645 F.3d 449 (1st Cir. 2011), 10-1965, Battista v. Clarke

Docket Nº:10-1965.
Citation:645 F.3d 449
Opinion Judge:BOUDIN, Circuit Judge.
Party Name:Sandy J. BATTISTA, Plaintiff, Appellee, v. Harold W. CLARKE, Commissioner of the Massachusetts Department of Correction, and Michael Corsini, Superintendent of Massachusetts Treatment Center, Defendants, Appellants. Kathleen M. Dennehy; Robert Murphy; Steve Fairly; Susan J. Martin; Gregory J. Hughes; UMass Correctional Health Program; Terre Marshal
Attorney:Richard C. McFarland, Legal Division, Department of Correction, with whom Nancy Ankers White, Special Assistant Attorney General, was on brief for appellants. Neal E. Minahan, with whom Christopher D. Man and McDermott Will & Emery LLP were on brief for appellee.
Judge Panel:Before BOUDIN, Circuit Judge, SOUTER,[*]Associate Justice, and STAHL, Circuit Judge.
Case Date:May 20, 2011
Court:United States Courts of Appeals, Court of Appeals for the First Circuit
 
FREE EXCERPT

Page 449

645 F.3d 449 (1st Cir. 2011)

Sandy J. BATTISTA, Plaintiff, Appellee,

v.

Harold W. CLARKE, Commissioner of the Massachusetts Department of Correction, and Michael Corsini, Superintendent of Massachusetts Treatment Center, Defendants, Appellants.

Kathleen M. Dennehy; Robert Murphy; Steve Fairly; Susan J. Martin; Gregory J. Hughes; UMass Correctional Health Program; Terre Marshall, Defendants.

No. 10-1965.

United States Court of Appeals, First Circuit.

May 20, 2011

Heard March 7, 2011.

Richard C. McFarland, Legal Division, Department of Correction, with whom Nancy Ankers White, Special Assistant Attorney General, was on brief for appellants.

Neal E. Minahan, with whom Christopher D. Man and McDermott Will & Emery LLP were on brief for appellee.

Page 450

Before BOUDIN, Circuit Judge, SOUTER,[*]Associate Justice, and STAHL, Circuit Judge.

BOUDIN, Circuit Judge.

In 1983, in state court in Massachusetts, Sandy Battista (born " David Megarry" ) was convicted of the rape of a child, robbery, and kidnapping. After serving that sentence, Battista was involuntarily committed in 2003 in a civil proceeding, Mass. Gen. Laws ch. 123A, § 14 (2008), to the Massachusetts Treatment Center for Sexually Dangerous Persons (" Treatment Center" ). Such persons are held civilly without limit in time until adjudged safe for release. Id. §§ 9, 14.

The Treatment Center, for which the Massachusetts Department of Correction (" the Department" ) is responsible, Mass. Gen. Laws ch. 123A, § 2, is an all-male facility housing three groups: criminals participating in treatment programs, civilly committed residents, and those awaiting adjudication as " sexually dangerous persons." Massachusetts law requires that civil detainees like Battista be separated from criminal ones. Durfee v. Maloney, Nos. CIV. A. 98-2523B, CIV. A. 98-3082B, 2001 WL 810385, at *15 (Mass.Super.Ct. July 16, 2001).

Battista is anatomically male but suffers from " gender identity disorder" (" GID" ), a psychological condition involving a strong identification with the other gender. GID is a disorder recognized in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (4th ed.1994). The diagnostic criteria include not only " cross-gender identification" but also " clinically significant distress or impairment in social, occupational, or other important areas of functioning." Id. at 537-38.

In 1996, Battista changed her name to Sandy and began to seek treatment from the Department, including administration of female hormones and access to female garb. Her early demands were met with skepticism and resistance. 1 In 1997, a Department consultant diagnosed her GID, but the Department offered no further evaluation or treatment until 2004. Prior to this case, Battista filed two suits seeking GID treatment and accumulated expert opinions confirming the seriousness of her condition and recommending accommodations including hormone therapy.

Battista filed her complaint in the present suit in July 2005 and in October 2005 sought to castrate herself with a razor blade. The suit, against various officials of the Department, charged deliberate indifference to her medical needs in violation of the Eighth and Fourteenth Amendments and 42 U.S.C. § 1983 (2006), as well as state law, including Mass. Gen. Laws ch. 12, §§ 11H-11I. In particular, Battista sought an injunction requiring that hormone therapy and female garb and accessories be provided to her.

In and around 2005 and 2006, the Department fenced with its own healthcare provider, the University of Massachusetts Correctional Health Program, which offered strong support for the GID diagnosis, asserted that harm could easily occur without adequate treatment, and recommended hormone therapy as medically

Page 451

necessary. The Department instead hired another gender specialist, who then agreed that hormone treatment might be appropriate along with other therapy.

Battista's first request to the district court for a preliminary injunction was denied in March 2006, with a finding that the defendants had not at this stage been shown to be deliberately indifferent to her medical needs. Battista v. Dennehy, No. 05-11456-DPW, 2006 WL 1581528, at *9-10, *12 (D.Mass. Mar. 22, 2006). After the further medical assessments continued to recommend hormone therapy, the Department stated that it would not implement treatments until security concerns were further evaluated. This proved to be a drawn-out process.

In August 2008, the first security review by the Department concluded that a feminine appearance would endanger Battista. The core security concern throughout has been that sexual contacts or assaults by other detainees would be made more likely by female clothing and accessories and the enhancement of breasts due to hormone therapy. The report, however, was fairly cursory, comprising only a few paragraphs, and in December 2008 the district court entered a preliminary injunction requiring psychotherapy, access to women's attire and accessories, monthly reports on Battista's condition, and a recommendation on hormone therapy after a six-month review.

In the six-month report, the doctors again prescribed the hormones. A first dose was administered, but then the Department put another indefinite hold on treatment pending a second security review. The September 2009 review again found the safety risk too high. This new report was more substantial although it more or less duplicated an earlier report prepared for an inmate who also had requested and been denied hormone therapy. Its security evaluation is at the core of the Department's substantive objection to hormone therapy for Battista.

Although hormone therapy had been provided for GID to inmates of some male prisons, the September 2009 report included data gathered under the Prison Rape Elimination Act of 2003 (" PREA" ) § 4, 42 U.S.C. § 15603, to argue that the risk of sexual assault was...

To continue reading

FREE SIGN UP