Edmo v. Corizon, Inc., No. 19-35017 (9th Cir. 2019)
Annotate this Case
Where, as here, the record shows that the medically necessary treatment for a prisoner's gender dysphoria is gender confirmation surgery (GCS), and responsible prison officials deny such treatment with full awareness of the prisoner's suffering, those officials violate the Eighth Amendment's prohibition on cruel and unusual punishment.
The Ninth Circuit affirmed the district court's entry of a permanent injunction after the district court concluded that gender confirmation surgery is medically necessary for plaintiff, a male-to-female transgender prisoner in the custody of the Idaho Department of Correction, and ordered the State to provide the surgery. The panel held that the record, as construed by the district court, established that plaintiff has a serious medical need, that the appropriate medical treatment is GCS, and that prison authorities have not provided that treatment despite full knowledge of plaintiff's ongoing and extreme suffering and medical needs. In so holding, the panel rejected the State's portrait of a reasoned disagreement between qualified medical professionals. The panel noted that its analysis was individual to plaintiff and was based on the record.
The panel also noted that it applied the dictates of the Eighth Amendment in an area of increased social awareness: transgender health care, and that the Eighth Amendment inquiry takes into account the medical community's developing understanding of what treatments are safe and medically necessary to treat gender dysphoria. Finally, the panel largely rejected the State's remaining contentions, but vacated the injunction to the extent it applied to the named defendants in their individual capacities.
Court Description: Eighth Amendment / Prisoner Rights. The panel affirmed the district court’s entry of a permanent injunction in favor of Idaho state prisoner Adree Edmo, but vacated the injunction to the extent it applied to defendants Corizon, Howard Yordy, Rona Siegert, Dr. Young, Dr. Craig, and Dr. Whinnery, in their individual capacities, in Edmo’s action seeking medical treatment for gender dysphoria. The district court concluded that Edmo had established her Eighth Amendment claim. The district court further concluded that gender confirmation surgery (“GCS”) was medically necessary for Edmo, and ordered the State to provide the surgery. The panel credited the district court’s factual findings as logical and well-supported, and held that the responsible prison authorities were deliberately indifferent to Edmo’s gender dysphoria, in violation of the Eighth Amendment. The panel held that the record, as construed by the district court, established that Edmo had a serious medical need, that the appropriate medical treatment was GCS, and that prison authorities had not provided that treatment despite full knowledge of Edmo’s ongoing and extreme suffering and medical needs. The panel rejected the State’s position that there was a reasoned disagreement between qualified medical professionals. The panel emphasized that its 4 EDMO V. CORIZON analysis was individual to Edmo, and rested on the record of this case. Addressing further aspects of the appeal, the panel rejected the State’s contention that the district court did not make the Prison Litigation Reform Act’s requisite “need- narrowness-intrusiveness” findings, causing the injunction to automatically expire and mooting the appeal. The panel held that the district court’s order, considered as a whole, made all the findings required by 18 U.S.C. § 3626(a)(1)(A), and Ninth Circuit precedent. The panel also held that the permanent injunction that the district court entered had not expired, and remained in place, albeit stayed. The panel accordingly denied the State’s motion to dismiss. The panel held that the district court did not err in granting a permanent injunction. Specifically, the panel held, based on the district court’s factual findings, that Edmo established her Eighth Amendment claim and that she will suffer irreparable harm – in the form of ongoing mental anguish and possible physical harm – if GCS is not provided. The State did not dispute that Edmo’s gender dysphoria was a sufficiently serious medical need to trigger the State’s obligations under the Eighth Amendment. The panel held that the district court did not err in crediting the testimony of Edmo’s experts that GCS was medically necessary to treat Edmo’s gender dysphoria and that the State’s failure to provide that treatment was medically unacceptable. The panel further held that the district court did not err in discrediting the State’s experts because aspects of their opinions were illogical and unpersuasive. Also, the panel held that the record demonstrated that Dr. Eliason acted with deliberate indifference to Edmo’s serious medical needs. The panel noted that its decision was in tension with the Fifth Circuit’s decision in Gibson v. Collier, 920 F.3d 212 (5th EDMO V. CORIZON 5 Cir. 2019), and the panel rejected that decision’s categorical holding that denying GCS cannot, as a matter of law, violate the Eighth Amendment. The panel held that the district court did not err in finding that Edmo would be irreparably harmed absent an injunction. The panel rejected the State’s contentions as to why the district court erred in this finding. The panel next considered the State’s challenges to the scope of the injunction. The panel held that the injunction was properly entered against Dr. Eliason because he personally participated in the deprivation of Edmo’s constitutional rights. The panel also held that because Edmo may properly pursue her Eighth Amendment claim for injunctive relief against Attencio, Zmuda and Ramirez in their official capacities, they were properly included within the scope of the district court’s injunction. On remand, the district court shall amend the injunction to substitute the current warden as a party for Yordy. The panel vacated the district court’s injunction to the extent it applied to Yordy, Siegert, Dr. Young, Dr. Craig, and Dr. Whinnery in their individual capacities because the evidence in the record was insufficient to conclude that they were deliberately indifferent to Edmo’s serious medical needs. The panel vacated the injunction as to Corizon, and remanded with instructions to the district court to modify the injunction to exclude Corizon. Finally, the panel held that the injunctive relief ordered was not overbroad. The panel considered the State’s challenges to the procedure used by the district court. The panel rejected the State’s contention that the district court erroneously converted the evidentiary hearing into a final trial on the merits without giving proper notice. The panel held that the State did receive notice, and in any event, the State had not 6 EDMO V. CORIZON shown any prejudice. The panel also rejected the State’s contention that the district court violated defendants’ Seventh Amendment right to a jury trial by converting the evidentiary hearing into a trial on the merits. The panel held that the State’s conduct waived its right to a jury trial with respect to issues common to Edmo’s request for an injunction ordering GCS and her legal claims.
The court issued a subsequent related opinion or order on February 10, 2020.
Some case metadata and case summaries were written with the help of AI, which can produce inaccuracies. You should read the full case before relying on it for legal research purposes.
This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.