Every day, when Kanautica Zayre-Brown walks the halls of Anson Correctional Institution in Polkton, North Carolina, she’s misgendered by her fellow inmates and correctional officers and called by her deadname.

Zayre-Brown, a transgender woman of color who received national media attention in 2019 following protests over her incarceration in a men’s facility, has been housed at Anson since her transfer on August 15, which only came after six months of public pressure from advocacy groups and community leaders.

In the U.S., the majority of transgender prisoners are housed in facilities that do not conform to their gender identities. Thus, Zayre-Brown’s transfer was a major victory. But now she faces a new obstacle: The N.C. Department of Public Safety has denied her the final gender-affirming surgery that would complete a medical transition she was undergoing prior to her incarceration.

“I feel like my mental health is depleting,” Zayre-Brown told the INDY recently. “I’m around females now and constantly reminded of my situation. It triggers my dysphoria even more.”

Zayre-Brown has asked the DPS to either provide her with vaginoplasty—the final surgery she views as necessary for her gender transition—or create a path where she can use her own resources to finance the procedure. According to Zayre-Brown, both requests have been repeatedly denied, even though they’ve been medically prescribed.

Zayre-Brown says that as a result of the denial, she’s been forced to purchase special undergarments that cost $100 a pair—at least six of them so far.

“Six hundred dollars is enough for me to get a doctor’s appointment at UNC,” Zayre-Brown says.

The state ACLU believes that denying Zayre-Brown gender-affirming surgery raises issues under the Eighth Amendment, which prohibits cruel and unusual punishment.

“Kanautica is just one example,” says Emily Seawell, the state ACLU’s acting senior staff attorney. “We know that there are other trans folks in the prison system in North Carolina and across the country. They are constantly misgendered, they are constantly deadnamed, and that is harmful to them. It causes them not just emotional harm—the suicide rates among trans folks are particularly high. And we know that trans women of color are targeted at much higher rates than anyone else in our population. So it’s an issue of safety for her, it’s an issue of personal agency and dignity. And it’s also an issue under the Eighth Amendment that she’s not being treated with cruel and unusual punishment.”

While the ACLU is representing Zayre-Brown, it would not comment on potential litigation. However, similar arguments have met with success elsewhere. 

In 2019, a three-judge panel on the Ninth Circuit Court of Appeals ruled that denying gender-affirming surgery to transgender inmates is prohibited under the U.S. Constitution. In 2014, the Fourth Circuit didn’t go quite so far; while it ruled that the court wasn’t required to provide the surgery to the inmate asking for it, it did say that denying it across the board violated the Eighth Amendment. 

DPS spokesman John Bull told the INDY in a statement that state law prohibited the department from discussing Zayre-Brown’s case. “What we can tell you is that requests for transgender accommodations, which would include medical procedures, by policy are reviewed by a multi-disciplinary committee. … Each individual’s situation is reviewed, and decisions [are] made on a case-by-case basis.”

Zayre-Brown says the media fervor that surrounded her case last year has died down since her transfer. 

“I guess, you know, needing medical care isn’t as fierce as me being transferred from a man’s facility to a female facility,” she says. “And I kind of understand that, but all this stuff is wrong. I understand I’m in prison, and I have to do my time. But they’re making it even harder for me.” 

Comment on this story at backtalk@indyweek.com. 

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