Mitchell v. Kallas, decided by the United States Court of Appeals for the Seventh Circuit on July 10, 2018, is a landmark case focusing on the constitutional rights of incarcerated individuals, specifically access to medical treatment for gender dysphoria. The case establishes a precedent under the Eighth Amendment, which protects inmates against deliberate indifference to serious medical needs.

Background of the Case

Lisa Mitchell, a transgender woman diagnosed with gender dysphoria in 2008, was incarcerated at Wisconsin's Columbia Correctional Institution in 2011. She requested hormone therapy, a medically recognized treatment for her condition.

Although Mitchell completed the required evaluations, including one by expert Cynthia Osborne, who endorsed her for treatment, Dr. Kevin Kallas, Mental Health Director at the Department of Corrections, denied her request in 2013. He cited an unwritten policy requiring at least six months remaining on an inmate’s sentence to receive hormone therapy. Mitchell was due for release that same month.

After her release, parole officers continued to restrict her access to hormone therapy and required her to present as male, compounding her gender dysphoria.

District Court Proceedings

In 2015, Mitchell filed a lawsuit under 42 U.S.C. § 1983, naming Dr. Kallas, Dr. Dawn Laurent, and three parole officers as defendants. She alleged deliberate indifference to her medical needs, a violation of her Eighth Amendment rights.

The district court dismissed claims against the parole officers and granted summary judgment to Drs. Kallas and Laurent, stating they were not deliberately indifferent and were entitled to qualified immunity.

Seventh Circuit Court of Appeals Ruling

• Dr. Laurent: The court upheld summary judgment, finding no evidence of her involvement in the denial of treatment.
• Dr. Kallas: The court reversed the summary judgment. It held that the unwritten six-month policy lacked formal documentation and may have been an administrative convenience rather than a medical judgment, which could indicate deliberate indifference.
• Parole Officers: The court also reversed the dismissal of claims against parole officers, stating that restricting access to necessary medical care could violate constitutional rights.

Significance and Impact

Mitchell v. Kallas reinforces the following key principles:

• Medical Necessity Over Convenience: Treatment decisions must be based on sound medical judgment, not policy convenience or budget constraints.
• Parole Conditions and Treatment: Conditions that prevent access to essential medical care can be unconstitutional.
• Judicial Scrutiny of Unwritten Policies: Courts will closely examine informal or undocumented policies that restrict necessary care.
• Obligation to Provide Care: Prisons and parole systems must ensure timely, medically appropriate treatment for all inmates, including transgender individuals.

This case is now a foundational precedent ensuring that correctional and parole systems cannot ignore the serious medical needs of transgender individuals under the Eighth Amendment.