On his first day back in office, President Trump signed an executive order that banned all forms of gender-affirming care for trans people in federal prisons. Six months later, a federal judge issued a preliminary injunction blocking the Bureau of Prisons (BOP) from enforcing the order. This block is still in effect today.
Despite the judge’s order, Uncloseted Media’s Hope Pisoni spoke with eight incarcerated trans women and reviewed legal statements by several more and found that the BOP is still denying trans people access to gender-affirming accommodations. Over the course of her monthslong investigation, Pisoni also found that the women who stood up for themselves reported being met with intense retaliation, from lengthened sentences to physical violence.
In the second episode of “UNCLOSETED, with Spencer Macnaughton,” Pisoni breaks down the investigation.
Watch the full podcast above or read the transcript below.
Spencer Macnaughton: Hi everyone, welcome back to UNCLOSETED with me, Spencer Macnaughton, a new podcast where we expand on our accountability-focused LGBTQ journalism that you may already be accustomed to from our Substack or our Instagram. And today, I am thrilled to have our very own investigative journalist, Hope Pisoni, on the pod to discuss her recent investigation that revealed how the Bureau of Prisons may be illegally denying trans incarcerated people gender-affirming care. Hope, welcome to the pod.
Hope Pisoni: Thanks so much for having me.
SM: So, let’s get right into it. You spoke to eight incarcerated trans women over the course of seven months, just unbelievable reporting, and you found that the Bureau of Prisons is illegally denying this care. Tell me a little bit more about how you discovered that and what you mean when you say they’re illegally denying them the care.
HP: So, it’s useful to take a quick step back and explain what has been happening in the Bureau of Prisons at the federal level in regards to trans people. On day one of his second term, President Trump signed an executive order which contained a number of anti-trans provisions in a number of public spheres, including specifically a ban on federal funds being used for gender-affirming care in prisons. The Trump administration was sued by the ACLU and Transgender Law Center in the coming months,claiming this is a violation of the Eighth Amendment’s ban on cruel and unusual punishment. A judge agreed in June that that challenge was likely to prevail in the case and issued what’s called a preliminary injunction, which means that the Bureau of Prisons was blocked from being allowed to enforce that executive order as the trial continues.
SM: So, Trump issues an executive order banning the care and then a judge intervenes and issues a preliminary injunction, meaning that that care should still, today, be legal for trans incarcerated people in federal prisons. Is that right?
HP: That’s correct.
SM: Got it. Okay, interesting. So then, you’re finding out, though, that this is not always happening, that the Bureau of Prisons isn’t still giving this care, which is supposed to be legally accessible. How specifically did you find that the trans women you spoke with aren’t able to get this care? What do you mean by that?
HP: I think it’s worth talking about, as well, what we mean by gender-affirming accommodations. There’s really three major categories, the first of which being gender-affirming health care, so hormone replacement therapy The second of which is more broadly termed social accommodations, which are things like chest binders for trans men or razors for trans women to shave facial and body hair, things that are really helpful, or female undergarments so that trans women do not have to expose their breasts to other inmates. All of these sorts of accommodations which are necessary to deal with gender dysphoria, and to just life in prison as the gender that they are. And the third is a more minor one, which was there used to be provisions that allowed transgender women to get a card that would exempt them from being searched by male guards. And those cards have also been revoked.
SM: And when it comes to hormones, obviously, those are things that can affect people physically. Some of these women have likely been waiting to get on them and are told they’re not gonna have them. What was the psychological impact for the women you spoke to when they realized they might not be able to get these hormones, which I know many of them describe as lifesaving?
HP: I spoke to some people who did indeed lose access. I spoke to a woman named Valerie, and she says she was not able to access her estrogen medication, which she had been on at that point for, I believe, 11 years, which is a very, very long time. And at that point, your body gets very used to the hormonal environment of being on medication, and the results of being off of it can be very damaging. She talked about being very on edge, very irritable, experiencing severe mood swings, all of these terrible emotional psychological effects, which is of course not to mention just the increase in dysphoria and the mental weight that that has.
I didn’t speak to this woman directly, but there was someone whose story I reviewed in legal documents who was also denied hormones for several months, who talks about having had dysphoria so bad as a result of being off of the hormones that she had essentially psychotic breaks where she was scratching at her arms trying to remove body hair that had been growing thicker and faster as a result of not being on estrogen and spironolactone.
Note: The declaration does not specifically describe these events as “psychotic breaks.”
