Monroe et al v. Rauner et al

Filing 680

ORDER GRANTING in part 606 Motion for Transfer. Signed by Chief Judge Nancy J. Rosenstengel on 11/16/2023. (kss)

IN THE UNITED STATES DISTRICT COURT
FOR THE SOUTHERN DISTRICT OF ILLINOIS
JANIAH MONROE,
MARILYN MELENDEZ,
LYDIA HELÉNA VISION,
SORA KUYKENDALL, and
SASHA REED, individually and on
behalf of a class of similarly situated
individuals,
Plaintiffs, 1
v.

Case No. 3:18-CV-00156-NJR

STEVEN BOWMAN,
MELVIN HINTON, and
LATOYA HUGHES,
Defendants.

MEMORANDUM AND ORDER
ROSENSTENGEL, Chief Judge:
This case was brought on behalf of a class consisting of all prisoners in the custody
of the Illinois Department of Correction (“IDOC”) who have requested evaluation or
treatment for gender dysphoria (Doc. 213). 2 The named Plaintiffs are transgender women
currently incarcerated in IDOC facilities. The named Defendants are, respectively, the
IDOC Chief of Health Services, the IDOC Chief of Mental Health, and the IDOC Acting
Director, all sued in their official capacity.
Plaintiffs have filed a Motion for Transfer of Class Member [Name Redacted] and

The named Plaintiffs, and many members of the Plaintiff class, use chosen names reflecting their
gender identity rather than their given names at birth. Throughout this Order, the Court refers to
each Plaintiff by their chosen name, which may not match the name in IDOC records.
2
The class was certified on March 4, 2020 (Doc. 213).
1

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Other Class Members out of Pinckneyville Correctional Center, based on the alleged
repeated violations of this Court’s Orders concerning showers and searches that have
harmed class members (Docs. 606, 607). 3 Defendants responded in opposition to the
motion (Doc. 617 and sealed exhibits Docs. 619-620), and Plaintiffs replied (Doc. 627 and
sealed Doc. 628). Plaintiffs subsequently submitted sealed Declarations from 22 class
members housed at Pinckneyville 4 regarding conditions there (Docs. 636, 640, 662).
An evidentiary hearing was held on October 12 and October 23, 2023 (Docs. 652,
664). Six class members testified regarding their experience at Pinckneyville with access
to private showers and requests for their body searches to be conducted by female staff
members. IDOC officials Lieutenant Mac-Shane Frank (Internal Affairs, Pinckneyville),
Pinckneyville Warden David Mitchell, Transfer Coordinator Doug Stephens, and
Dr. Shane Reister also testified.
BACKGROUND
The Court’s first Order for preliminary injunctive relief in this matter was entered
on December 19, 2019, following a two-day evidentiary hearing completed on August 1,
2019 (Docs. 186, 187, amended on March 4, 2020 at Doc. 212). Among other matters,
Defendants were ordered to cease the policy and practice of depriving gender dysphoric
prisoners of medically necessary social transition and to develop a policy to allow such
transition (including individualized placement decisions, avoidance of cross-gender strip

Doc. 606 is the Motion with class members’ names redacted; Doc. 607 is the sealed, unredacted
version.
4
One of these class members had been transferred from Pinckneyville to Centralia Correctional
Center as of October 12, 2023, and one other class member was moved to Menard Correctional
Center shortly thereafter.
3

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searches, and access to gender-affirming clothing and grooming items), and to advise the
Court regarding steps taken to train all correctional staff on transgender issues.
(Doc. 212).
The second Order for preliminary injunctive relief was entered on August 9, 2021,
after a four-day bench trial 5 (Docs. 331, 332). 6 That Order included preliminary findings
of fact and conclusions of law from the bench trial and noted that the December 2019
Preliminary Injunction (Doc. 212) continued in force. It included specific timelines related
to hormone therapy and consideration of class members’ requests for transfer to a facility
matching their expressed gender; directed Defendants to “immediately ensure that
transgender inmates are allowed access to a private shower;” and directed that “Plaintiff
class members shall be allowed to choose the gender of the correctional officer who will
conduct a search of their person, and the search SHALL BE conducted by a correctional
officer of the gender requested.” (Doc. 331, pp. 11-12) (emphasis in original).
Supplemental briefing and responses were ordered (Doc. 331, pp. 13-24).
On December 13, 2021, the Court advised the parties that a Special
Master/Monitor would be appointed to oversee Defendants’ compliance with the
ordered injunctive relief and implementation of IDOC’s revised Administrative
Directives regarding transgender prisoners, and to assess and advise the Court and
parties regarding further policy revisions needed to remedy the unconstitutional

The undersigned had issued a verbal ruling for specific preliminary injunctive relief at the close
of the bench trial on August 5, 2021, later set forth in the Order of August 9, 2021 (Doc. 331;
Doc. 349, pp. 972-92).
6
A correction to the ordered injunctive relief was made on August 18, 2021, to reflect the correct
target testosterone level for transgender females undergoing hormone treatment (Doc. 336).
5

