Scott Gibson v. Bryan Collier
920 F.3d 212
| 5th Cir. | 2019Background
- Plaintiff Scott L. Gibson, a male-born Texas prisoner diagnosed with gender dysphoria, received counseling and hormone therapy and repeatedly requested sex reassignment surgery (SRS); a TDCJ clinic note indicated an evaluation was ordered but TDCJ denied referral under Policy G-51.11.
- Gibson sued pro se seeking injunctive relief to require TDCJ to evaluate him for SRS, alleging Eighth Amendment deliberate indifference based on a categorical policy barring SRS.
- The Director moved for summary judgment only on immunity grounds (qualified and sovereign). The district court denied immunity defenses but sua sponte granted summary judgment on the merits without prior notice to Gibson.
- The Fifth Circuit reviewed de novo and affirmed on the merits: it concluded (1) there is significant, good‑faith medical disagreement about the necessity/effectiveness of SRS and (2) denial of SRS (and refusal to evaluate where SRS is controversial and rarely provided) is not necessarily "cruel and unusual."
- The court relied heavily on the First Circuit’s en banc decision in Kosilek v. Spencer to show lack of medical consensus and emphasized that a practice cannot be "unusual" if widely followed (no state had voluntarily provided SRS to inmates before litigation-driven California relief).
- Judge Barksdale dissented, arguing procedural error (sua sponte summary judgment without notice/allowing discovery), that the record was insufficient, and that individualized medical assessment (including the ordered-but-withheld evaluation) could show deliberate indifference.
Issues
| Issue | Plaintiff's Argument | Defendant's Argument | Held |
|---|---|---|---|
| Whether denial of evaluation/provision of SRS violates the Eighth Amendment (deliberate indifference) | Gibson: TDCJ’s policy operates as a blanket ban preventing individualized medical assessment and thus shows deliberate indifference to his serious medical need | Director: TDCJ provided treatment (counseling, hormones); SRS is medically controversial so refusal is not deliberate indifference | Held for Director: medical controversy over SRS means no Eighth Amendment violation as a matter of law |
| Whether medical consensus exists that SRS is "medically necessary" for gender dysphoria | Gibson: WPATH Standards support that SRS is medically necessary for many patients | Director: WPATH is contested; respected experts disagree about necessity/efficacy | Court: No medical consensus; Kosilek establishes substantial disagreement, defeating claim |
| Whether a categorical policy barring SRS is per se unconstitutional absent individualized assessment | Gibson: categorical refusals can constitute deliberate indifference when not based on medical judgment | Director: States may refuse contested treatments; widespread practice of denying SRS makes refusal not "unusual" | Court: Not unconstitutional; widespread non‑provision weighs against finding "unusual" punishment |
| Whether appellate court should reach the merits given procedural defects below (sua sponte summary judgment; lack of discovery) | Gibson/Dissent: procedural defects require remand for discovery and an individualized inquiry | Majority: Gibson (now with counsel) asked the court to reach the merits and forfeited procedural objections; record shows futility | Court: Reached merits and affirmed summary judgment on substantive grounds; dissent would remand |
Key Cases Cited
- Estelle v. Gamble, 429 U.S. 97 (1976) (Eighth Amendment forbids deliberate indifference to serious medical needs)
- Kosilek v. Spencer, 774 F.3d 63 (1st Cir. en banc 2014) (no medical consensus that SRS is universally necessary; prison choosing alternative treatments did not violate Eighth Amendment)
- Delaughter v. Woodall, 909 F.3d 130 (5th Cir. 2018) (mere disagreement with medical treatment insufficient for Eighth Amendment claim)
- Norton v. Dimazana, 122 F.3d 286 (5th Cir. 1997) (prisoners are not entitled to preferred treatment; disagreement among professionals does not establish deliberate indifference)
- Celotex Corp. v. Catrett, 477 U.S. 317 (1986) (summary judgment standard and movant’s burden to show absence of genuine issue)
- Leatherman v. Tarrant County Narcotics Intelligence & Coordination Unit, 28 F.3d 1388 (5th Cir. en banc 1994) (requirement of notice before sua sponte grant of summary judgment to nonmovant)