SM: Wow, unbelievable and horrifying imagery there to think about from these conversations you had with some of these women. And we talk about gender-affirming care, and I think a lot of people know what we’re talking about when we say that, but when we say gender-affirming accommodations, there were a lot of other little things, like you mentioned: undergarments and razors. What did you learn about the impact that has when those things are taken away? Which, a lot of people might think, “Eh, it’s a razor or an undergarment.” What does this mean to these women, having those things removed as it relates to their gender identity?
HP: Yeah, and I completely understand what you mean when you say that for a lot of people, it’s not necessarily intuitive. Like, “Oh, why this is something that’s considered such a huge deal?” But the way that people explain it, it really starts to make sense. So, for instance, if you are a woman in prison and you’ve been on estrogen for a very long time, you have breasts and you have a female body, or a very visually understandable as female body, and in the federal prison you are surrounded by men, which means that you’re going to attract unwanted sexual attention. And say that you used to be able to have bras that you could wear, but the prison took them away. Now you don’t have a bra, and so whenever you’re forced to change in the communal showers or any other sort of scenario, you’re forced to expose your breasts to a crowd of men, and people describe how dehumanizing that can be, how objectifying that can feel. Or, for instance, with razors, I mean, this is something I can speak to myself. Facial hair is an extremely common and potent part of gender dysphoria for a lot of trans women and not being allowed access to good razors or being allowed to shave for very long periods of time could lead to growing a beard or a mustache, which a lot of people said can be, perhaps understandably, very bad for gender dysphoria because it heightens that incongruity.
SM: Yeah, that’s really interesting and something, as a cis man, I don’t have to think about, but it’s really fascinating to learn. So, I guess the basic question I have is: How? How are they allowed to just illegally remove a lot of this care? I mean, it’s illegal, no?
HP: Well, it’s illegal, but of course, the only people who are going to be able to report these things, a lot of the time, are the people incarcerated, and of course, they don’t have the same access to media in the outside world. For instance, in Kansas, you saw that the state took away people’s driver’s licenses, and we were able to hear about that almost immediately because people were posting on social media, reporting to the news, but if you’re in prison, you can’t necessarily do that. And more importantly, even though there are people like me who are reporters, talking to the people on the inside, the Bureau of Prisons has made a concerted effort to, in many of these cases, cut off access to the outside world. So, for starters, just the baseline things: Calls with people incarcerated, if you are not their lawyer, can only last up to 15 minutes at a time, and they have to front the bill a lot of the time as well to cover the costs of that.
SM: The incarcerated people do?
HP: Yes.
SM: Got it.
HP: So that’s an immediate barrier all on its own. While there are ways for news media representatives to schedule interviews with people, the ball is entirely within the Bureau of Prisons’ Court to decide whether or not that is allowed. So, I had multiple interview requests for longer conversations with people. One of them I just never ended up getting an answer back, and another one I was denied, told that me having an interview with that person would “[disrupt] the good order of the institution,” and I later found out from the woman that I had been trying to speak to that she was later informed by an official at her prison that if she called me on the phone, or any other reporter, she would be thrown in a more restrictive unit, which, as I mentioned earlier, more restrictive units often mean even more restrictions on access to gender-affirming care. So, it’s a double bind, and a lot of the time these women, even when people are looking, are cut off from being able to tell the press what’s happening. It’s just challenge after challenge after challenge.
SM: It’s interesting. You don’t think about how hard it would be to talk about injustice inside prison walls compared to the ease to which somebody could say, “Hey, I’m having my driver’s license revoked in Kansas.” So, it’s a really interesting comparison that you draw there.
Another theme that you found through your reporting was retaliation. When some incarcerated trans women that you spoke with tried to speak out, tried to raise their hand and say, “this isn’t right, this is illegal,” they report facing retaliation. One of the main folks in the piece was Grace Pinson, who is a prolific jailhouse lawyer, you describe her as. She’s serving time for mailing a death threat to President George Bush in 2007, but since she’s been in there, she has been a major activist and advocate for not just herself, but many other trans folks housed in prison. Is that right? Tell me about Grace and the retaliation she’s faced.
