Several court cases have affirmed the right to receive treatment for gender dysphoria in federal prisons.
A federal judge in 2012 ordered the Massachusetts Department of Corrections to provide sex reassignment surgery for Michelle Kosilek, a transgender woman serving a sentence for murder. He ruled that the state had violated the inmates' constitutional rights in denying the surgery.
In federal prisons, guidelines for housing of transgender inmates in sex-segregated facilities are regulated by the Prison Rape Elimination Law.
An estimated 15,000 transgender people are serving in the military, according to NCTE, according to a 2011 National Transgender Discrimination Survey.
“They can’t even talk to a psychologist about this without being thrown out,” said Keisling. “And the psychologists can’t keep a secret. They have to report it out.”