Monroe

IN THE UNITED STATES DISTRICT COURT

FOR THE SOUTHERN DISTRICT OF ILLINOIS

JANIAH MONROE,1

MARILYN MELENDEZ,

LYDIA HELÉNA VISION,

SORA KUYKENDALL, and

SASHA REED, individually and on behalf

of a class of similarly situated individuals,

Plaintiffs,

v. Case No. 3:18-CV-156-NJR

LAMENTA CONWAY,

MELVIN HINTON, and

LATOYA HUGHES,

Defendants.

MEMORANDUM AND ORDER

ROSENSTENGEL, District Judge:

On September 12, 2025, and December 11, 2025, the Court ordered preliminary

injunctive relief (Docs. 1008, 1009, 1070, 1071) to address certain unconstitutional

conditions at Menard Correctional Center (“Menard”) affecting inmates seeking

treatment for gender dysphoria. Pursuant to the Prisoner Litigation Reform Act

(“PLRA”), the Court’s December expired after 90 days, on March 11, 2026. See 18 U.S.C.

§ 3626(a)(2). Plaintiffs, once again, have asked the Court to re-issue the preliminary relief

for a further 90 days (Doc. 1111). On March 12, 2026, the Court heard testimony at an

evidentiary hearing. At the conclusion of the hearing, the Court announced from the

bench its decision to re-issue the injunction. The Court set out the specifics of the

1 The named Plaintiffs, and many members of the Plaintiff class, use chosen names reflecting their gender

identity rather than their given names at birth, which may not match the name in IDOC records.

injunctive relief in a separate order. (Doc. 1124). This memorandum and _ order

summarizes the evidence adduced at the hearing and explains why the Court determined

injunctive relief remains necessary.

BACKGROUND

The Court recounted the lengthy history of this litigation in its September 2025

order and incorporates by reference that portion of its decision. (Doc. 1008).

This case was brought in January 2018 on behalf of a class of Plaintiffs, certified as

“all prisoners in the custody of IDOC who have requested evaluation or treatment for

gender dysphoria.” (Doc. 213). The named Plaintiffs are transgender women currently

incarcerated in Illinois Department of Corrections (“IDOC”) facilities. The named

Defendants are, respectively, the Acting IDOC Medical Director, IDOC’s Chief of Mental

Health, and the IDOC Director, all sued in their official capacity.

Plaintiffs assert that Defendants’ policies and practices subject the class to a

substantial risk of serious harm and injury from inadequate and delayed evaluation and

treatment of gender dysphoria, in violation of their rights under the Eighth Amendment,

and they seek injunctive relief to remedy the flaws in IDOC’s treatment of transgender

inmates. (Doc. 1, pp. 36-38; Doc. 935).* The alleged problems include the IDOC’s:

e use of committees comprised of unqualified officials to make decisions

regarding the medical treatment, security, and placement of transgender

inmates;

e widespread delays or denials in evaluating prisoners for gender dysphoria

and in providing hormone therapy and hormone monitoring;

2 Plaintiffs filed a supplemental complaint on May 15, 2024 (Doc. 935), to which Defendants responded at

Doc. 968.

Page 2 of 30

e failure to consider or provide gender-affirming surgery as part of medically

necessary treatment for gender dysphoria;

e failure to accommodate and facilitate social transition for individuals with

gender dysphoria, including lack of access to gender-affirming clothing and

grooming items, failing to make individualized housing placement

decisions, and permitting cross-gender strip searches; and

e failing to provide access to medical and mental health providers competent

to treat gender dysphoria.

The Court issued several rounds of injunctive relief to Plaintiffs during the initial

phase of the litigation. On December 5, 2024, the Seventh Circuit Court of Appeals

vacated the then-operative injunction, concluding it had expired 90 days after its

issuance, pursuant to the Prison Litigation Reform Act (“PLRA”). Monroe v. Bowman,

122 F.4th 688 (7th Cir. 2024).

After the case returned to this Court, Plaintiffs filed a supplemental complaint, and

the Court issued an amended scheduling order to govern the proceedings on remand.

