A federal court judge issued a rebuke of Connecticut’s Department of Correction last week in a case involving an incarcerated transgender woman, who argued the agency initially refused to treat her for gender dysphoria even after an attempt at self-castration. 

Judge Vanessa Bryant of the U.S. District Court of Connecticut granted a motion for summary judgment Friday in favor of Veronica-May Clark, formerly Nicholas Clark, who sued the DOC and some of its medical staff on allegations they violated a constitutional prohibition on cruel and unusual punishment by failing for years to provide adequate gender-affirming care. 

As of Wednesday, the case remained ongoing and the judge had ordered the two parties to meet and develop a plan to proceed within the next month. However, in Friday’s 73-page decision, Bryant denied a motion for summary judgment by lawyers from Connecticut’s Attorney General’s Office and rejected state arguments explaining long delays in treatment.

“[T]he Provider-Defendants’ denial of any medical care for a period of ten months followed by failing to follow the endocrinologist’s instructions, as well as failing to provide qualified health treatment, despite her repeated complaints and history of self-castration, could lead a reasonable jury to find the Provider-Defendants’ conduct was extreme and outrageous,” the judge wrote.

In an email Wednesday, a spokesperson for the Department of Correction declined to comment on pending litigation. Meanwhile, the ACLU of Connecticut, whose lawyers have represented Clark since 2021, issued a press release lauding the ruling.

“Today’s ruling is a victory for Ms. Clark, incarcerated people, and trans people everywhere,” Elana Bildner, a senior staff attorney with the ACLU Foundation of Connecticut, said. 

Much of the case hinges on the agency’s actions after a grisly incident on July 15, 2016, when Clark, who is serving an effective life sentence on a 2007 murder conviction, attempted to castrate herself using a pair of nail clippers.

Over the course of about 20 minutes, Clark cut into herself and succeeded in extracting a testicle from her scrotum before stopping due to excruciating pain, according to court documents. Staff members found her bleeding in a cell at Cheshire Correctional Institution and transported her to John Dempsey Hospital for treatment.

Later, DOC officials called the incident “horrific,” according to court documents, and declined to transfer Clark back to Cheshire Correctional Institution for fear of traumatizing staff members who witnessed its aftermath. 

Bryant called the argument “disingenuous” in Friday’s ruling. 

“It defies credulity that DOC could appreciate the trauma its staff experienced, and yet not appreciate the trauma Ms. Clark was experiencing which compelled her to try to castrate herself with a nail clipper,” Bryant wrote. “The pain she must have been experiencing is inescapably palpable.” 

What followed the incident was a series of written grievances and requests by Clark for treatments including hormone replacement therapy and gender reassignment surgery, according to court documents.

Clark eventually met with an endocrinologist and began hormone therapy in 2017. However, a follow-up appointment recommended by the doctor was never made and Clark’s hormone levels continued to fluctuate in the range of a normal adult male, according to the ruling. 

Meanwhile, Clark made a series of written requests describing inconsistent treatment, unfilled prescriptions, and unscheduled surgeries. In 2019, she filed the lawsuit naming the DOC commissioner, as well as Dr. Gerald Valletta, licensed clinical social worker Richard Bush and advanced nurse practitioner Barbara Kimble-Goodman. 

In a motion last April, an attorney for the state argued that Clark had identified as a man when she entered the prison system and continued to do so until 2016. 

The department and the University of Connecticut Health Center had long maintained a policy of providing hormone therapy only to inmates who had been receiving it prior to their incarceration, according to the motion.

The agency has since changed its policy and retained a transgender consultant, according to the motion, which described difficulties contracting outside health care providers to administer the gender-affirming care sought by Clark and others. 

In the motion, Assistant Attorney General Janelle Medeiros wrote that Clark could not establish that the DOC had acted recklessly, given the substantial care and steps the agency had taken to progress her treatment. 

“At best, Plaintiff’s claim appears to be that she is not getting the care she would prefer as fast as she would like—despite her highly unrealistic timeframe for which she believes such care should occur,” Medeiros wrote. 

Friday’s ruling suggests the judge found many of the state’s arguments unconvincing. For instance, Bryant dismissed testimony by one doctor who initially said Clark was not a candidate for genital reconstructive surgery then later said that she may be a candidate without seeing the patient again. 

“The circumstances suggest litigation gamesmanship rather than a fair and reasoned assessment of Ms. Clark’s medical needs,” the judge wrote. 

Clark expressed relief after the judge’s ruling, in a statement included in a press release from the Connecticut ACLU. She called gender-affirming care a common sense treatment, which she should not have had to fight for. 

“I hope the state will stop fighting and start providing me with the health care that I need, and I hope my case means no one else will have to experience the pain that I have,” Clark said.