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treatment of class members (Doc. 370).
The undersigned issued the full findings of fact and conclusions of law related to
the August 2021 bench trial on February 7, 2022, in the third Order for injunctive relief
(Docs. 383, 384). As clarified in an Order entered earlier today, November 16, 2023, the
third Order for injunctive relief, filed in February 2022, provided permanent injunctive
relief after the bench trial on the merits. (Doc. 678). This Order incorporated the evidence
adduced during the bench trial as well as supplemental filings from the parties pursuant
to the August 9, 2021 Order (see Docs. 335, 346, 355, 357, 359, 369), summarized progress
toward compliance with prior orders and areas where compliance had not yet been
achieved, incorporated the previously ordered injunctive relief, and ordered additional
injunctive relief. As relevant to the Motion to Transfer, the additional relief directed
Defendants to update the Court on steps taken to avoid cross-gender body searches
including IDOC’s transgender identification policy, consideration of transfer requests,
and measures taken to ensure private shower access (Doc. 383, pp. 78-81, 86-87).
The Court appointed two Co-Monitors, Dr. Amanda Harris and julie graham,
MFT, on April 5, 2022, and May 10, 2022, respectively (Docs. 418, 423). Each Co-Monitor
has submitted reports detailing their observations regarding compliance and
noncompliance with the ordered injunctive relief. Co-Monitor graham was assigned
monitoring duties regarding IDOC’s compliance with the search and private shower
provisions.
Plaintiffs filed a Motion for Contempt Finding in November 2022 (Doc. 455; see also
Defendants’ Response at Doc. 462 and Reply at Doc. 477). The Court held several status
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hearings related to the issues raised in the contempt motion and directed the parties to
meet in an effort to resolve issues. Several meetings between the parties and the CoMonitors were held in early 2023 as a result, however, those meetings ceased after
Defendants filed their Motion to Vacate the previously ordered injunctive relief Orders
(Doc. 587). That motion was denied. (Doc. 678).
TESTIMONY AT EVIDENTIARY HEARING
Plaintiffs’ Evidence
O.A.
O.A., a transgender woman, stated in her Declaration filed September 18, 2023,
that upon her arrival at Pinckneyville on June 16, 2023, she had been physically attacked
by correctional officers who pushed her down and trampled on her legs (Doc. 636, pp. 23). Officer Koontz and other staff have called her “faggot” and repeatedly told her she is
in a men’s facility. She has consistently been unable to have a private shower because
other prisoners are allowed to walk through the area while she is in the shower. The
shower curtain is “skimpy,” allowing people nearby to see in. Further, prison staff in the
“bubble” near the shower can see into the enclosure. On June 27, 2023, O.A. was strip
searched by a male officer who ignored her transgender ID. She has filed grievances over
these incidents but sometimes staff will not give her grievance forms. In late June, an
officer tore up the letter she was planning to send to her lawyers. An officer also tore up
another letter she received from the ACLU; on the same day, she saw an officer spit on
her food tray.
At the hearing, O.A. testified that she had been housed at Pinckneyville for about
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five months after having been transferred there from Centralia Correctional Center
(Doc. 654, pp. 9-20). She does not feel safe at Pinckneyville. She described an incident in
late August 2023 when she was taking what was supposed to be a private shower, and
an officer let other prisoners out into the area to go to Health Care for insulin shots
(Doc. 654, pp. 12-13). She was scared and wrote a grievance. She was interviewed by
Lieutenant Frank about the incident, and he pressured her to sign his written summary
without reading it first. She had not been informed of the outcome of that investigation
(Doc. 654, p. 21).
On September 26, 2023, when O.A. was on her way to an attorney visit, an officer
told her that having her attorney call the prison would make her time worse at
Pinckneyville (Doc. 654, pp. 13-14). She tried to tell the sergeant about this but was
ignored, so she began a hunger strike. The next day she was moved to a hunger strike
unit, where Officer Adcock did not allow her to have a shower and called her derogatory
names (Doc. 654, pp. 15-16). Officer Adcock, who is male, had previously strip-searched
O.A. Warden Mitchell refused to speak to O.A. unless she ended her hunger strike.
O.A. has requested to transfer to Logan 7 three or four times since coming to
Pinckneyville. She is on hormone injections and began her transition four years ago. The
mental health supervisor at Pinckneyville (Ms. Loos) told O.A. that Dr. Puga would not
transfer any transgender inmate to Logan until after they had surgery. O.A. had
requested surgery but got no response. Her hormone levels are currently in the target
range (Doc. 654, p. 17). She had also been told her transfer was denied because of her
7

Logan Correctional Center is designated to house female prisoners.

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criminal history and/or discipline history, and her predator/vulnerable status. She
requested review of that status by writing to Dr. Melvin Hinton but has not received a
response (Doc. 654, p. 23).
O.A. also filed a grievance after she was sexually abused and harassed by a male
nurse who gave her a hormone injection. Lieutenant Frank, with another officer present,
interviewed her on September 25, 2023. She had not been informed of the outcome of that
investigation.
M.L.
M.L. is a transgender woman, housed at Pinckneyville since August 23, 2023. In
her Declaration and her testimony, she stated that in September 2023, Officer Sims
wrapped his hands around her neck and shoved her against a wall (Doc. 640, p. 37;
Doc. 654, p. 27). She was refused medical attention and was unable to file a grievance
over the incident because staff would not give her a grievance form. She is on suicide
watch and is not allowed a private shower; two male prisoners can see her whole body
and she cannot lock the shower door. She is “always” searched by a male officer
(Lieutenant Ridgeway) despite her ID card noting she should be searched by a female
officer.
Her hormone treatment, which she had been on since November 2021 at
Lawrenceville Correctional Center, was halted when she came to Pinckneyville despite
her desire to continue it (Doc. 654, p. 29).
On the day of her testimony, M.L. was searched by a male officer (Sims), who
ordered her to submit to the strip search or he would document she refused her legal call.
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The same thing had happened the previous day. Sims also mocked her and called her
names while she was on suicide watch (Doc. 654, pp. 28-29).
M.L. was due to be transferred to Menard after the hearing; she had previously
been sexually assaulted while housed there.
A.B.
A.B., also a transgender woman, has been at Pinckneyville since April 2022
(Doc. 654, p. 36). She does not have access to a private shower because other inmates,
porters, and officers walk around the deck near the showers and the shower curtains are
not wide enough to prevent people from seeing in (Doc. 640, p. 7; Doc. 654, pp. 38-39, 4142). When a lockdown is imposed, she has to shower while male inmates are out in the
dayroom; this happens at least once weekly. When officers announce shower time for
her, they use language such as “tranny showers” and “gay showers.”
She is not allowed to have a female officer conduct a pat-down body search despite
showing her ID card stating she should be searched by a female.
Officer Koontz called her “faggot ass sissy transgender bitch” in July 2023
(Doc. 640, p. 7; Doc. 654, p. 36). She never got a response to her grievance over that
incident. Officer Vaughn has told other inmates she has AIDS. The Internal Affairs officer
called her a “fag” while discussing her hunger strike and crisis watch on September 23,
2023. She is not safe continuing her transition at Pinckneyville due to her fear of other
inmates and staff.
K.C.
K.C. is a transgender woman, housed at Pinckneyville since August 7, 2023
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(Doc. 640, p. 19). Because of mistreatment and an assault on her by staff members, she
had been on a hunger strike for 26 days when she testified (Doc. 654, p. 47). On August
17, 2023, Officer Sims hit K.C. in the face and shoulder with a large, heavy key ring that
he threw from the gallery above her (Doc. 654, pp. 49-51). The next day she was
interviewed by Lieutenant Frank about the incident; he accused her of lying and insisted
what happened was an accident. She changed her statement to say the keys hit her on the
face (not on her head) because of Lieutenant Frank’s pressure (Doc. 654, p. 51). On August
16, 2023, an officer slammed a chuckhole on her finger while K.C. was requesting help to
submit a mental health slip; nearby officers laughed at the incident (Doc. 640, p. 20). Staff,
including mental health staff, do not call her by her preferred name or pronouns. She
cannot always get grievance forms to complain about the mistreatment.
On September 1, 2023, a male nurse administered K.C.’s hormone injection and
then spanked her buttocks, leaving her feeling violated and unsafe (Doc. 640, p. 20).
She does not have access to a private shower. On August 15, 2023, during her
shower time, an inmate grabbed her buttocks. She filed a PREA 8 complaint; the matter is
still under investigation (Doc. 640, p. 20). Officers call over the intercom “trans shower,”
“tranny showers,” or “gay showers” when it is her shower time (Doc. 640, p. 21; Doc. 654,
p. 58). The shower curtain in 5 House has a mesh net and does not block the entire shower
door; people on the top gallery or walking past can see into the shower (Doc. 654, pp. 56).
S.C.
S.C. has been at Pinckneyville since September 2022 (Doc. 640, p. 24). She fears for
8

