Ophelia De'Lonta v. Gene Johnson
2013 U.S. App. LEXIS 2005
| 4th Cir. | 2013Background
- De’lonta is a Virginia inmate and pre-operative transsexual with gender identity disorder (GID).
- She sues under 42 U.S.C. § 1983 claiming denial of adequate medical treatment violates the Eighth Amendment.
- District court dismissed for failure to state a claim; the appeal reverses and remands.
- Post-settlement with VDOC, De’lonta has received hormone therapy, counseling, and cross-dressing allowances, but persistent GID symptoms remain.
- She has repeatedly urged for sex reassignment surgery per the Standards of Care, but has never been evaluated by a GID specialist.
- The court holds the complaint plausibly alleges deliberate indifference by officials in denying consideration for surgery.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether denial of surgery consideration plausibly shows deliberate indifference | De’lonta alleges persistent, severe GID symptoms and requests surgery. | Plaintiffs lack a constitutional right to preferred treatment; denial is not deliberate indifference. | Yes; claim plausibly alleges deliberate indifference. |
| Whether existing treatment suffices to negate deliberate indifference | Therapy and hormone treatment are insufficient to address ongoing risk. | Some treatment aligns with Standards of Care; not failure of care. | Not dispositive; ongoing need for surgery evaluated. |
| Whether settlement of earlier suit forecloses new Eighth Amendment claims | Settlement cannot immunize ongoing constitutional issues. | Settlement bars later claims. | Settlement does not foreclose potential deliberate indifference review. |
Key Cases Cited
- Farmer v. Brennan, 511 U.S. 825 (U.S. 1994) (deliberate indifference standard; knowledge of risk required)
- Ashcroft v. Iqbal, 556 U.S. 662 (U.S. 2009) (plausibility standard for pleading claims)
- Bell Atl. Corp. v. Twombly, 550 U.S. 544 (U.S. 2007) (pleading must state plausible claims)
- De’lonta I, 330 F.3d 630 (4th Cir. 2003) (recognizes duty to protect from self-destruction; deliberate indifference standard applied)
- Bowring v. Godwin, 551 F.2d 44 (4th Cir. 1977) (medical necessity standard governs treatment adequacy)
- Cooper v. Dyke, 814 F.2d 941 (4th Cir. 1987) (government officials may be liable for inadequate treatment even if not completely deprived)
- Langford v. Norris, 614 F.3d 445 (8th Cir. 2010) (inadequate care can violate Eighth Amendment; not only total deprivation)
- Lee v. Downs, 641 F.2d 1117 (4th Cir. 1981) (prisoners must be protected from self-destructive behavior)