On January 8, 2021, the United States Court of Appeals for the Eighth Circuit held that mid-litigation treatment of a prisoner’s gender dysphoria with hormone therapy mooted her claims, requiring dismissal.

Arkansas prisoner Stansel Alexander Prowse brought federal suit against Arkansas Department of Corrections (ADC) officials, alleging that ADC had a blanket policy of refusing to treat prisoners who suffer from gender dysphoria with hormone therapy. She sought injunctive relief, requiring prison officials to provide hormone therapy. Prowse also brought a nominal damages claim, but that claim was barred by Eleventh Amendment sovereign immunity because Prowse erroneously sued prison officials only in their officials capacities.

The district court dismissed the complaint with prejudice for failure to state a claim. Prowse appealed.

During oral argument, the parties alerted the Eighth Circuit for the first time that Prowse had been receiving hormone therapy for several months. The court then ordered a supplemental briefing addressing whether the case was moot.

In support of their brief, prison officials filed an affidavit of defendant Robert Parker, a member of ADC’s Gender Dysphoria Management and Treatment Committee. Parker explained that the committee approved Prowse for hormone therapy on May 21, 2020, after a prison psychiatrist and physician “determined that hormone therapy was clinically recommended for Ms. Prowse.” Parker also averred that Prowse had received hormone therapy “continuously” since then and “will continue to receive hormone therapy so long as her treating medical professionals determine that hormone therapy is clinically indicated or recommended.” Prowse did not dispute Parker’s claim that she has regularly received hormone therapy since May 2020.

The Court first noted that “a defendant cannot always moot a case simply by voluntarily ceasing its unlawful conduct after the plaintiff files suit,” and recognized “Prowse’s understandable concern that a ruling that her claim is moot might result in prison administrators ceasing to provide her with hormone therapy.” Nevertheless, it held that “the fact that Prowse is currently receiving hormone therapy renders moot her claim that ADC has a blanket policy of denying hormone therapy to” prisoners suffering from gender dysphoria.

Relying on Parker’s uncontested affidavit, the Court found “that it is unreasonable to expect prison administrators would deny her ‘clinically indicated’ hormone therapy in the future.” As such, it concluded that Prowse’s injunctive relief claim for hormone therapy was moot because “prison administrators have established that the unconstitutional conduct Prowse alleges ‘could not reasonably be expected to recur.’”

The Court also rejected new arguments that Prowse raised for the first time on appeal that the case is not moot because prison officials have denied her: (1) adequate medical monitoring of her gender transition; and (2) state-issued women’s clothing and personal hygiene products made available to female prisoners.

The Court found that although the first issue “may form the basis of another lawsuit,” it was “not properly before the court in this one and (does) not overcome mootness.” It then declined to consider the second issue, finding that Prowse “failed to meaningfully brief this issue on appeal.” See: Prowse v. Payne,_ F3d _ (8th Cir. 2021)

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