Keohane v. Dixon

  • Latest Update: Dec 13, 2024
A row of prison doors.

On September 30, 2024, the Florida Department of Corrections issued a health services bulletin setting new rules for the medical care that would be provided to transgender people in its custody. Contrary to the medical mainstream, the bulletin suggests those seeking hormone therapy may have endured “short-termed delusions or beliefs which may later be changed and reversed” and recommended against providing any gender-affirming medical care unless extensive barriers were overcome. That same day, at Florida Department of Corrections facilities across the state, transgender inmates were rounded up and informed that FDC policy had been changed, “up to and including hormone therapy.” They were specifically told that they would no longer have access to clothing and grooming standards that accord with their gender identity and would have 30 days to comply.

Transgender women like our clients Reiyn Keohane, Sasha Mendoza, and Sheila Diamond were told that those who did not cut their hair in compliance with male grooming standards would be forcibly shorn, and those who did not turn in their female undergarments and feminine canteen items would be disciplined. Transgender men like our clients Karter Jackson and Nelson Boothe were told that those who did not turn in their male undergarments and male canteen items would be disciplined.

In October 2024, the ACLU filed emergency litigation on behalf of Reiyn — who has been receiving gender-affirming hormone therapy and clothing and grooming accommodations while in FDC custody since 2016—and a proposed class of transgender inmates with gender dysphoria, on the grounds that the new policy constitutes a violation of their Eighth Amendment right to medically necessary care. The ACLU previously filed a 2016 lawsuit on behalf of Reiyn that led to the now-rescinded policy permitting access to hormone therapy and female clothing and grooming accommodations for transgender women in FDC custody, which for more than six years permitted hundreds of transgender inmates to access needed gender-affirming care.

On January 31, 2025, the district court denied the government’s motion to dismiss the case, and the parties proceeded to discovery. On October 22, 2025 the district granted class certification for all inmates in FDC custody with gender dysphoria who are denied social accommodations.

WHAT'S AT STAKE

On September 30, 2024, the Florida Department of Corrections rescinded its policy regarding treatment of gender dysphoria, which allowed for hormone therapy when deemed medically necessary, as well as access to clothing and grooming standards that accord with one’s gender identity. Under this new policy, grooming and clothing accommodations have been stripped away, and hormone therapy is not permitted unless an exception is deemed constitutionally required. The ACLU brought a class action challenging the policy under the Eighth Amendment’s protections against cruel and unusual punishment.

The Latest: On March 13, 2026 we filed our opposition to Defendants’ motion for summary judgment. Trial is set for July 2026.

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Enforced Dysphoria: A Letter from a Transgender Woman Denied Care in a Florida Men’s Prison

This is a guest blog post by Reiyn Keohane, ACLU of Florida client. Reiyn is a transgender woman currently being denied hormone therapy and other treatment for gender dysphoria in a Florida prison. We have filed a lawsuit on her behalf to restore her medically necessary treatment. She wrote the below letter to let the world know about her experiences as a transgender woman being denied care in a Florida prison.

In the years I have been incarcerated, I have been made to endure more cruelty by the State of Florida than I ever imagined the government could commit. I am a transgender woman—but to the classification officers there is no such thing. If they say you’re male, you go to men’s prison, where you will be forced to “act like a man” under threat of being locked up in solitary, beaten, and humiliated. I have suffered through it all.

I have been forced to strip with men, and been slapped and hit for telling the officers in charge of the search that the rules say I must be searched separately. I have been handcuffed, thrown to the ground, and held down so officers could shave my head. I have been called a punk, a sissy, and a faggot; I have been beaten while handcuffed for asking to see mental health professionals.

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