Wolfe v. Horn

Decision Date29 January 2001
Docket NumberNo. 97-CV-3114.,97-CV-3114.
Citation130 F.Supp.2d 648
PartiesJessica E. WOLFE, v. Martin F. HORN, et al.
CourtU.S. District Court — Eastern District of Pennsylvania

Susan R. Becker, Stephanie G. Colman, Ballard Spahr Andrews & Ingersoll, Philadelphia, PA, for plaintiff.

Beth Anne Smith, Office of Atty. Gen., Philadelphia, PA, Benjamin A. Post, Post

& Schell, P.C., Craig A. Stone, John F. Yanick, Mette, Evans and Woodside, Harrisburg, PA, Brigid Q. Alford, Boswell, Tintner Piccola & Wickersham, Harrisburg, PA, Alan S. Gold, Senn Robins, Monaghan & Gold, P.C., for defendants.

MEMORANDUM AND ORDER

ANITA B. BRODY, District Judge.

In this action pursuant to 42 U.S.C. § 1983 and Pennsylvania law, Jessica E. Wolfe, a state prisoner, alleges: (1) deliberate indifference to her serious medical needs under the Eighth and Fourteenth Amendments to the United States Constitution, and Article I, Section 13 of the Pennsylvania Constitution, (2) violation of the Equal Protection Clause, and (3) medical malpractice. All of the defendants have moved for summary judgment.1

I will grant summary judgment in favor of all defendants on the equal protection claim, and dismiss the § 1983 damage claims against Martin F. Horn, Martin L. Dragovich and Kenneth D. Kyler on the basis of qualified immunity. I will deny summary judgment on the deliberate indifference and medical malpractice claims.

I. FACTUAL BACKGROUND

Wolfe is a male-to-female pre-operative transsexual.2 While retaining male genitalia, Wolfe suffers from a gender identity disorder that causes her to identify as a woman. Having experienced this disorder from a young age, Wolfe's medical history reflects depression, alcoholism and suicidal impulses.

In October 1994, Wolfe sought treatment at the Persad Center in Pittsburgh ("Persad"), which specializes in the treatment of transsexuals. In April 1995, Persad accepted Wolfe into a therapeutic program. In February 1996, following extensive psychotherapy, a Persad endocrinologist prescribed "Estrace" and "Lupron" hormones to suppress Wolfe's testosterone production and align her body more closely with her gender identity.3 Prozac was prescribed for Wolfe's depression.

On March 13, 1996, Wolfe was arrested and detained at Allegheny County Jail. Wolfe continued to receive hormonal treatment in Allegheny County Jail. On July 29, 1996, after being sentenced to a minimum term of five years imprisonment, Wolfe was transferred to SCI-Pittsburgh. Wolfe continued to receive hormonal treatment at SCI-Pittsburg.

On August 6, 1996, Wolfe was transferred to SCI-Camp Hill, where she was examined by John Mitchell Hume, M.D. Wolfe explained to Hume that she suffered from transsexualism, that an endocrinologist had prescribed hormones for her, and that she continued to receive such hormones at Allegheny County Jail and at SCI-Pittsburgh. Hume told Wolfe that he would discontinue hormonal treatment. In Wolfe's medical chart, Hume noted that hormones posed risks to Wolfe because she smoked, was forty pounds overweight and had marginally elevated blood pressure. Nevertheless, Hume agreed to refer Wolfe to another psychiatrist for a "second opinion." On September 27, 1996, that psychiatrist promised to reinstate Wolfe's hormonal therapy. However, Hume refused to approve hormonal treatment because there was no indication of such a promise in the files. Hume prescribed psychotherapy, group therapy and Prozac. Hume did not offer to gradually taper-off the hormones, advise Wolfe that she would endure withdrawal symptoms, or monitor Wolfe's progress through withdrawal.

In late September 1996, after Wolfe had exhausted her last supply of Estrace, she suffered severe withdrawal symptoms, including headaches, nausea, vomiting, cramps, hot flashes, and hair loss. In addition, the hormonal effects on Wolfe's breast size, body hair and voice pitch dissipated. As Wolfe reacquired masculine physical features, she became depressed and suicidal. On October 15, 1996, Hume told Wolfe that she had "survived the withdrawal," and would no longer receive any hormones.

Martin L. Lasky, D.O., Medical Director of SCI-Camp Hill, affirmed Hume's decisions. After personally evaluating Wolfe when she arrived at SCI-Camp Hill, Lasky instructed a Physician's Assistant not to refill Wolfe's Estrace prescription. Subsequently, Wolfe appealed to Kyler, Superintendent of SCI-Camp Hill, and Horn, Secretary of the Pennsylvania Department of Corrections. Kyler and Horn declined to interfere with Hume and Lasky's medical decisions.

On November 19, 1996, Wolfe was transferred to SCI-Mahanoy, where she remains incarcerated to date. At SCI-Mahanoy, she was evaluated by Louis Martin, M.D. and Peter Baddick, D.O. Neither Martin nor Baddick provided hormonal therapy to Wolfe. Initially, Martin provided monthly counseling sessions and prescribed Prozac. On January 6, 1997, Baddick determined that he would prescribe "no treatment at present." In a meeting on April 2, 1997, Baddick reported that hormones would not be prescribed because surgery was unavailable, and hormones might expose Wolfe to risks of cancer and thrombophlebitis. Wolfe appealed to Dragovich, then-Superintendent of Mahanoy, who declined to intervene.4

II. DISCUSSION

In this litigation, Wolfe does not seek a sex change operation, nor does she necessarily seek hormonal therapy or any particular cure. See Madera v. Correctional Medical Systems, 1990 WL 132382 * 3 (E.D.Pa.1990) (no "absolute" right to hormones). Rather, she seeks some form of therapy to alleviate her suffering from transsexualism while in prison. The defendants move for summary judgment on all of Wolfe's claims under 42 U.S.C. § 1983, the Pennsylvania Constitution, and Pennsylvania negligence standards.

