The North Carolina Department of Public Safety, now known as the North Carolina Department of Adult Correction (NC DAC) has continually denied Kanautica Zayre-Brown, an incarcerated transgender woman in their custody, access to gender-affirming surgery.

The American Civil Liberties Union, ACLU of North Carolina, and Patterson Harkavy LLP filed a complaint on behalf of Kanautica Zayre-Brown, a transgender woman incarcerated at Anson Correctional Institution who is being denied essential gender-affirming health care. Mrs. Zayre-Brown has been diagnosed with gender dysphoria, a serious medical condition, and for several years has requested necessary treatment consistent with established medical standards. DAC officials’ pattern of inhumane treatment has caused Mrs. Zayre-Brown physical health complications and extreme emotional and psychological distress, leading to thoughts of self-harm and suicide.

In spite of the fact that Mrs. Zayre-Brown is a woman and DAC has known about her gender dysphoria diagnosis since she entered custody, DAC housed her in male facilities for nearly two years before transferring her to Anson CI, a women’s facility where she has continued to be a target of discrimination due to suffering from gender dysphoria.

DAC’s refusal to provide necessary care for Mrs. Zayre-Brown violates the U.S. and North Carolina constitutions, the Americans with Disabilities Act (ADA), and the Rehabilitation Act of 1973. The complaint seeks damages and an injunction requiring DAC to provide Mrs. Zayre-Brown with necessary medical care and accommodations for her gender dysphoria, including the use of gender-consistent terminology, consistent hormone therapy maintenance, and gender-affirming surgery. In response to litigation from the ACLU and ACLU affiliates, courts across the country have consistently recognized the right of incarcerated transgender people to adequate health care and safety measures. In late December 2021, a federal court ruled on a motion and ordered the Bureau of Prisons to evaluate Cristina Nichole Iglesias for gender-affirming surgery. This landmark decision marks the first time a court has ordered the federal government to address an incarcerated person’s medical need for gender-affirming surgery.

UPDATE: On April 16, 2024, following an evidentiary hearing, Judge Cogburn issued an order ruling that the state’s process for evaluating whether gender-affirming surgery is medically necessary for incarcerated individuals is unconstitutional.  The judge stated that DAC violated Mrs. Zayre-Brown's rights under the Eighth Amendment by failing to give her request individualized consideration. He further ordered that the DAC either provide Mrs. Zayre-Brown with the surgery she has requested or, within 30 days of the order, form a new committee containing at least two medical doctors with gender dysphoria expertise to reevaluate Mrs. Zayre-Brown's request.