Druley v. Patton, 601 F. App'x 632

Ms. Druley, an Oklahoma prisoner, sues ODOC employees under 42 U.S.C. § 1983 for alleged Eighth Amendment and Equal Protection violations related to her transgender health care.
Prior to incarceration, she had gender-identity disorder and underwent two of three gender reassignment surgeries; name and birth records identify her as female.
She alleges hormone treatment was stopped/started irregularly and dosages were below World Professional Association for Transgender Health (WPATH) standards.
She seeks a TRO and preliminary injunction to raise hormone levels to WPATH levels, allow feminine undergarments, and move to non-air-conditioned housing.
The magistrate recommended denying injunctive relief; the district court adopted the recommendation, denying both TRO and preliminary injunction.
The appellate court lacks jurisdiction to review the TRO denial but has jurisdiction to review the district court’s denial of the preliminary injunction.

Issue	Plaintiff's Argument	Defendant's Argument	Held
Whether the TRO denial is appealable.	Druley seeks review of TRO denial as immediately appealable.	No final order or practical denial of an injunction; TRO denial not appealable.	TRO denial dismissed; not appealable.
Whether the district court abused its discretion in denying the preliminary injunction.	WPATH hormone levels are medically necessary; failure to provide them constitutes irreparable harm.	Insufficient medical evidence; no likelihood of success on merits; WPATH guidelines flexible; no irreparable harm shown.	Abuse of discretion not shown; denial affirmed.
Whether Druley can establish Eighth Amendment deliberate indifference to a serious medical need.	ODOC failed to provide required hormone therapy per WPATH; continued risk of harm without treatment.	No medical evidence demonstrating the specific levels; treatments are a medical judgment; not deliberately indifferent.	No substantial likelihood of success; no deliberate indifference proven.
Whether Druley can prevail on an Equal Protection claim based on housing and attire.	Transgender status warrants protection; denial of feminine attire and housing could be unequal.	Transgender status not a protected class for strict scrutiny; clothing/housing rationally related to penological interests.	No likelihood of success; rational relation shown.

Supre v. Ricketts, 792 F.2d 958 (10th Cir. 1986) (establishes standard for Eighth Amendment medical-care claims in prison)
Kosilek v. Spencer, 774 F.3d 63 (1st Cir. 2014) (recognizes flexible, individualized standards of care for transgender health)
Etsitty v. Utah Transit Auth., 502 F.3d 1215 (10th Cir. 2007) (no protected-class status for transgender employees in this context)
Brown v. Zavaras, 63 F.3d 967 (10th Cir. 1995) (dissenting/affirming treatment claims for transgender prisoners; equal protection considerations)
City of Cleburne v. Cleburne Living Center, 473 U.S. 432 (1985) (rational-basis review applies to non-suspect classifications)
Populist Party v. Herschler, 746 F.2d 656 (10th Cir. 1984) (distinguishes appealability of TROs and injunctions)
United States v. Colorado, 937 F.2d 505 (10th Cir. 1991) (practical effect requirement for TRO appeal denials)
Garza v. Davis, 596 F.3d 1198 (10th Cir. 2010) (liberal construction of pro se briefs in injunctive-review context)