Get a copy of your facility’s grievance system procedures and file a grievance right away. It is important that you “exhaust your administrative remedies” as soon as possible by filing grievances that put your facility on notice that you believe your rights have been violated. The grievance procedures are specific to each facility and sometimes deadlines are very short.

Under the Prison Litigation Reform Act (PLRA), a federal law passed in 1996, people in custody who wish to file a lawsuit in federal court must first exhaust all of the administrative remedies available to them. Failing to do so gives a correctional facility a reason to ask a court to throw out such a case. If you do not file a grievance within the time period provided and pursue it through every level of appeal, it is likely that any lawsuit you bring will be dismissed.

To exhaust your administrative remedies at the federal level, the Bureau of Prisons (BOP) requires that you:

1. file a “request for an administrative remedy” with your institution within 20 days of the violation of your rights;
2. appeal any decision that you do not like to a regional office within 20 days;
3. appeal the decision with 30 days.

There are very few exceptions to the exhaustion requirement, but the Prison Rape Elimination Act (see below for more about the PREA) provides for one: If you have been sexually assaulted, you may still file a grievance related to the sexual abuse even if the deadline to do so has otherwise passed.

For more details about the PLRA and how to file a lawsuit in federal court, see the Jailhouse Lawyer’s Manual.

Transgender people have struggled to access medically necessary care for years and have suffered a great deal because of bias and misunderstanding. U.S. courts have begun to recognize the health needs of transgender people, with several recent prison-related victories putting the issue in the spotlight. All seven Circuit Courts that have addressed gender dysphoria have recognized it as a serious medical condition.

• In Fields v. Smith, the 7th Circuit upheld the lower court ruling that denying medically necessary transition-related health care violated the Eighth Amendment’s prohibition against cruel and unusual punishment.
• In Adams v. Bureau of Prisons,4 the Bureau of Prisons agreed to reverse their “freeze frame” policy that prevented transgender prisoners from accessing transition-related care unless they could prove that they had already started it prior to incarceration (see “Health Care” for more about the new policy).
• In Norsworthy v. Beard, a California District Court found that refusal of transition-related surgery to a transgender prisoner could constitute sex discrimination.
• Even in Kosilek v. Spencer, where a transgender woman was denied the right to receive transition-related surgery, the Massachusetts court recognized that gender dysphoria is a serious medical condition.
• In Hicklin v. Precythe (formerly Hicklin v. Lombardi) Lambda Legal filed a federal lawsuit on behalf of Jessica Hicklin, a 38-year-old White transgender woman incarcerated at the Potosi Correctional Center, a facility for male inmates, in Missouri. The case challenges a Missouri Department of Corrections (MDOC) “freeze-frame” policy barring access to hormone therapy for transgender people if they were not receiving treatment prior to incarceration, and seeks other medically necessary gender dysphoria treatment for Ms. Hicklin, including access to gender-affirming canteen items and permanent body hair removal. On February 9, 2018 in an important victory for incarcerated transgender people everywhere, the District Court in Missouri granted Ms. Hicklin’s Motion for Preliminary Injunction, granting her immediate access to the necessary medical care to which she is entitled under the 8th Amendment.

Prison officials often deem certain people “at-risk” and segregate them from the general population in “protective custody” or “solitary confinement.” Long-term isolation is a violation of human rights because it amounts to punishment and can cause serious psychological damage.

Lambda Legal joined five other LGBT advocacy organizations in 2012 in urging a Senate panel to stop the discriminatory placement of transgender inmates and immigrant detainees in solitary confinement. Lambda Legal testified that, “Solitary confinement affects many people incarcerated in U.S. jails, prisons and detention facilities, but none so significantly as transgender inmates and immigrant detainees involuntarily confined not because of their actions, but because of their identities.”

The American Civil Liberties Union (ACLU) also testified, stating that “...for prisoners and detainees who are lesbian, gay, bisexual, transgender, have intersex conditions (LGBTI), or are gender-nonconforming, solitary confinement is too often the correctional management tool used to separate them from the general population.”

Under the PREA, facilities may use segregation in isolation, solitary confinement or protective custody only as a last resort. This means taking other steps to prevent abuse such as permitting transgender people to shower separately and exploring alternatives such as moving an aggressor to another cell or facility. Facilities must justify any use of isolated segregation for more than 30 days.