Colorado settles landmark lawsuit to improve safety, care for trans women inmates

Taliyah Murphy was in prison when she learned that lawyers were filing a class-action lawsuit on behalf of women like her—trans women locked in Colorado's men's facilities, facing years of sexual assault, extortion, and indifference from guards. The letter arrived in early 2018. It gave her hope.

Murphy and hundreds of other trans women in Colorado's prisons had endured systematic violence. They asked for safer housing. They requested medical treatment for gender dysphoria, the psychological distress that arises when a person's assigned sex at birth conflicts with their gender identity. The requests were denied. "We were targets for victimizing, whether it was sexual assault, extortion, you name it," Murphy said years later, after her release in 2020. "Most of the time, the guards just looked the other way."

The numbers tell a brutal story. A 2007 study of trans women in California prisons found that 59 percent reported sexual assault during incarceration—a rate thirteen times higher than for other inmates. A 2014 Department of Justice survey found that 35 percent of trans inmates reported assault in the preceding twelve months. Housing assignments in American prisons are made almost entirely based on anatomy, despite federal law requiring that safety concerns be considered. For trans people, that policy amounts to what civil rights attorney Paula Greisen called "putting targets on their back."

Greisen filed the class-action lawsuit in 2019 alongside the Transgender Law Center, a California-based organization. The case was prompted by a young trans woman who had been housed safely in a juvenile facility with girls, then transferred to an adult men's prison, where she was brutally raped. Her requests to be housed with women were rejected. When Greisen took on her case, she discovered the violence was not isolated. She reached out to Colorado's attorney general and governor. Nothing changed. "The Department of Corrections in every state—it's like trying to turn around the Titanic," Greisen said. "You often have to sue to get their attention."

Now, nearly six years after that first letter to Murphy, a historic settlement is being finalized. A consent decree—expected to be approved by a state judge by early March—will require Colorado to establish two new voluntary housing units for trans women, making Colorado the first state to offer such units through court order. The state will pay 2.15 million dollars in compensation to affected trans women, approximately 400 of whom are eligible as beneficiaries. The settlement mandates updated staff training, improved medical and mental health care, limits on cross-gender searches by correctional officers, and a requirement that staff use correct names and pronouns.

The barriers to gender-affirming care inside prisons have been formidable. Colorado's corrections department required multiple recommendation letters from medical and mental health providers before considering someone for transition-related surgery—a standard that contradicts guidelines from the World Professional Association for Transgender Health, which recommends an informed consent model. Many prisons offer gender-affirming care on paper but lack qualified providers. Murphy herself pursued surgery twice during her incarceration. In 2019, a corrections psychiatrist finally recommended her for the procedure. But other medical providers lacked the training to evaluate her, and the process stalled. She received surgery only after her release in 2020.

Untreated gender dysphoria can lead to depression, anxiety, self-harm, and suicidality—conditions already disproportionately affecting trans people due to discrimination and social stress. Matthew Murphy, an assistant professor of medicine at Brown University who oversees gender-affirming care for Rhode Island's corrections system, noted that the Constitution requires prisons to provide the same standard of care available in the community. "With Medicaid and private insurance increasingly covering gender-affirming care," he said, "there's a growing precedent." As of December 2023, 148 trans women were housed in Colorado prisons, with only nine in women's facilities. Before 2018, all were housed with men.

The new settlement creates a 100-bed voluntary unit at Sterling Correctional Facility and a 44-bed integration unit at the women's prison, where trans women can spend months adjusting before permanent placement. Eligibility will be decided case-by-case by a committee including medical experts and prison officials. Critically, trans women cannot be forced into these units or punished for refusing them. The Department of Corrections has already hired an independent medical expert and a gender-affirming care specialist to oversee housing assignments and surgical consultations. Taliyah Murphy, now a small business owner in Colorado Springs pursuing a degree in finance and accounting, hopes the settlement allows incarcerated trans women to focus on rehabilitation instead of survival. "We want them to leave better off than they came in and get the care they need," she said. "That's what this is all about."