NC officials seek dismissal of prisoners’ gender transition lawsuit

North Carolina prison officials are seeking the dismissal of a federal lawsuit challenging the state’s ban on funding for prisoners’ gender transition procedures. State legislative leaders are also seeking a court ruling against the plaintiff prisoners.

Five inmates filed suit in February against the secretary and chief medical officer of the NC Department of Adult Correction. The inmates in Kwiatkowski v. Dismukes followed up in March with court filings seeking an injunction and class-action status for their complaint.

The suit challenges provisions of House Bill 805, approved in the North Carolina General Assembly in 2025 over Gov. Josh Stein’s veto.

A US magistrate judge granted top state lawmakers’ request to intervene in the case. Now Senate Leader Phil Berger, R-Rockingham, and House Speaker Destin Hall, R-Caldwell, seek a “judgment on the pleadings.” That means the trial judge would decide the case based on the initial complaint without further hearings or written briefs.

“Plaintiffs challenge N.C. Gen. Stat. § 143C-6-5.6(b1), a provision of S.L. 2025-84 (H.B. 805) that has been in effect since July 2025,” lawmakers’ lawyers wrote Thursday. “The challenged subsection generally prohibits the use of State funds for prisoners’ surgical gender transition procedures, puberty-blocking drugs, or cross-sex hormones but does not ‘prevent State funds from being used … to address medical complications resulting in imminent physical harm, including the treatment of any infection, injury, disease, or disorder that has been caused by or exacerbated by a previously performed or privately funded gender transition procedure.’”

“Plaintiffs’ suit is an attempt to dictate treatment protocols to the State, and their complaint fails on its own terms for several independent reasons,” the court filing continued.

“To start, Plaintiffs lack standing,” legislative lawyers argued. “Each Plaintiff is already receiving hormones, and a separate statutory section and prior prison practice independently prohibit State funding of surgical gender transition procedures. If Plaintiffs prevail in challenging § 143C-6-5.6(b1), nothing in the complaint establishes that Plaintiffs’ treatment would change. Even if Plaintiffs somehow have standing, their speculative assertions about future treatment changes are unripe.”

“Plus, no Plaintiff alleges exhausting their administrative remedies for their cross-sex hormone prescriptions, as the Prison Litigation Reform Act (‘PLRA’) requires, and most Plaintiffs do not allege grieving for performance of surgical gender transition procedures,” the court filing continued.

“Even accepting Plaintiffs’ allegations as true, their Eighth Amendment claim still fails on the merits,” legislative lawyers argued. “Objectively, Plaintiffs identify no medical record that might support the proposition that a different course of cross-sex hormones or a specific surgery is medically necessary for them. Subjectively, Plaintiffs readily acknowledge that Defendants do not believe their treatment of Plaintiffs is inhumane. The Court should grant judgment on the pleadings.”

Adult Correction Secretary Leslie Cooley Dismukes and chief medical officer Arthur Campbell filed a separate motion Thursday to dismiss the prisoners’ lawsuit.

“Plaintiffs lack standing,” state government lawyers wrote. “Additionally, this matter should be dismissed because Plaintiffs have not exhausted their administrative remedies as required under the Prisoner Litigation Reform Act (hereinafter ‘PLRA’).”

A March court filing asked for the case to be treated as a class-action lawsuit.

The class would cover “all current and future people in DAC custody who have or will have gender dysphoria, and have been prescribed or may require cross-sex hormone therapy or gender-affirming surgery to treat gender dysphoria,” according to a memorandum supporting the motion. “Joinder of all individual class members is impracticable because there are likely dozens of putative class members in state custody, the class’s fluid composition will fluctuate day to day, and the class contains future members who cannot be identified now.”

A separate motion sought an injunction blocking HB 805’s provisions.

“In 2024, this Court held that Defendants violated the Eighth Amendment by imposing a de facto ban on gender-affirming surgery for state prisoners suffering from gender dysphoria,” the prisoners’ lawyers wrote. “By categorically prohibiting potentially necessary medical treatment, Defendants failed to provide ‘the individualized medical evaluation the Eighth Amendment requires.’”

“Now the state legislature has effectively codified this surgery ban and restricted the use of hormone therapy, a treatment that the North Carolina Department of Adult Correction (DAC) has long recognized may be medically necessary to treat gender dysphoria,” the court filing continued. “This statute, known as HB805, prohibits state funds from being ‘used, directly or indirectly, for the performance of or in furtherance of surgical gender transition procedures, or to provide puberty-blocking drugs or cross-sex hormones to any prisoner’ in state custody. These treatments are only permitted if a patient would suffer ‘imminent physical harm.’”

The plaintiff prisoners “are currently prescribed hormone therapy, and some are candidates for gender-affirming surgery,” their lawyers wrote. “They have faced abrupt stoppages in their hormone therapy since the law’s passage and experienced predictable suffering as a result. Their requests for surgery have been summarily denied.”

The prisoners are citing the Eighth Amendment in seeking an injunction against the ban in HB 805. “Plaintiffs are not asking the Court to order any particular course of treatment for any particular person,” the court filing explained. “They are simply asking that their serious medical condition – gender dysphoria – be treated according to medical necessity like any other condition.”

In a court document answering the complaint, top lawmakers objected to class certification that would extend the lawsuit beyond the five named plaintiffs: AJ Kwiatkowski, Ashlee Inscoe, Pumpkin Snuggs, Lulubell Frazier, and Tremayne Izzard.

Lawmakers argue that the suit “fails to state a claim upon which relief can be granted and should be dismissed” and that its claims “are barred, in whole or in part, by lack of standing, ripeness, or mootness.”

“There is medical uncertainty concerning the proper treatment of gender dysphoria, and the North Carolina Legislature has authority to regulate the treatment of gender dysphoria,” lawmakers’ lawyers argued.

“HB 805 constitutes a valid exercise of the State’s legislative authority over appropriations and correctional administration,” the court filing continued. “HB 805 is rationally related to legitimate governmental interests, including (1) allocation of limited public resources, (2) regulation of public expenditures, (3) correctional administration, (4) and the State’s authority to define publicly funded medical care.”

“Federal courts must afford substantial deference to legislative judgments concerning correctional policy and public expenditures,” lawmakers’ lawyers added.

The plaintiffs face the “imminent loss of essential healthcare” due to HB 805, according to the initial complaint filed on Feb. 6. The law prohibits the use of state funds for surgical gender transition procedures, puberty-blocking drugs, and cross-sex hormones for any prisoner in the state system.

“HB805 only permits gender-affirming hormone therapy or surgery if, absent that treatment, a patient will experience ‘imminent physical harm,’ with no consideration of a patient’s mental or behavioral health or longer-term physical consequences. It provides no exceptions for a patient’s mental health,” the lawsuit continued.

“HB805 presents a medically unjustified barrier to gender-affirming medical care in North Carolina prisons regardless of an individual patient’s needs,” the plaintiffs’ lawyers wrote. “To allow gender-affirming care only when a patient faces imminent physical harm is a gross departure from the standard of care and has no basis in sound medical practice.”

“NC officials seek dismissal of prisoners’ gender transition lawsuit” was originally published on www.carolinajournal.com.