HP: Yeah, so Grace has represented herself and won in multiple cases against the Bureau of Prisons, which, as I’m sure you can imagine, is very unusual. There was some coverage of this a couple years ago with the Marshall Project, and she’s also, like you mentioned, helped over—I believe I got a list that had over 20 people on it, both cis and trans at her prison, that she’s helped advocate for themselves and stand up for their rights and represent themselves. And that of course means that she has an extra target on her back, especially because she’s been very vocal for most of the time that the lawsuit has been running about the treatment that she’s faced, about the denial of gender-affirming care and gender-affirming accommodations that she’s faced and about the retaliation that she’s faced.
SM: And you mentioned in the report that there was an incident where she was assaulted by staff in October. What happened there?
HP: Yeah, so I later heard about this both from her over the phone, and from a couple people who witnessed it over the phone and in a legal declaration submitted by her to the court. She was assaulted by staff, they broke her arm, they cut the clothes off her body, walked her down the hallway naked and left her in restraints around her torso, wrists and legs for 10 hours. And I want to read something from the legal declaration that she says she was told by a prison official. She says he told her, “Don’t play the victim. I know what you’ve been writing to that judge in DC. You did the crime and put yourself here. You know you were born with a penis and would be put in a male prison. The judge doesn’t run this prison. I run this prison.”
SM: Wow, that is a harrowing description and a harrowing quote. In a report, the BOP did confirm that the altercation took place, but they claimed that it was not in retaliation for Pinson’s advocacy and that she sustained “minor injuries.” It’s just crazy, these examples you give, Hope. I mean, the retaliation, the suppression of being able to speak with the media and then just the inability to genuinely access this care. You’ve done a lot of reporting on trans incarcerated people now, you did another story on state prisons. What have you learned about how the public views the incarcerated population, and the trans incarcerated population, based on the responses that you’ve received? I know we’ve had a lot of feedback on these articles.
HP: It has been good to see that within trans communities, there are people who do care about these issues. It’s obviously a very important and very egregious violations of rights. But there’s also been some pushback to all of the prison reporting that I’ve done. Especially my first article, which was about state prisons across the US, got a lot of pushback, especially because it got picked up by an anti-trans publication online, which was taking great issue with the fact that some of the people who were featured in that story had, in fact, done very horrible things to end up in prison. I won’t sugarcoat it. Some of the people that I’ve spoken to for both of these stories have done very horrible things to end up in prison. Some haven’t, some have. And we got a lot of pushback because of that. That article on our article picked up some decent traction.
SM: And Hope, what do you think of that on a personal level? When people say, “Look, why do these people who have done such horrible things deserve rights? They shouldn’t even have them.” That’s what a lot of the rhetoric became, especially in these far-right spaces. What do you say to that?
HP: I think that you can learn a lot about a society and a culture by seeing how they treat the most vulnerable people among them. Seeing how they treat people who are least seen as people, in a way, you could say. Incarcerated people are very vulnerable and very stigmatized, as are trans people. In the intersection between that, you see this very intense dehumanization and depersonalization, where, I think it should be fair to say, in a just society, that no matter what someone has done or no matter how we feel about someone, they should not be faced with cruel and unusual punishment. And I think that the things we’ve described, like being beaten, being put in chains, having your healthcare taken away, being forced into hormonal imbalance, all of these things are cruel and unusual. And the reason that I think that these attitudes say so much about a society and say so much about a culture is that, in a way, it shows us how people think it’s okay to treat someone when they can get away with it. “This treatment is okay for these people,” ultimately means “this treatment is okay for people.” And on a personal level, I don’t think that’s right, I don’t think that’s just and I don’t think that’s constitutional either, frankly.
SM: Well, we’re learning it is not constitutional, but they’re still operating in that way, hence the importance of your investigation. And also, I’ve learned this in the past, too. I remember when I was doing a story on far-right people way back at 60 Minutes and Nick Fuentes, the far-right nationalist, put my head, photoshopped it and put 11 of my head in an egg carton, and it went viral on Twitter. And some of these far-right people even posted your picture and started retweeting it as the journalist with these threatening messages. I mean, you cover a lot of really important stories on the LGBTQ community and the trans community. What’s that been like, receiving even just a bit of that pushback from folks who are so adversarial and immediately go on the offensive, in certain ways in a threatening manner?
HP: Yeah, there was a major right-wing influencer who tweeted about the article about our article, posted my face. There was a lot of nasty stuff that was being said about me, some very transphobic, some antisemitic, actually. I do think that it is interesting. I mean, at the end of the day, I’m fine. I’ve been able to put the distance between it and me to not have it really affect me mentally so much. But more than anything my reaction is, I think it’s interesting and indicative of some of the stuff I was just talking about, that for all of the controversial topics that I’ve talked about thus far, that the thing that has gotten me the most hate and the most negative attention by far is saying that people who do bad things don’t deserve to be abused and don’t deserve to have their rights violated. And again, I think that’s just very telling of where the cultural conversation is about incarcerated people, and even additionally how that compounds with the intense amounts of transphobia in society right now.