Prison Rape Elimination Act.

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her safety every day due to the violence and hatred against transgender people (Doc. 654,
p. 60). She has been housed in the Health Care unit because of a fall that fractured her
vertebrae, and since September 15, 2023, has been in an overflow area near Health Care,
Wing 6-A. Before her fall, she had been housed in 5 Delta 17 (Doc. 654, p. 66). She does
not have access to a private shower; she must shower sitting down and the officer in the
bubble can see her body from above. She has noticed Officer Jones looking at her in the
shower (Doc. 654, pp. 63-64). The top of the shower curtain is mesh and does not fully
cover the person showering; she filed a grievance over this on October 7, 2023, but has
not received a response (Doc. 654, pp. 64, 68). Before she was moved to the Health Care
unit, she stopped asking for a private shower because it was unsafe. Staff announce
“tranny showers,” “transgender showers,” and—one time “fag showers”—over the
intercom. She was harassed and bullied while in the single shower line (Doc. 640, pp. 2425).
S.C. had to discontinue hormone treatment because of medical complications. The
medical director (Dr. Myers) refuses to acknowledge she is transgender; mental health
staff often misgender her and many other staff misgender her and call her names
(Doc. 640, p. 25; Doc. 654, pp. 61-62). On September 22, 2023, she was searched by a male
officer before leaving the prison for an MRI, despite her ID notation for search by a
female. She was in a wheelchair and endured the search so she could attend the medical
appointment. The male officer who patted her down massaged her leg and groped her
private area (Doc. 654, pp. 62-63; 66-67). She filed a PREA complaint over the incident on
September 27, 2023 (Doc. 654, p. 69). She met with the Warden on September 26, 2023, to
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discuss her complaints against Dr. Myers and issues with Lieutenant Frank, and later met
with external investigator Stanhouse (Doc. 654, pp. 70-71).
S.C. had been approved for a transfer to Graham before her injury but has been
told she now cannot go there because it is not an ADA facility (Doc. 640 p. 26). On October
4, 2023, she discussed the possibility of a transfer to a minimum security level and an
emergency transfer for her safety with Lieutenant Frank (Doc. 654, p. 65).
D.B.
D.B., a transgender woman, testified from Centralia Correctional Center, where
she had been transferred from Pinckneyville eight days before the hearing (Doc. 654,
p. 72). She had been at Pinckneyville since December 2021. While there, she endured
harassment and abuse from other inmates, including having feces thrown into her cell,
which ruined all her belongings. She received no response to her complaint about the
incident (Doc. 640, p. 15). Correctional officers also treated her with hostility—C/O Hall
threw away D.B.’s ID card, which prevented her from going to chow or recreation
(Doc. 654, pp. 75-76). Officer Sims called her a faggot and gay. The culture in 5 House,
where she and most of the other transgender women were housed, was that staff seemed
to hate transgender people (Doc. 640, p. 16).
D.B. requested to be searched by a female officer at Pinckneyville, but her requests
were often refused. She has been forcibly patted down by male officers. If a female officer
was summoned to perform the search, she sometimes had a long wait for the officer to
arrive (Doc. 640, p. 16).
D.B. did not feel safe using the shower at Pinckneyville because it was not private.
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She used her own bed sheet to cover the shower door because officers allowed workers
to walk by the showers while she was inside. After moving to Centralia, she felt relief to
be away from the mental abuse, discrimination, and harassment, and was now able to
continue her transitioning. She had stopped taking her hormones while at Pinckneyville
because the muscle breakdown made her more vulnerable, and she feared being
assaulted.
Defendants’ Evidence
Lieutenant Mac-Shane Frank
Lieutenant Frank is the Internal Affairs Supervisor at Pinckneyville, where he has
worked since June 2014 (Doc. 644, p. 81). He interviewed O.A. multiple times regarding
her complaints. Frank prepares written statements summarizing his interviews.
Frank concluded that O.A.’s June 2023 complaint (Case No. 2023-PNK-5130),
which included allegations of a physical attack on her by staff, a strip search by a male
officer, and a private shower violation on July 10, 2023, 9 were unsubstantiated (Doc. 654,
pp. 85, 99-100). He denied forcing or coercing O.A. to sign his written statement or
accusing her of lying (Doc. 654, p. 83). Frank investigated O.A.’s complaint that other
inmates were allowed out during her shower. He substantiated with video evidence and
staff statements that two individuals in custody were let out of their cell and exited the
wing, but he had not yet interviewed those individuals to complete the investigation
(Doc. 654, pp. 85-86). He later stated this shower complaint was unsubstantiated

Defendants included documentation on Case No. 2023-PNK-5130 with their response to the
Motion to Transfer (Sealed Doc. 619).

