Rosati v. Igbinoso
Decision Date | 26 June 2015 |
Docket Number | No. 13–15984.,13–15984. |
Citation | 791 F.3d 1037 |
Parties | Philip Walker ROSATI, Plaintiff–Appellant, v. IGBINOSO, Chief Medical Officer, Pleasant Valley State Prison; Susan L. Hubbard, Director of California Department of Corrections, Defendants–Appellees. |
Court | U.S. Court of Appeals — Ninth Circuit |
Jon W. Davidson, Peter C. Renn (argued), Lambda Legal Defense and Education Fund, Inc., Los Angeles, CA; Alison Hardy, Prison Law Office, Berkeley, CA, for Plaintiff–Appellant.
Kamala D. Harris, Attorney General, Jonathan L. Wolff, Senior Assistant Attorney General, Thomas S. Patterson, Supervising Deputy Attorney General, Jose A. Zelidon–Zepeda and Neah Huynh (argued), Deputy Attorneys General, San Francisco, CA, for Defendants–Appellees.
Cori A. Lable, Daniel V. McCaughey, Michael T. Packard, and Kevin P. Budris, Ropes & Gray LLP, Boston, MA, for Amicus Curiae World Professional Association for Transgender Health.
Appeal from the United States District Court for the Eastern District of California, Ralph R. Beistline, Chief District Judge, Presiding. D.C. No. 1:12–cv–01213–RRB.
Before: BARRY G. SILVERMAN, RONALD M. GOULD, and ANDREW D. HURWITZ, Circuit Judges.
Philip Walker Rosati (now known as Mia Rosati) is a transgender inmate in the California prison system.1 Rosati filed a pro se 42 U.S.C. § 1983 complaint claiming that prison officials violated the Eighth Amendment through deliberate indifference to her serious medical needs. Rosati alleges that she suffers from severe gender dysphoria
for which sexual reassignment surgery (“SRS”) is the medically necessary treatment, but that prison officials refuse to provide the surgery. The district court dismissed the complaint at screening without leave to amend for failure to state a claim. Rosati, now represented by counsel, appeals. We have jurisdiction under 28 U.S.C. § 1291 ; we reverse the dismissal and remand for further proceedings.
In determining whether a complaint should be dismissed for failure to state a claim under the Prison Litigation Reform Act, 28 U.S.C. § 1915(e)(2)(B)(ii), we apply the familiar standard of Federal Rule of Civil Procedure 12(b)(6). See Watison v. Carter, 668 F.3d 1108, 1112 (9th Cir.2012). “[A] complaint must contain sufficient factual matter, accepted as true, to state a claim to relief that is plausible on its face.” Akhtar v. Mesa, 698 F.3d 1202, 1212 (9th Cir.2012) (quoting Ashcroft v. Iqbal, 556 U.S. 662, 678, 129 S.Ct. 1937, 173 L.Ed.2d 868 (2009) ) (internal quotation marks omitted).
Deliberate indifference to the serious medical needs of an inmate is “cruel and unusual punishment” under the Eighth Amendment.See Estelle v. Gamble, 429 U.S. 97, 104–06, 97 S.Ct. 285, 50 L.Ed.2d 251 (1976). To demonstrate deliberate indifference, “plaintiffs must show that [prison officials] were (a) subjectively aware of the serious medical need and (b) failed to adequately respond.” Conn v. City of Reno, 591 F.3d 1081, 1096 (9th Cir.2010), vacated, ––– U.S. ––––, 131 S.Ct. 1812, 179 L.Ed.2d 769 (2011), reinstated in relevant part, 658 F.3d 897 (9th Cir.2011). An inmate challenging denial of treatment must allege that the denial “was medically unacceptable under the circumstances,” and made “in conscious disregard of an excessive risk to [the inmate]'s health.” Jackson v. McIntosh, 90 F.3d 330, 332 (9th Cir.1996).
1. “A district court should not dismiss a pro se complaint without leave to amend unless ‘it is absolutely clear that the deficiencies of the complaint could not be cured by amendment.’ ” Akhtar, 698 F.3d at 1212 (quoting Schucker v. Rockwood, 846 F.2d 1202, 1204 (9th Cir.1988) (per curiam)). At oral argument, the state defendants conceded that the district judge erred by dismissing without leave to amend. This concession alone justifies reversal. But, even absent the concession, we conclude that the complaint, although not drafted with the skill and brevity expected of counsel, stated an Eighth Amendment claim upon which relief could be granted. See id. ( ).
2. Rosati's complaint plausibly alleges that she has severe gender dysphoria
, citing repeated episodes of attempted self-castration despite continued hormone treatment.2 Rosati also alleges that the medically accepted treatment for her dysphoria is SRS, supporting that allegation with copious citations to the World Professional Association for Transgender Health (“WPATH”) Standards of Care.3 Rosati plausibly alleges that prison officials were aware of her medical history and need for treatment, but denied the surgery because of a blanket policy against SRS. Indeed, the state acknowledged at oral argument that no California prisoner has ever received SRS. See, e.g., Colwell v. Bannister, 763 F.3d 1060, 1063 (9th Cir.2014) ( ).
Even absent such a blanket policy, Rosati plausibly alleges her symptoms (including repeated efforts at self-castration) are so severe that prison officials recklessly disregarded an excessive risk to her health by denying SRS solely on the recommendation of a physician's assistant with no experience in transgender medicine. See Pyles v. Fahim, 771 F.3d 403, 412 (7th Cir.2014) ( ); Hoptowit v. Ray, 682 F.2d 1237, 1252–53 (9th Cir.1982) (), abrogated on other grounds by Sandin v. Conner, 515 U.S. 472, 115 S.Ct. 2293, 132 L.Ed.2d 418 (1995).
Although Rosati lacks a medical opinion recommending SRS, she plausibly alleges that this is because the state has failed to provide her access to a physician competent to evaluate her.See De'lonta v. Johnson, 708 F.3d 520, 526 n. 4 (4th Cir.2013) (“Appellees ... take pains to point out that, absent a doctor's recommendation, De'lonta cannot show a demonstrable need for sex reassignment surgery. However, we struggle to discern how De'lonta could have possibly satisfied that condition when, as she alleges, Appellees have never allowed her to be evaluated by a [gender dysphoria
] specialist in the first place.”).
3. We express no opinion on whether SRS is medically...
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