(Docs. 935, 1000). Plaintiffs also moved for a preliminary injunction requiring Defendants

to transfer class members out of Menard Correctional Center, a maximum-security level

prison, to another IDOC facility. (Docs. 873, 874). The Court held an evidentiary hearing

on the motion from May 27-30, 2025, and heard testimony from 13 witnesses.

On September 12, 2025, the Court granted Plaintiffs’ motion and ordered several

remedial measures. (Doc. 1009). First, Defendants were to file, under seal by September

19, 2025, a list of class members presently housed at Menard.* Second, Defendants were

3 Defendants complied with this directive at Doc. 1011-1 and Doc. 1013.

Page 3 of 30

to transfer every class member residing at Menard to another facility by October 15, 2025.4

The Court cautioned Defendants against transferring any class member to Pinckneyville

Correctional Center in light of issues with that facility discussed in prior orders.

(Doc. 680). Third, the Court directed Defendants to consider each class member’s specific

gender dysphoria condition, their gender identity, related safety issues, and whether a

transfer to a facility matching their gender identity would be appropriate in assessing

where each class member would be transferred. Fourth, Defendants were to notify each

class member of their new placement at least seven days before their transfer and provide

an explanation of the reasons for the decision. A copy of each decision also was to be

furnished to class counsel. Fifth, the Court barred Defendants from placing any class

member at Menard going forward and instructed Defendants to assign class members to

a different institution if they arrived at Menard through the intake process. If an

individual housed at Menard later is identified as a class member, they must be

transferred within 21 days. Sixth, if a class member was not moved to Logan Correctional

Center (a women’s facility) or another facility matching their gender identity, they were

to be permitted to submit a request to transfer to such a facility within 60 days of the

initial transfer. Seventh, Defendants were to provide the Court and class counsel monthly

reports on the status of class members housed at Menard and the timing and result of

any transfer decisions. Finally, Defendants were to provide a status report regarding

certain matters “in progress” as of the May 2025 evidentiary hearing, including the status

4 Defendants submitted a list of 38 individuals who were transferred from Menard as of October 16, 2025

(Doc. 1025).

of mental health staff vacancies at Menard.5 The Court also announced that it would hold

a subsequent evidentiary hearing within 90 days “to evaluate whether the above

injunctive relief shall be extended.” (Doc. 1008, p. 71). Defendants filed an interlocutory

appeal of the preliminary injunction on October 10, 2025 (Doc. 1006) and subsequently

moved to stay portions of the September order pending the appeal. (Doc. 1024). The

Court denied the motion for a stay on November 24, 2025. (Doc. 1048).

Plaintiffs moved to re-issue the injunction on October 24, 2025. (Doc. 1028). After

conducting an evidentiary hearing on December 8, 2025, the Court concluded that the

injunction should be re-issued with terms substantially similar to the prior order.

(Doc. 1070). The Court narrowed the scope of the relief slightly, however, requiring

Defendants to transfer from Menard only those class members with a confirmed gender

dysphoria diagnosis. (Id. at p. 32). The Court ordered that inmates housed at Menard who

seek an evaluation for gender dysphoria should be assessed within seven working days

and directed IDOC to confirm the diagnosis “in its sole discretion” within 14 days of the

evaluation. (Id.). If IDOC confirmed that an inmate at Menard suffered from gender

dysphoria, the inmate was to be transferred to another facility within 21 days. (Id.).

Defendants appealed the re-issued injunction, and the Seventh Circuit consolidated the

appeal with the appeal of the prior injunction. See Monroe v. Hughes, Nos. 25-2803/25-

3256 (7th Cir.). Both appeals remain pending.

On February 27, 2026, Plaintiffs moved to re-issue the preliminary injunction for

5 Defendants filed this report at Doc. 1011.

an additional 90 days. (Doc. 1111). Defendants filed a response in opposition. (Doc. 1120).

The Court held an evidentiary hearing on March 12, 2026. At the conclusion of the

hearing, the Court announced from the bench that it would grant Plaintiff’s motion.

