Amid waves of anti-transgender laws taking effect in the U.S., Makyyla Holland's case is helping to protect LGBTQ+ individuals incarcerated in Broome County, New York.

Holland's original complaint alleged that while incarcerated for six weeks in 2021, the transgender woman was denied access to her medication, including her hormone therapy and antidepressants; was beaten by correctional officers after refusing to take off her clothes in front of male guards; and was forced to live and shower with male inmates.

On Thursday, a settlement was announced. It includes a new countywide policy that mandates the housing of inmates consistent with their gender identity and access to gender-affirming care. Holland will also receive $160,000 as part of the deal.

Access to medication to treat Holland's gender dysphoria is considered medically necessary. Evidence has shown that trans individuals can struggle severely with mental health issues such as heightened anxiety and depression without it.

"It felt like I wasn't human," Holland told NPR of her time in the Broome County Jail.

Holland, now 25, filed the lawsuit in March 2022 with the aid of the New York Civil Liberties Union and the Transgender Legal Defense & Education Fund.

Her treatment was a result of the Broome County Jail's "pervasive policies, practices, and customs of discrimination against transgender people and people with disabilities," Holland's attorneys alleged in her lawsuit.

Her experience is one shared by many transgender people incarcerated in the United States. Being forced to stay in prisons and jails that don't align with their gender identity puts transgender individuals at greater risk of assault, discrimination and abuse, NPR's previous reporting has showed.

Holland's lawsuit pointed to the similar experiences of multiple transgender women who were held in custody at the Broome County Jail.

Additionally, a 2020 report found that since 2011, at least nine inmates had died at the Broome County Jail. Activists have disagreed with the official number and say at least 11 had died up until that point.

Holland's settlement viewed as a "great step"

Broome County's new policy under the settlement mirrors one reached in Steuben County, New York. As part of that settlement with Jena Faith, a transgender woman, the county agreed to change its jail policies to house people consistent with their gender identity, to respect an individual's name and pronoun changes and to provide gender-affirming care.

Gender-affirming care can include providing certain medical care, providing clothes and toiletries consistent with a person's gender identity and applying grooming standards consistent with a person's gender identity.

"It's just another really great step in terms of setting an example of how trans people in custody should be treated, not only in Broome County but across the state of New York as well as the country," said Shayna Medley, senior litigation staff attorney at the Transgender Legal Defense & Education Fund. "The policy that Broome County has adopted as part of the settlement is a really great example that we hope other localities can use."

Despite a growing level of anti-LGBTQ+ sentiment across the country, the legal defense fund and other advocacy organizations are succeeding in many lawsuits filed on behalf of other incarcerated trans individuals, Medley said.

"We're definitely seeing progress being made in the state and local level by many civil rights groups across the country," she said.

They still have to contend with the changing makeup of courts that can decide against them, but Medley says, "I think there's definitely momentum in this area."

Incremental lawsuits bring about change slowly, however.

"It would be difficult if not impossible to bring about the kind of wide-scale change we need through individual lawsuits. We need state law to do that," said Gabriella Larios, staff attorney at the New York Civil Liberties Union.

The NYCLU has been working to pass the Gender Identity Respect, Dignity and Safety Act, which would codify all the protections included in the Holland and Faith settlements into state law, said Larios.

After her experience, Holland said, she is working to move on.

"I'm happy it's over," she said. "I do hold some trauma from being incarcerated. But I do know that it is a healing process."

She said she hopes to advocate for her trans community and for those incarcerated in the future.

"No matter what is the reason that a person is incarcerated, we are all human," she said. "No matter what, we all deserve to be treated with dignity and respect."

Copyright 2023 NPR. To see more, visit https://www.npr.org.

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