Guthrie v. Wetzel

• Decision Date: 13 December 2021
• Docket Number: CIVIL 1:20-CV-02351
• Parties: DAWN GUTHRIE, Plaintiff, v. JOHN WETZEL, et al., Defendants.
• Court: U.S. District Court — Middle District of Pennsylvania

DAWN GUTHRIE, Plaintiff, v. JOHN WETZEL, et al., Defendants.

CIVIL No. 1:20-CV-02351

United States District Court, M.D. Pennsylvania

December 13, 2021

Mannion, Judge

REPORT AND RECOMMENDATION

Susan E. Schwab United States Magistrate Judge

I. Introduction.

The plaintiff, a transgender prisoner, contends that the defendants violated her constitutional rights by refusing to provide her with adequate care for her gender dysphoria, including gender affirming surgery. Currently pending is a motion to dismiss the plaintiff's complaint filed by all of the defendants. For the reasons that follow, we will recommend denying that motion.

II. Background and Procedural History.

On December 15, 2020, the plaintiff, Dawn Guthrie (“Guthrie”), began this action by filing a complaint. Doc. 1. In her complaint, Guthrie alleges that the defendants have deprived her of her Eighth Amendment right to be free from cruel and unusual punishment. Id. at ¶ 109. Guthrie names John Wetzel^[1] (“Wetzel”), the former Secretary of the Pennsylvania Department of Corrections (“DOC”), Dr. Paul Noel (“Noel”), the former Chief of Clinical Services at State Correctional Institutional at Mahanoy (“SCI-Mahanoy”), Dr. Arlene Seid (“Seid”), the Chief of Clinical Services at SCI-Mahanoy, and Dr. Palukuri Reddy (“Reddy”), the Chief of Psychiatric Services at SCI-Mahanoy as defendants (collectively “Defendants”). Id. at ¶¶ 5-8. Guthrie is suing Wetzel in his individual and official capacity, Noel in his individual capacity, Seid in her official capacity, and Reddy in his individual and official capacity. Id.

Guthrie has been incarcerated within the DOC since September 17, 2013. Id. at ¶ 9. Guthrie is currently incarcerated at SCI-Mahanoy, a men's prison. Id. at ¶ 10. Guthrie is a transgender woman who has lived fully as a woman since 2016. Id. at ¶ 13. Guthrie was diagnosed with gender dysphoria in 1998, and the DOC affirmed her diagnosis in February 2016. Id. at ¶¶ 14-15. As of December 1, 2017, the DOC recognizes Guthrie's gender as female Id. at ¶ 17. Guthrie was incarcerated at State Correctional Institute Muncy (“SCI-Muncy”), a women's prison, from March 27, 2019, until August 2019, when she was transferred to SCI Mahanoy after receiving a misconduct. Id. at ¶ 18. Guthrie avers that her transfer out of SCI-Muncy was authorized by Wetzel and members of the Gender Review Committee (“GRC”). Id. at ¶ 19.

Due to her gender dysphoria, Guthrie alleges she has “a history of a suicide attempt, repeated suicidal ideation, depression, ideation about autocastration, physical and sexual assault, and persistent sexual harassment.” Id. at ¶ 29. Guthrie claims that DOC Policy Statement 13.2.1, Section 19 (“Section 19”), which addresses the treatment of gender dysphoria, is constitutionally inadequate and discriminatory. Id. at ¶¶ 47-71. Guthrie avers that Noel and Seid have the overall responsibility for the medical treatment of inmates diagnosed with gender dysphoria and that Reddy has the overall responsibility for the mental health diagnosis and treatment of inmates diagnosed with gender dysphoria. Id. at ¶¶ 51-52. Guthrie alleges that, pursuant to Section 19, medical and mental health vendors must provide training to their practitioners on evaluation, treatment, and management of patients with gender dysphoria with annual refresher training and that Noel, Seid, and Reddy must pre-approve this training. Id. at ¶¶ 53-54.

Per Guthrie, Section 19 establishes a gender dysphoria Treatment Review Committee (“TRC”), which “establishes DOC policies, reviews and approves every individual treatment plan, and reviews all requests for gender affirming surgery.” Id. at ¶ 55. Guthrie further asserts the gender dysphoria Treatment Review Committee is “made up of at least six people, none of whom are medical professionals involved in the direct care of gender dysphoria identified persons. Further, upon information and belief, none specialize in in transgender issues or treatment.” Id. at ¶ 56. Guthrie states that Noel, Seid, and Reddy are members of this committee. Id. at ¶ 57. Guthrie also asserts that the psychology staff and prison psychiatrist develop a gender dysphoria “individual recovery plan” (“IRP”) for each inmate with gender dysphoria and that the Treatment Review Committee must unanimously approve any treatment beyond the initial IRP. Id. at ¶¶ 58-59. Guthrie avers that if an outside specialist recommends gender affirming surgery, then the case is referred to the Gender Review Committee (“GRC”), which includes non-medical staff and does not include medical and mental health staff who provided direct care to the individual. Id. at ¶¶ 61-66. Guthrie asserts that Wetzel has the ability to implement changes and revisions to this policy. Id. at ¶ 70.