Because analysis of the state-law claims may be facilitated by resolution of the Eighth and Fourteenth Amendment claims pursuant to § 1983, I begin with the elements of a § 1983 action: (1) the alleged misconduct was committed by a person acting under color of state law; and (2) the plaintiff was deprived of rights, privileges, or immunities secured by the Constitution or laws of the United States. See West v. Atkins, 487 U.S. 42, 48-57, 108 S.Ct. 2250, 101 L.Ed.2d 40 (1988). The defendants do not dispute that they were acting under color of state law. See id. However, they seek summary judgment on the Eighth and Fourteenth Amendment claims, and raise a number of defenses to suit under § 1983.5

Summary judgment is appropriate "if the pleadings, depositions, answers to interrogatories, and admissions on file, together with the affidavits, if any, show that there is no genuine issue as to any material fact and that the moving party is entitled to a judgment as a matter of law." Fed.R.Civ.P. 56(c); Celotex Corp. v. Catrett, 477 U.S. 317, 322-23, 106 S.Ct. 2548, 91 L.Ed.2d 265 (1986). A court must determine "whether the evidence presents a sufficient [factual] disagreement to require submission to a jury or whether it is so one-sided that one party must prevail as a matter of law." Anderson v. Liberty Lobby, Inc., 477 U.S. 242, 251-52, 106 S.Ct. 2505, 91 L.Ed.2d 202 (1986). At the summary judgment stage, the Court must view the evidence, and draw all reasonable inferences, in the light most favorable to the non-moving party. See Dici v. Com. of Pa., 91 F.3d 542, 547 (3d Cir.1996).

A. "Deliberate Indifference" Claims

When prison officials are deliberately indifferent to an inmate's serious medical needs, they violate the Eighth Amendment's ban against "cruel and unusual punishments." See Estelle v. Gamble, 429 U.S. 97, 97 S.Ct. 285, 50 L.Ed.2d 251 (1976). To establish this violation, two prongs must be met: (1) "deliberate indifference," (2) to a prisoner's "serious" medical needs. See Monmouth County Correctional Institutional Inmates v. Lanzaro, 834 F.2d 326, 346 (3d Cir.1987); West v. Keve, 571 F.2d 158, 161 (3d Cir.1978).6 Negligent malpractice, standing alone, is not actionable under the Eighth Amendment. See Estelle, 429 U.S. at 105-06, 97 S.Ct. 285; Durmer v. O'Carroll, 991 F.2d 64, 67 (3d Cir.1993); White v. Napoleon, 897 F.2d 103, 110 (3d Cir.1990).

Courts have consistently considered transsexualism a "serious medical need" for purposes of the Eighth Amendment. See Cuoco v. Moritsugu, 222 F.3d 99, 106 (2d Cir.2000); White v. Farrier, 849 F.2d 322, 325 (8th Cir.1988); Meriwether v. Faulkner, 821 F.2d 408, 411-13 (7th Cir. 1987). Accordingly, the defendants focus their summary judgment motions on the "deliberate indifference" prong, rather than the "serious medical needs" prong.

When a prisoner has received medical attention and merely questions its adequacy, courts hesitate to second-guess professional judgments under the guise of the Eighth Amendment. See Inmates of Allegheny County Jail v. Pierce, 612 F.2d 754, 762 (3d Cir.1979); United States ex rel. Walker v. Fayette County, 599 F.2d 573, 575 n. 2 (3d Cir.1979). Prisoners are only entitled to "some" kind of medical attention. See Farrier, 849 F.2d at 327; Meriwether, 821 F.2d at 413. Thus, courts have rejected demands for hormonal therapy by transsexuals who did not take hormones outside of the prison setting. See Maggert v. Hanks, 131 F.3d 670 (7th Cir. 1997); Long v. Nix, 86 F.3d 761 (8th Cir. 1996); Brown v. Zavaras, 63 F.3d 967, 970 & n. 2 (10th Cir.1995); Supre v. Ricketts, 792 F.2d 958 (10th Cir.1986); Farmer v. Carlson, 685 F.Supp. 1335 (M.D.Pa.1988); Lamb v. Maschner, 633 F.Supp. 351 (D.Kan.1986).

The case is different when prison officials terminate medical treatment that was previously recommended and administered by a medical professional. In Phillips v. Michigan Dep't. of Corrections, 731 F.Supp. 792 (W.D.Mich.1990), aff'd, 932 F.2d 969, 1991 WL 76205 (6th Cir.1991), the plaintiff had taken hormones immediately before incarceration, and her therapy was initially continued in prison. Upon plaintiffs transfer to a different facility, her hormones were withdrawn by a prison doctor....

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    ...v. Horn, 130 F.Supp.2d 648 (E.D.Pa. 2001). A pre-operative transsexual inmate brought a [ss] 1983 action against prison officials and medical professionals, alleging that their failure to permit him to continue hormone treatment therapy violated his constitutional rights. The district court......
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