Roy Mitchell, Jr. v. Kevin Kallas
895 F.3d 492
7th Cir.2018Background
- Mitchell, a transgender woman diagnosed with gender dysphoria in 2008, requested hormone therapy while incarcerated in Wisconsin in November 2011.
- DOC's multi‑step evaluation (including an outside consultant, Cynthia Osborne) took about 13 months; Osborne concluded Mitchell was an "excellent candidate" for hormone therapy.
- DOC Mental Health Director Dr. Kevin Kallas denied hormone treatment in January 2013 because Mitchell was scheduled for release within a month; DOC allegedly had an unwritten six‑month minimum rule for initiating hormones.
- After release on parole, parole agents forbade Mitchell from taking hormones or presenting as a woman and prevented her from following DOC's suggestion to seek community hormone treatment.
- Mitchell sued under 42 U.S.C. § 1983 claiming Eighth Amendment deliberate indifference by DOC clinicians and by parole officers; district court granted summary judgment for the clinicians and dismissed parole officers; Seventh Circuit affirms in part, reverses in part, and remands.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether delay in evaluation (≈13 months) and limited counseling amounted to Eighth Amendment deliberate indifference | Mitchell: Delay and failure to provide hormone therapy or effective treatment aggravated her serious medical need | Defendants: Resource limits and provision of counseling were adequate; delay not clearly unconstitutional | Delay alone (13 months) did not clearly establish liability; qualified immunity for delay claim (no clearly established law that this length was unconstitutional) but delay is troubling and factfinder may consider it |
| Whether denial of hormone therapy after Osborne's recommendation (based on imminent release/blanket six‑month rule) was deliberate indifference | Mitchell: Denial after individualized recommendation was effectively a total denial of needed care and was not a medical judgment but a blanket rule | Kallas: Decision based on medical judgment to allow stabilization time (unwritten six‑month practice) | Court: Jury could find deliberate indifference if denial rested on a blanket calendar rule rather than individualized medical judgment; summary judgment improper on this theory |
| Whether parole agents violated constitutional rights by forbidding Mitchell from seeking hormones or presenting as a woman after release | Mitchell: Parole agents blocked her access to community care and imposed gender‑presentation conditions that harmed her medical needs | Parole agents: No duty to provide care; conditions challenged as proper parole supervision | Court: Mitchell pleaded sufficient facts to proceed; parole agents may be liable for blocking a parolee from obtaining medically indicated care; dismissal reversed and remanded |
| Whether Dr. Laurent (psychological supervisor) is liable for deliberate indifference | Mitchell: Laurent was aware of distress and failed to act to secure timely treatment | Laurent: Lacked authority/involvement in Committee decisions; did not participate in denial | Court: Summary judgment for Dr. Laurent affirmed—insufficient personal involvement to impose § 1983 liability |
Key Cases Cited
- Estelle v. Gamble, 429 U.S. 97 (1976) (prisoners must rely on prison authorities for medical care; deliberate indifference to serious medical needs violates Eighth Amendment)
- Petties v. Carter, 836 F.3d 722 (7th Cir. 2016) (deliberate‑indifference standard requires actual knowledge and disregard of substantial risk)
- Fields v. Smith, 653 F.3d 550 (7th Cir. 2011) (refusal to provide effective treatment for gender dysphoria can violate Eighth Amendment)
- Arnett v. Webster, 658 F.3d 742 (7th Cir. 2011) (delays that exacerbate injury or prolong pain may constitute deliberate indifference)
- Perez v. Fenoglio, 792 F.3d 768 (7th Cir. 2015) (failure to provide specialist‑recommended care can be deliberate indifference)
- De'lonta v. Johnson, 708 F.3d 520 (4th Cir. 2013) ("some treatment" does not necessarily equal constitutionally adequate treatment)
- Meriwether v. Faulkner, 821 F.2d 408 (7th Cir. 1987) (psychological suffering can be a serious medical need subject to Eighth Amendment protection)
- McDonald v. Hardy, 821 F.3d 882 (7th Cir. 2016) (custodial staff who interfere with necessary medical care can violate the Eighth Amendment)