9

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(Doc. 654, p. 96). His investigation of O.A.’s PREA abuse allegation is still ongoing
(Doc. 654, p. 88).
Frank described the shower facilities in Pinckneyville, which include single stall
showers in Units 6-B and 5, as well as the Health Care Unit shower (Doc. 654, pp. 91-94).
Two Exhibits were admitted: Exhibit M depicts the shower configuration in Units 1
through 4, which is similar to that in sickbay (Sealed Doc. 655); Exhibit N shows the
shower stalls that are located in Housing Unit 5 (Sealed Doc. 656). Exhibit M depicts a
wide shower opening that is covered by a curtain, the top portion of which consists of
see-through mesh. To the left of the curtained area is a partial wall with an open area
above. The wall stops at the same height as the solid portion of the shower curtain; this
would allow the person inside the shower to be viewed from the chest or shoulders up.
Exhibit N depicts a metal-framed door leading to a single shower stall. Approximately
the bottom third of the door is solid metal. The upper two-thirds of the door is clear and
covered with an opaque shower curtain, but there is a gap of a few inches on the left side
of the curtain where the inside of the shower can be viewed.
Frank described the shower policy for transgender individuals, stating they have
the same shower access as others in general population but are allowed to shower when
no other individuals in custody are on the wing (Doc. 654, pp. 95-96). He explained that
a transgender individual may be let out for a shower at the same time that individuals
going to insulin line are let out, but the expectation is that those people would be out of
the unit before the transgender individual would take her shower (Doc. 654, pp. 97-98).
Frank’s investigation of S.C.’s allegation that a male officer groped her during a
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pat down search connected to her medical transport is ongoing (Doc. 654, pp. 89-90). He
also interviewed K.C. after her complaint of being struck by the key ring, and denied
threatening or coercing her regarding her statement (Doc. 654, pp. 90-91).
Frank confirmed that policies or memos had gone out regarding search
procedures, and stated, “unfortunately, it’s not happening like the policy and the memos
is written.” (Doc. 654, p. 97).
Warden David Mitchell
Mitchell has been Warden/Chief Administrative Officer at Pinckneyville for about
two years and eight months (Doc. 668, p. 6). He signs off on the decisions on all grievances
and does the initial review on grievances marked “emergency” to determine whether
they should be handled on an emergency/expedited basis. He receives about 10-15
grievances each day. He will deem a matter to be an emergency if it involves an
individual’s immediate safety or security, a due process violation, medical issues, or
anything that a reasonable person would think is an emergency. Mitchell is receiving
grievances from class members and is not aware of any inmate being denied grievance
forms. Individuals in custody may speak with Mitchell in person when he tours the
facility (usually on a weekly basis); they also may write to him or call the constituent
services/complaint line, which is available to inmates’ family and friends (Doc. 668,
pp. 8-9, 11). Complaints about staff conduct are referred to Internal Affairs for
investigation. If the complaint is against an Internal Affairs officer, it is investigated by
an external state investigator (Doc. 668, pp. 9-10).
Mitchell has been contacted by Co-Monitor julie graham numerous times via email
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and once by telephone. He has forwarded her concerns regarding staff to Internal Affairs
(Lieutenant Frank). Mitchell has personally looked into shower curtain complaints. The
investigations of issues raised by graham have not yet been concluded (Doc. 668, pp. 2021).
Class members are allowed to have a private shower on the wing during the 3-to11 p.m. shift after the facility count check (Doc. 668, p. 12). Mitchell reiterates the private
shower policy with staff every three months. Id. He is aware of two private shower
violations. In the first incident, staff documented that some individuals were out on the
wing during a class member’s private shower. An Employee Review Hearing will be held
to determine whether discipline of the involved staff member is warranted (Doc. 668,
p. 13). The other incident is still under investigation by Internal Affairs. No staff members
have yet been found guilty (Doc. 668, p. 20).
Mitchell is aware that if a class member has “female” on the back of their ID, a
body search or pat-down should be conducted by a female staff member (Doc. 668, p. 14).
Approximately three female staff have volunteered to conduct such searches; if they are
not available, a person from the Region 2 volunteer list will be sought. Staff have been
trained on the policy.
If a staff member self-reports a search violation, it would be referred for an
Employee Review Hearing. If a complaint is made or a violation is otherwise alleged,
Mitchell refers it to Internal Affairs to investigate. He is aware of two or three instances
of search policy violations (Doc. 668, p. 15). One was reported by the staff member, who
was not aware the individual searched was a class member because they did not have
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their ID at the time of the search. The other two instances are pending a hearing. He has
followed up by reiterating the policy through shift commanders, warden’s bulletins,
memos, and talking to staff during rounds (Doc. 668, p. 16). Mitchell estimated that the
last instance of a cross-gender search of a class member happened two or three months
ago, but it may have been three weeks ago (Doc. 668, p. 20).
Most class members at Pinckneyville are housed in B or D wing in 5 House, but
some are in other areas (Doc. 668, p. 18).
Mitchell had not participated in any training about misgendering of class members
or the care of individuals with gender dysphoria (Doc. 668, p. 19). It would be hard for
