an
unreasonable risk to her health and life;
9. Sex reassignment surgery would allow plaintiff “to
reduce the high dosages of hormones she receives, which put
her at increased risk for heart and vascular condition and
certain types of cancer”;
10. If she goes untreated or if treatment is discontinued,
there is a severe risk that she “will experience
suicidal tendencies, the impulse to engage in
self-castration, or self-harm, clinically significant
depression, anxiety, and mental
attached to her amended complaint copies of the responses to
her administrative grievance. At the first step, Warden
Tanner denied relief, stating:
Your complaint seeking sex reassignment surgery and an
eventual transfer to a female prison has been reviewed.
According to your medical record, you were properly evaluated
by the medical staff at his [sic] facility and subsequently
prescribed hormone replacement therapy. You have been
referred to the management team for continued review of your
status. Documentation in your medical record indicates that
you are non-compliant with taking your treatment regime as
prescribed. As a result of your non-compliance, you are not
eligible for consideration for gender affirming surgery. You
are encouraged to comply with your treatment plan and
continue to meet with the mental health staff as needed.
Your request for a remedy is denied.
second and final step of the administrative remedy procedure,
Secretary LeBlanc's designee then likewise denied relief,
It has been determined that your complaint is without merit.
The medical staff has addressed your concerns in an
appropriate manner and in accordance with DOC Health Care
Policy. Medical opinion is controlling. The care you have
received as well as the care you will continue to receive
from the Medical staff is determined adequate for your health
care concerns. As such, this office has accepted staff's
position in this matter and concurs with the response
provided at the First Level. Therefore, administrative
intervention is not forthcoming.
Your request for relief is denied.
Motion for Preliminary Injunction
has filed a motion for a preliminary
injunction. Under the law of this Circuit, a
plaintiff must make a clear showing that her case satisfies
the following four criteria before she can receive a
preliminary injunction: (1) a substantial likelihood exists
that she will succeed on the merits of her claim; (2) a
substantial threat of irreparable harm exists if the
injunction is not granted; (3) the threatened injury
outweighs any harm to the defendants if the injunction is
granted; and (4) the injunction will not undermine the public
interest. See Valley v. Rapides Parish School
Board, 118 F.3d 1047, 1051 (5th Cir. 1997); see
also Ingebresten v. Jackson Public School District, 88
F.3d 274, 278 (5th Cir. 1996); Doe v. Duncanville
Independent School District, 994 F.2d 160, 163 (5th Cir.
1993); Holland American Insurance Co. v. Succession of
Roy, 777 F.2d 992, 997 (5th Cir. 1985). She must satisfy
all four factors; a failure to satisfy even one of the four
factors requires a denial of the preliminary injunction.
See Mississippi Power & Light v. United Gas Pipe Line
Co., 760 F.2d 618, 621 (5th Cir. 1985).
reasons explained infra, plaintiff's claims
should be dismissed. Therefore, she cannot show that there is
a substantial likelihood that she will succeed on the merits
of her claims, and, accordingly, her motion for a preliminary
injunction should be denied.
Motion for Default Judgment
has also filed motion for the entry of a default
judgment. However, for the following reasons, it
is clear that the motion should be denied because the
defendants were never technically in default and, in any
event, a default judgment would be inappropriate.
because plaintiff is an inmate, her civil action is subject
to the Prison Litigation Reform Act of 1995
(“PLRA”). “[U]nlike in the typical civil
case, defendants do not have to respond to a complaint
covered by the PLRA until required to do so by the
court, and waiving the right to reply does not
constitute an admission of the allegations in the
complaint.” Jones v. Bock, 549 U.S. 199,
213-14 (2007) (emphasis added); 42 U.S.C. § 1997e(g)(1).
In the instant case, the Court never entered an order
directing the defendants to respond to the complaint, and,
therefore, they were not in default. See, e.g.,
McCurdy v. Johnson, No. 2:08-cv-01767, 2012 WL
3135906, at *1-2 (D. Nev. Aug. 1, 2012).
the motion for default judgment is premature because a
default has not been entered pursuant to Fed.R.Civ.P. 55(a).
See Structural Concrete Products, LLC v. Clarendon
America Insurance Co., 244 F.R.D. 317, 328 (E.D. Va.
2007); Griffin v. Foti, Civ. Action No. 03-1274,
2003 WL 22836493, at *1 (E.D. La. Nov. 24, 2003); Great
Atlantic & Pacific Tea Co. v. Heath, Civ. Action No.
95-509, 1995 WL 258317, at *1 (E.D. La. Apr. 27, 1995).
even if the defendants had been in default, and even if a
default had been entered, entry of a default judgment still
would not be warranted. Entry of a default judgment is matter
of discretion, and “a party is not entitled to a
default judgment as a matter of right, even where the
defendant is technically in default. In fact, default
judgments are a drastic remedy, not favored by the Federal
Rules and resorted to by courts only in extreme
situations.” Lewis v. Lynn, 236 F.3d 766, 767
(5th Cir. 2001) (citations, quotation marks, and brackets
omitted); accord Griffin, 2003 WL ...