Guthrie claims that she has a long history of suicidal ideation, including at least one suicide attempt prior to her incarceration and that the DOC staff is aware of her depression and suicidal ideation. Id. at ¶¶ 73-74. Guthrie also states that the DOC staff are not fully familiar with the World Professional Association for Transgender Health (“WPATH”) Standards of Care, that she has lacked access to transgender specialists while in prison, and that she has not been allowed to meet with an outside transgender specialist while incarcerated. Id. at ¶¶ 74-76. For three years, Guthrie has undergone hormone replacement therapy. Id. at ¶ 81. Based on the support of her mental health providers, Guthrie requested gender affirming surgery on January 18, 2018; however, her request was denied on June 10, 2019, and Guthrie claims she was not provided any rationale for the denial. Id. at ¶¶ 82, 97. Additionally, Guthrie claims that she has been denied laser hair removal, female commissary items, and permanent access to a razor. Id. at ¶¶ 85, 87, 91.

Guthrie claims that as a result, her gender dysphoria and suicidal ideation have worsened, with Guthrie being put on “Constant Watch, the closest level of monitoring for DOC inmates experiencing acute suicidal ideation.” Id. at ¶¶ 100-104. Guthrie claims that Defendants are aware of Guthrie's psychological distress and that she is at risk of serious injury or death as a result of her gender dysphoria. Id. at ¶ 106. According to Guthrie, all of the Defendants violated her Eighth Amendment right to be free from cruel and unusual punishment “through their deliberate indifference to her serious medical needs, including but not limited to their failure to provide her access to a transgender health specialist, gender affirming surgery and other necessary medical care.” Id. at ¶ 109. Additionally, Guthrie claims that all of the Defendants have violated her Eighth Amendment rights “through their deliberate indifference to her serious medical needs by their interference with her attempt to socially transition including but not limited to denial of access to female commissary items and transferring her out of a women's prison.” Id. at ¶ 110.

For relief, Guthrie requests a declaratory judgment that Defendants violated her Eighth Amendment rights. Id. at 20. Guthrie also requests injunctive relief allowing her access to an outside transgender healthcare specialist, medical care for her gender dysphoria, including but not limited to laser hair removal and gender affirming surgery. Id. Guthrie also seeks injunctive relief granting her access to female commissary items and wishes to be transferred to a women's prison. Id. Additionally, Guthrie requests injunctive relief that Defendants provide “adequate training on the Standards of Care to all staff providing medical or mental health treatment to transgender individuals.” Id. For further injunctive relief, Guthrie also requests that Wetzel, Seid, and Reddy “enact and enforce more appropriate policies to utilize direct care providers and specialists in transgender healthcare in assessing a gender dysphoria identified person's treatment plan, including but not limited to access to gender affirming surgery.” Id. Guthrie also seeks unspecified compensatory and punitive damages against the Defendants and attorney's fees and costs. Id. at 20-21.

Currently pending is the Defendants' motion to dismiss the complaint against all defendants. Doc. 6. That motion has been fully briefed. Doc. 7. For the reasons discussed below, we will recommend that the Defendants' motion be denied.

III. Pleading and Motion-to-Dismiss Standards.

In accordance with Fed.R.Civ.P. 12(b)(6), the court may dismiss a complaint for “failure to state a claim upon which relief can be granted.” When reviewing a motion to dismiss under Rule 12(b)(6), “[w]e must accept all factual allegations in the complaint as true, construe the complaint in the light favorable to the plaintiff, and ultimately determine whether plaintiff may be entitled to relief under any reasonable reading of the complaint.” Mayer v. Belichick, 605 F.3d 223, 229 (3d Cir. 2010). In making that determination, we “consider only the complaint, exhibits attached to the complaint, matters of public record, as well as undisputedly authentic documents if the [plaintiff's] claims are based upon these documents.” Id. at 230.

“A Rule 12(b)(6) motion tests the sufficiency of the complaint against the pleading requirements of Rule 8(a).” I.H. ex rel. D.S. v. Cumberland Valley Sch. Dist. 842 F.Supp.2d 762, 769-70 (M.D. Pa. 2012). “Under Federal Rule of Civil Procedure 8(a)(2), a pleading must contain a ‘short and plain statement of the claim showing that the pleader is entitled to relief.'” Ashcroft v. Iqbal, 556 U.S. 662, 677-78 (2009) (quoting Fed.R.Civ.P. 8(a)(2)). The statement required by Rule 8(a)(2) must give the defendant fair notice of the nature of the plaintiff's claim and of the grounds upon which the claim rests. Erickson...