him to know if a class member had been denied access to a grievance form. He has
received at least one grievance regarding a lack of access to grievance forms (Doc. 668,
pp. 19-20).
Doug Stephens
Doug Stephens is the Transfer Coordinator for the IDOC, based in Springfield, and
has worked in that office since May 1997 (Doc. 668, p. 22). His office is in charge of
placement for all individuals brought into custody in the reception center, their initial
and subsequent placements in facilities, and their security level.
Mr. Stephens explained the criteria assessed by his office when considering a
recommendation for transfer: the individual’s time to MSR; their security level; any
medical/mental health issues; substance abuse issues; security threat group issues; Keep
Separate From (“KSF”) or enemy issues; any protective custody needs; previous
adjustments at other facilities; their kind of commitment; and vulnerable status (Doc. 668,
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p. 23). An individual can request a transfer through their counselor or the classification
committee at their facility (Doc. 668, pp. 23, 28). If the warden approves, the transfer
request would come to Stephens’ office, where the final approval or denial would be
made. If the warden denies the transfer request, then the process is over (Doc. 668, p. 28).
A facility can request a transfer for reasons such as a reduced security placement, mental
health or substance abuse treatment; again, if the warden approves, the transfer office
will make the final determination (Doc. 668, p. 24). If the transfer request is for the inmate
to move to a particular facility, Stephens’ office looks at the reason for the transfer,
determines whether the person meets the criteria for the requested facility including
whether they had been at that facility before and why they were transferred out, as well
as all the criteria he listed.
Security levels include maximum, medium, and minimum security; an
individual’s security level may be reduced if they had been in programming or had not
received discipline. Pinckneyville is a medium security facility; other medium facilities
are Graham, Big Muddy River, Centralia, Danville, Dixon, Hill, Illinois River, Shawnee,
Sheridan, and Western. Menard also houses medium security prisoners (Doc. 668, pp. 25,
33). Logan is a multilevel facility, housing maximum, medium, and minimum-security
individuals (Doc. 668, p. 33). A person who has been disciplined may be transferred
laterally to another medium-security facility, but a higher amount of discipline could
bump them up to maximum security (Doc. 668, p. 25-26). A Keep Separate From list
would prevent a medium or minimum-security individual from transferring to a facility
housing their enemy, because it is more difficult to keep inmates separate in those
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facilities as opposed to in a maximum-security facility. Bed space in the new facility is
also a factor in transfer decisions.
Approved transfers are normally carried out on a Wednesday (Doc. 668, pp. 2829). Stephens’ office may approve an immediate transfer if requested by a warden, for
instance, if there was a staff assault or safety/security concern. At times, an inmate whose
transfer is approved may not be moved right away; there may be a “transfer stop” for a
medical hold or medical appointment, for example.
In the past, the transfer office did not consider whether a person has gender
dysphoria in making transfer decisions. However, about two or three months ago, they
began to look at whether an individual is transgender and “potentially placing them in
specific facilities throughout the department.” (Doc. 668, p. 31). When making transfer
decisions, Stephens’ office does not take into consideration whether a class member will
have access to a private shower at any facility or whether staff of the appropriate gender
will be available to conduct body searches (Doc. 668, p. 32). Those issues are handled at
the facility level. Likewise, the availability of group therapy for class members and
whether there are pending complaints about harassment of class members are not part of
the transfer determination; the Transfer Coordinator’s office is not notified of complaints.
Stephens was not aware of any class members who have a pending transfer
request to move to Logan and knew of no plans to transfer any class member there
(Doc. 668, pp. 33-34). As of the week before the hearing, Stephens had not been aware
that IDOC is required to reevaluate requests for transfer to Logan every six months.
Stephens approved the transfer of O.A. from Centralia to Pinckneyville on June
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15, 2023, after considering the request for seven minutes (Doc. 668, p. 34). He would have
looked at all the criteria he listed, including KSF issues, current discipline, and security
level. Stephens did not speak to any medical professionals before making the decision to
transfer O.A., nor did he consider her own preferences based on any safety concerns
(Doc. 668, pp. 34-35).
Stephens’ office receives about 200-400 transfer requests each week. He would not
normally speak with medical or mental health staff before approving a transfer. It would
be the warden’s responsibility to address any medical issues and get approval to transfer.
The Office of Health Services would decide whether to lift a medical hold to allow a
transfer.
Dr. Shane Reister
Dr. Reister is IDOC’s Southern Regional Psychologist Administrator. 10 He
described the PRISM 11 program at Centralia Correctional Center (Doc. 668, p. 37). The
facility has potential bed space for at least 104 individuals in the PRISM program, but
they do not have enough mental health or BHT (Behavioral Health Technician) providers
to expand the population to that size. They are attempting to hire staff. Currently,
individuals who are on the waiting list to enter the PRISM program may transfer to
Centralia while they wait to be admitted to PRISM. There are 34 people on the wait list,