SM: It’s interesting, you say, the intersection of incarcerated folks and trans folks and the way people feel like they can treat that intersection just because of who they are. And Hope, I mean, where do we go now? Are they still operating illegally? What’s next for the women you spoke to? Do they just have to deal with it until further notice? What can we look for moving forward?
HP: So, the lawsuit is still ongoing. There was a fairly major development which actually broke into some news outlets in February. It’s worth noting that there had been these developments for a while, but there wasn’t a lot of news pickup until recently. The Bureau of Prisons released a new policy, which got some coverage because it’s very awful. It essentially codifies that even people who have been on hormones for years will be weaned off of them gradually and that people who [don’t] already have them will not be able to get them, which is essentially what the executive order and the memo were always saying, but said in more specific terms. I do want to note about that, I have seen a lot of coverage of this policy that has reported its passage somewhat straightforwardly, saying this is a new policy, this is what’s going to be happening now. I want to qualify that it’s a little bit more complicated than that. Checking the text of the policy and speaking with the lawyers on the case reveals that it is also covered by the preliminary injunction. So, in theory, it also should not be enforced by the BOP until the injunction is either lifted or what have you in the case of what happens with the lawsuit.
Now, as we’ve just spoken about, whether or not they’ll actually follow that is unclear. We’ve just spoken about how many times that they’ve violated the injunction in just the past year without this policy. But for what it’s worth, I spoke on background with a staff member at one prison, and I spoke with a few people who are incarcerated as well for updates. And it sounds like in the vast majority of cases, nothing has really changed, that the status quo of some violations and sometimes just malicious compliance, you could say, that’s still the same, nothing has changed. And it seems that the goal of this policy is, rather than to be introducing a new thing now, to be on the books so that when the injunction gets lifted, there’s immediately a plan and a policy to go into effect to take away these hormones and all of those things. I do want to note—there is one person for whom this new policy does seem to be in effect, and that is Grace Pinson. I got multiple people who reported to me that she, and as far as I can tell, only she—I have not gotten any other reports from any other people—did have her hormones taken away almost immediately. Which, again, is just in my eyes, a very clear form of retaliation. And not just in my eyes: This almost immediately meant that the BOP was brought back in front of a judge because he had just told the BOP to clamp down on the retaliation. And then mere days later, oh look, one of the biggest advocates suddenly had her hormones taken away. So, it’s not just my opinion. It’s also that the BOP has come under a distinct amount of scrutiny from the judge in the case for their claims that they’re not retaliating.
SM: And when it comes to the women that you spoke to, it must be just so much uncertainty, so much fear, how are they feeling? Is there any takeaway about how they’re feeling with the uncertainty of what’s happening from a legal perspective in the outside world right now?
HP: Yeah, I got a lot of messages and calls from people after that new policy went forth. I had some people who were crying on the phone. People were really, really concerned. And that’s another part of things, right? This is a thing we talk about with a lot of anti-trans policies at all levels affecting all people. You don’t always know what’s going to be enforced and what isn’t, but that’s part of how it works. It’s a scare tactic. It pushes people in an environment of fear to either sit down and shut up or, in some cases, even go back into the closet. And it’s very disconcerting.
SM: I mean, one thing that is certainly only gonna help is explaining what’s happening in there and reporting these stories. So I’m really grateful to you for doing this investigation and all your work in this area. And the Federal Bureau of Prisons did get back to you via email. Their Office of Public Affairs, Scott Taylor from there said “We do not address allegations, and for privacy, safety, and security reasons, the Federal Bureau of Prisons does not discuss the conditions of confinement for any individual in custody. Additionally, the BOP does not comment on matters related to pending litigation or ongoing legal proceedings.” If you want to see their full response, you can head to unclosetedmedia.com. Hope, thank you so much for coming on the podcast and sharing this really important investigation. If you want to read Hope’s full investigation, head to unclosetedmedia.com, and please subscribe and like and follow UNCLOSETED with me, Spencer Macnaughton. You can find us anywhere you get your podcasts or on YouTube. Thanks again, Hope.
HP: Sure, thanks for having me.