Dr. Reister testified at the August 2021 trial regarding the development of the PRISM program
at Centralia and other matters relevant to class members. He is a Licensed Clinical Psychologist
and has held his current position since 2013. (Doc. 383, pp. 47-50).
11
The PRISM program is a special housing unit created to address safety concerns of transgender
prisoners. Participants may be transgender or cisgender, and must agree to take part in peer
education and training on anti-racism, anti-transphobia, anti-heterosexism, and anti-sexism
(Doc. 383, p. 50).
10

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11 of whom are in other institutions (Doc. 668, pp. 38-39). The current population in the
PRISM program is in the low 20s (Doc. 668, p. 42). The goal is to have individuals in the
PRISM program who will be respectful of others’ gender identity in a safe space.
Many IDOC locations have staffing problems with mental health providers.
Pinckneyville is not fully staffed, but Dr. Reister expects that new staff will start soon
(Doc. 668, p. 40). Transgender-specific group programming is due to restart soon at
Pinckneyville. Dr. Reister did not know about staffing issues that may exist at Logan
(which is not in his region), other than they are missing a mental health authority
(Doc. 668, p. 44). Dr. Reister oversees about 11 institutions in the Southern region,
including Pinckneyville, where he visits once every month or two to meet with mental
health providers (Doc. 668, p. 45). There is a severe mental health backlog at
Pinckneyville, such that hundreds of people are not being seen at the recommended
intervals (Doc. 668, pp. 45-46). Other facilities also have a mental health backlog (Doc. 668,
p. 48). Pinckneyville has many inmates with disciplinary problems, who may end up in
restrictive housing (Doc 668, p. 46). People with antisocial personality disorder are less
concerned about misgendering or the impact of their behavior on transgender
individuals and could impact other prisoners’ safety (Doc. 668, p. 48). Pinckneyville and
Menard both have large restrictive housing areas.
The transfer process to Logan for class members is handled by Dr. Puga’s office
(Doc. 668, p. 44). Dr. Reister does as much as he can to help on transgender issues in
addition to his other responsibilities (Doc. 668, p. 47). He continues to participate in
transgender care telephonic conferences, where providers can talk about cases and get
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feedback on working with transgender individuals (Doc. 668, pp. 48-49).
Dr. Reister has discussed with Co-Monitor graham plans for a discussion-style
training for staff on transgender issues, and he believes Dr. Puga is submitting a plan to
the training academy for feedback (Doc. 668, pp. 41-42).
Report by Co-Monitor julie graham
Co-Monitor graham has sent email messages to Warden Mitchell a number of
times, most recently with the concern raised by the class members who testified at the
recent hearing over possible retaliation against them (Doc. 668, p. 50). The shower curtain
issue is confusing because some photographs seem to depict appropriate privacy
measures, but she did not receive pictures of other showers. Warden Mitchell is supposed
to be addressing these matters. If she tells Warden Mitchell about a concrete thing that is
a problem, he handles it (Doc. 668, p. 52). Nonetheless, complaints about staff have
continued for the past year and a half.
Co-Monitor graham interviewed class members at Pinckneyville in March 2023;
they raised the same complaints then as they raised with class attorneys months later
(Doc. 668, p. 51). It seems that private shower access is getting worse, especially with
lockdowns and staffing problems. More than a year ago, Warden Mitchell assured
graham that staff are not announcing “gay or tranny showers,” but this complaint has
come up in every subsequent interview, as well as in the ACLU documentation.
“Something is broken there, because people are still experiencing it.” (Doc. 668, p. 52). If
people don’t file grievances, the Warden will not know about the problem, but class
members cannot file grievances without access to the forms or grievances are destroyed.
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She has suggested that grievance forms be set out in the dayroom so inmates don’t have
to go through a staff member. Complaints persist that staff interfere with access to
grievance forms.
Progress on training programs is extremely slow. Dr. Reister indicated he would
begin the new training at Pinckneyville because there are so many complaints about staff
there (Doc. 668, p. 53). She observed that when changes happen, staff get reactive and
resentful about anything that seems to be an additional requirement, because they are
overworked and understaffed. Changes [regarding transgender prisoners] are perceived
as “special treatment,” but it is simply just appropriate treatment and following the law.
Staff need a chance to vent about that and to be reeducated about how to think about
treatment of transgender people. The didactic training to date is generally not held in
person, which is why the “T for T” (training for trainers) is important—that training
would be in person. But that has not happened yet, and graham had not heard that there
is a plan to follow through with the T for T. Graham thinks that the discussion-based
training suggested by Dr. Reister and Dr. Puga is a better plan.
Supplement to Record Submitted After Evidentiary Hearing
On November 9, 2023, Plaintiffs filed supplemental information in support of their
Motion to Transfer (Doc. 671 and Sealed Doc. 672). The Sealed document (labeled
“Exhibit A”) consists of the PRISM Wait List and related lists referenced by Dr. Reister
during his testimony. Dr. Reister provided this list to Plaintiffs after the hearing
concluded. Plaintiffs contend that the potential transfer of class members to the PRISM
program at Centralia is not a realistic substitution for transfers to Logan to achieve safety
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or social transition for class members. PRISM is currently at capacity. Of the 34
individuals on this waiting list, only nine are identified as transgender or trans woman;
19 are identified as cisgender; and 6 have no gender identity indicated (Doc. 672, p. 2).
Defendants have been given until November 17, 2023, to respond to Plaintiffs’
supplementary material (Doc. 673).
LEGAL STANDARDS
Modification of Permanent Injunction
“The scope of an injunction has no rigid perimeter, and a court may modify an
injunction to adapt to changed circumstances.” Rockwell Graphic Systems, Inc. v. DEV
Industries, Inc., 91 F.3d 914, 920 (7th Cir. 1996). Lack of full compliance can be the sort of
changed circumstance that justifies extending a means contemplated by the original
injunction or issuing additional substantive measures and injunctive relief. Norman v.
McDonald, 930 F. Supp. 1219, 1227 (N.D. Ill. 1996); see also Hutto, v. Finney, 437 U.S. 678,
687 (1978) (a pre-PLRA case finding that the “long and unhappy history of the litigation”
justified a comprehensive order with time limits to insure against the risk of inadequate
compliance); see also United States v. Spectrum Brands, Inc., 924 F.3d 337, 358 (7th Cir. 2019)
(approving the district court’s reasonable modifications of a permanent injunction to
ensure compliance with the spirit of the original injunction and prevent future similar
harms that led to such injunction). To grant any prospective relief under the Prison
Litigation Reform Act, the court must find “that such relief is narrowly drawn, extends
no further than necessary to correct the violation of the Federal right, and is the least
intrusive means necessary to correct the violation of the Federal right.” 18 U.S.C.
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§ 3626(a)(1). A court must also “give substantial weight to any adverse impact on public
safety or the operation of a criminal justice system caused by the relief.” Id.
Eighth Amendment Deliberate Indifference
The Eighth Amendment prohibits cruel and unusual punishment and “imposes a
duty upon states to provide adequate medical care to incarcerated individuals.” Boyce v.
Moore, 314 F.3d 884, 888-89 (7th Cir. 2002). Deliberate indifference to the “serious medical
needs of a prisoner constitutes the unnecessary and wanton infliction of pain forbidden
by the Constitution.” Rodriguez v. Plymouth Ambulance Serv., 577 F.3d 816, 828 (7th Cir.
2009) (citation omitted). Deliberate indifference has two elements. The first is whether the
prisoner has an “objectively serious medical condition.” Arnett v. Webster, 658 F.3d 742,
750 (7th Cir. 2011); Greeno v. Daley, 414 F.3d 645, 653 (7th Cir. 2005). The second element
requires a showing that a prison official has subjective knowledge of—and then
consciously disregards—an excessive risk to inmate health. Greeno, 414 F.3d at 653; see
also Petties v. Carter, 836 F.3d 722, 728 (7th Cir. 2016). Deliberate indifference involves
“intentional or reckless conduct, not mere negligence.” Berry v. Peterman, 604 F.3d 435,
440 (7th Cir. 2010).
Over the course of this matter, the evidence has demonstrated pervasive
deficiencies in delivery of medically necessary care and treatment for transgender
individuals in custody on a systemic, statewide level in IDOC correctional institutions.
See, e.g., Wellman v. Faulkner, 715 F.2d 269, 272 (7th Cir. 1983); Cleveland–Perdue v. Brutsche,
881 F.2d 427, 430–31 (7th Cir. 1989) (recognizing claims of systemic health care
deficiencies as a distinct category of deliberate indifference claims, as opposed to one
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based on “isolated instances of indifference to a particular inmate’s medical needs”). In
this context, deliberate indifference can be demonstrated by “proving there are such
systemic and gross deficiencies in staffing, facilities, equipment, or procedures that the
inmate population is effectively denied access to adequate medical care[,]” or by showing
“repeated examples of negligent acts which disclose a pattern of conduct by the prison
medical staff” which result in an excessive risk of serious harm. Wellman, 715 F.2d at 272;
see also Rasho v. Jeffreys, 22 F. 4th 703, 710 (7th Cir. 2022) (“persistence in a course of action
known to be ineffective” can support an inference of deliberate indifference) (citing
Whiting v. Wexford Health Sources, Inc., 839 F.3d 658, 662–63 (7th Cir. 2016); Phillips v. Sheriff
of Cook Cnty., 828 F.3d 541, 554 (7th Cir. 2016)).
DISCUSSION
Back in 2019, Defendants conceded that Plaintiffs’ gender dysphoria is a serious
medical condition. (Doc. 186, pp. 29-30). In the December 2019 Preliminary Injunction,
the Court concluded that Plaintiffs met their burden of showing a likelihood of success
on the merits of their deliberate indifference claim. (Doc. 186, p. 35). This Court
recognized in that initial Order that social transition for persons with gender dysphoria
is an important component of medical treatment. This includes recognition of their
gender identity, chosen name, and pronouns; consideration for placement in a facility
matching their gender identity; and access to gender affirming commissary items
(Doc. 186, pp. 24-35). Among other matters, Defendants were ordered to allow class
members’ social transition by developing policies to make individualized placement
decisions and to avoid cross-gender strip searches (Docs. 186, 212).
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Two years later, the evidence adduced during the August 2021 bench trial showed
that Defendants had allowed the unconstitutional conditions of Plaintiffs’ confinement to
persist, despite their awareness that during this period Plaintiffs were not receiving
adequate medical care or social transition for their gender dysphoria and suffered serious
harm (anxiety, depression, suicidal ideation and suicide attempts, and self-mutilation) as
a result. Plaintiffs’ 2021 trial testimony explained the irreparable harm they continued to
experience due to Defendants’ failure to provide even minimally adequate treatment of
their gender dysphoria. The Court concluded that the evidence introduced at trial
showed serious ongoing violations of the Eighth Amendment, and this conclusion was
supported by the parties’ supplemental filings. Consistent with the Court’s discussion in
the previous Orders (Docs. 186, 331), the undersigned found that Plaintiffs were entitled
to additional injunctive relief (Docs. 383, 384). The harm to Plaintiffs could not be
compensated with monetary damages, and the balance of harms and the public interest
weighed in favor of granting injunctive relief. The undersigned made rulings from the
bench on August 5, 2021, ordering that Defendants must immediately ensure class
members’ access to a private shower; Defendants shall allow class members to choose the
gender of the officer who will conduct a search of their person and the search shall be
conducted by an officer of the requested gender; and Defendants shall evaluate class
members’ requests to transfer to a facility matching their expressed gender within 120
days (Doc. 328, pp. 16-18). These directives were memorialized in the August 2021 and
February 2022 Orders for injunctive relief (Docs. 331, 383).
More than two years after the August 2021 bench trial, the testimony given in
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connection with Plaintiffs’ Motion to Transfer, as well as the Declarations from class
members, demonstrates Defendants’ ongoing failure to comply with this Court’s Order
to provide class members with private showers and to honor their choice of gender of the
official who will perform body searches at Pinckneyville.
Promises and intentions to correct the shower facilities to provide privacy and
safety have gone unfulfilled and attempts to address identified problems have failed.
These problems have persisted even though Co-Monitor graham has communicated class
members’ repeated reports of private shower violations to Defendants and directly to
Warden Mitchell on a number of occasions during 2022 and 2023 (see Docs. 444, 450, 460,
546, 559, 573, 591, 647).
Defendants’ Exhibits M and N depict that the shower facilities offered to class
members obviously fail to completely shield their bodies from view (Docs. 655, 656). Each
of the six class members who testified related similar experiences of the lack of privacy
in Pinckneyville’s shower facilities: other inmates were allowed into the shower area or
were otherwise in a location where they could see into the shower, and guards were in
positions allowing them to see into the shower from above. Some, but not all, of these
problems were due to the inadequacy of the shower curtains.
Clearly, this Court’s Orders in 2019 and 2021 and its permanent injunctive Order
from 2022 have not been sufficient, at least at Pinckneyville, to achieve what would seem
to be a simple goal of providing private shower facilities to the transgender women who
are currently housed in that male-designated institution. Not only that, prison officials’
persistent announcements of “tranny” or “gay” shower time and the like endangers class
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members by “outing” them to fellow inmates who have targeted them for abuse. Such
treatment by staff members and other inmates has caused class members to fear for their
safety to the extent that some have discontinued their gender-affirming hormone
treatment to avoid becoming a target and/or reduce their vulnerability if attacked.
Class members’ testimony regarding cross-gender body and strip searches is
extremely concerning. The undersigned was shocked to learn that a transgender woman
class member (M.L.) was forced to undergo a search by a male officer immediately before
her appearance to testify at the recent hearing (Doc. 654, pp. 26-27). Class members’ ID
labels showing they are to be searched by a female are consistently ignored by staff.
Pinckneyville officials have utterly failed to comply with this Court’s clear directive that
they must honor class members’ choice of gender of the person who will conduct searches
of their person. Defendants’ own witness, Frank, admitted that searches are “not
happening like the policy and the memos is [sic] written.” (Doc. 654, p. 97). Transgender
female class members testified in earlier proceedings, as well as in the recent hearing, that
having to submit to body searches by male officers is traumatic and humiliating. Even
worse, one class member (S.C.) testified that her pat search by a male officer further
crossed the line into sexual abuse (Doc. 654, p. 63). In that incident, the search was in
connection with a pre-planned medical appointment, so officials would have had
advance notice to provide a female officer to conduct the search, yet failed to do so. These
ongoing violations of the unambiguous Orders of this Court are unacceptable, especially
in light of IDOC officials’ knowledge that these Orders and IDOC’s own policies are not
being followed.
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Finally, it is notable that according to Doug Stephens, about two or three months
ago his office began to consider—for the first time—whether transgender individuals
requesting transfers should potentially be placed in “specific facilities throughout the
department” (Doc. 668, p. 31). On the one hand, this statement raises a concern because
Defendants were ordered in August 2021 to consider transfer requests from class
members who wished to move to a facility matching their gender identity within
120 days, and then to reconsider any denials within 180 days thereafter, thus specific
facility placement (Logan or Centralia/PRISM) should have been a consideration long ago
(Doc. 331, p. 11). On the other hand, if Mr. Stephens’ statement indicates that Defendants
are considering possible consolidation of class members’ placement into fewer facilities
within IDOC, such a move is likely to be beneficial to class members. Co-monitor graham
has advocated for this approach to facilitate matters such as appropriate training of
prison staff regarding treatment of class members, to simplify the provision of private
showers and searches by staff of class members’ chosen gender, and to potentially help
keep gender affirming items stocked in those facilities’ commissary.
To summarize, the evidence demonstrates that the constitutional violations
previously found by this Court regarding searches and showers are still ongoing at
Pinckneyville. The Court finds that to remedy the continuing constitutional violations
experienced by the 22 class members at Pinckneyville who submitted a Declaration in
support of the Motion to Transfer, additional injunctive relief is necessary. The additional
relief outlined below is narrowly tailored to address the repeated and rampant harm and
harassment faced by inmates at Pinckneyville, especially regarding shower and search
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procedures. This relief is warranted due to the repeated violations of the Court’s
permanent injunction and constitutional violations described above. These measures will
help ensure the constitutionally required treatment and safety of transgender inmates
currently residing at Pinckneyville. By ordering officials at Pinckneyville and the
Placement Office to seriously and appropriately evaluate transfer requests by the 22 class
members who submitted declarations in support of the Motion to Transfer, the Court has
selected the least intrusive means of remedying the ongoing constitutional violations and
has preserved the discretion of IDOC officials in approving and effecting transfers. As
shown by the long-standing noncompliance with the Court’s other orders on shower and
search issues, the Court’s previously attempted injunctive relief has proven ineffective.
This relief is also granted in consideration of any adverse impact on public safety or the
operation of a criminal justice system. The Court finds no adverse impact on public safety
in requiring IDOC officials to seriously consider transfer requests in the interest of safety
and security of the transgender inmates seeking transfer. As far as the operation of a
criminal justice system, these measures are meant to increase safety and security as well
as minimally interfere with Pinckneyville officials’ discretion in managing the operation
of their facility.
The Court reiterates its extreme disappointment in the apparent and ongoing
mistreatment of class members in IDOC institutions. The recalcitrance of IDOC officials
in complying with the ordered injunctive relief is wearing on the undersigned’s patience.
It is hoped that these additional measures will mitigate some of the more egregious
violations.
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Accordingly, the Motion to Transfer is GRANTED IN PART as follows:
1. For each of the 22 class members who submitted a Declaration in support of
the Motion to Transfer and who are still housed at Pinckneyville, Defendants
shall construe that Declaration as a request from that individual to transfer to
another institution (see Docs. 636, 640, 662). Defendants shall evaluate these
transfer requests and issue a decision on each, on or before December 22, 2023.
2. Each transfer request referenced above shall be evaluated in light of the criteria
listed by Transfer Coordinator Doug Stephens: how long before the individual
is eligible for release on MSR; their security level; any medical/mental health
issues; any substance abuse issues; any security threat group issues; any
enemy/KSF issues; any protective custody needs; the individual’s previous
adjustment at other facilities; the nature of the individual’s commitment; the
individual’s vulnerable status; and whether the individual meets the criteria
for the requested facility (Doc. 668, pp. 23-24). In addition, the transfer
evaluation shall include consideration of each individual’s gender dysphoria
condition (including related mental health considerations), gender identity,
related safety issues, and whether a transfer to a facility matching the
individual’s gender identity is appropriate. (See Docs. 331, 383, 584). The
person who makes the transfer decision, whether the Warden, an official in the
Transfer Coordinator’s office, or another official, must show how these criteria
were applied.
3. At the conclusion of each transfer evaluation, Defendants shall issue a written
decision to each class member so evaluated, which shall explain the reason(s)
for the decision in light of each criterion, and certify that each of the criteria
listed in #2 was considered. Defendants shall forward a copy of each decision
to the parties’ counsel and to the Co-Monitors. Approved transfers shall be
implemented as soon as possible.
4. In addition, on or before December 29, 2023, Defendants shall file with the
Court, under seal, an attestation under penalty of perjury by the official who
made the decision on each transfer request, that the official considered each
criterion in making their decision. Where a transfer request is denied, the
attestation shall explain in detail the reason(s) for such denial in light of the
criteria enumerated above. If a transfer is denied due to a KSF designation, the
attestation shall identify the individual(s) who must be kept separate and shall
confirm that the KSF individual is still located at the facility where the class
member would otherwise be eligible to transfer to.
5.

For each transfer request from a Pinckneyville class member that is denied,
Defendants shall reconsider that request 60 days after such denial, and shall
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issue another decision within 75 days of the denial. The reconsideration
decision will be considered and communicated to the class member, counsel,
the Co-Monitors, and filed with the Court in the manner outlined in
paragraphs 2-4 above. Going forward, any transfer request that is denied upon
reconsideration shall again be reconsidered under these provisions.
IT IS SO ORDERED.
DATED: November 16, 2023
____________________________
NANCY J. ROSENSTENGEL
Chief U.S. District Judge

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