EVIDENTIARY RECORD

A. Stipulations of Fact

Prior to the hearing, the Parties stipulated to the following facts:

1. Menard serves as an intake Facility for the Illinois Department of

Corrections (“IDOC”).

2. Warden [Anthony] Wills retired on January 1, 2026. Effective December 24,

2025, IDOC named Matthew Plummer as the day-to-day Warden of

Menard.

3. The day-to-day Warden of Menard is responsible for approximately 2000

individuals in custody housed at Menard maximum and medium security

units and 800 staff.

4. No warden within IDOC has the authority to hire or fire IDOC staff.

5. IDOC currently employs approximately 21 mental health professionals at

Menard ranging from Behavioral Health Technicians through Physician.

6. There are currently 12 vacancies for mental health providers assigned at

Menard.

7. West House currently does not have cameras located within the housing

unit.

(Doc. 1111-1).

B. Plaintiffs’ Evidence

1. C.H.6

C.H., who identifies as a transgender woman, testified via video from Menard

Correctional center, where she currently resides. She realized at the age of four that she

identified as a woman. Before her incarceration, she talked to a therapist and learned

about treatment options, such as medication, but she did not pursue them at the time.

Prior to arriving at Menard, C.H. was in the Sangamon County Jail and Graham

Correctional Center. At Sangamon County, she sought treatment for gender dysphoria

but was only offered protective segregation. After arriving at Graham on May 1, 2025,

she told a nurse and officers that she was transgender. C.H. was told she would be

referred to a counselor, but that never happened, and she was not evaluated for gender

dysphoria.

C.H. was transferred to Menard on June 25, 2025, and she told a guard that she is

a transgender woman. The guard advised her to write the unit counselor, which she did,

but she got no response.

C.H. testified that Menard guards frequently voice anti-trans slurs when walking

past her cell and have threatened her with physical harm, making comments like, “This

isn’t the time to be a tranny. You could find yourself hanging from the bars,” and “Same

thing happened to one of our staff, it happened to a tranny here.” Regarding the second

comment, C.H. learned the guard referred to an officer who had been badly beaten.

6 The Court will refer to the class member witnesses by their initials, as their testimony includes highly

sensitive personal health information. (See Order at Doc. 966, granting motion to redact transcripts).

C.H. is so fearful of an attack that she is scared to leave her cell. In or about October

2025 she told her cellmate she is transgender. He threatened to kill her in her sleep or beat

her if she left her bed. She was so fearful of going to sleep that she refrained from taking

the mental health medications that made her sleepy. She wrote multiple letters to her

counselor, unit sergeant, and other officers seeking protection. She was moved to

protective custody (“PC”) in the West House on October 7, 2025, where she remains. But

she continues to be fearful in PC because her cellmate there has threatened her, guards

make disparaging comments and threats, and she has seen what other inmates do to

transgender prisoners. There are no surveillance cameras in the West House PC area. She

wrote multiple requests for a single cell to her counselor, as recently as last week, and

made the same request to mental health staff, but neither responded.

C.H. notified Mental Health in October 2025 and November 2025 that she is a

transgender woman. She made a transfer request and filed another grievance, and on

January 6, 2026, a guard brought her a transfer sheet to fill out listing which three prisons

she preferred for transfer (this document was admitted as Plaintiffs’ Exhibit 1). She met

with Ms. Klausing (Menard’s transgender coordinator) after completing the transfer

request. In late January 2026, C.H. had a brief telepsychiatry appointment evaluate her

for gender dysphoria. That doctor told C.H. she would be seen again for evaluation via

telepsych, but no follow-up has yet occurred. She wrote Mental Health again and filed a

grievance in February 2026 seeking transgender care. Menard officials have not

diagnosed C.H. with gender dysphoria. Documents submitted to the Court show that a

telepsych appointment for C.H. on February 24 or 25, 2026, was canceled (Sealed Doc.

1112-3, Declaration of C.H.). C.H.’s Gender Dysphoria Evaluation of January 24, 2026,

noted she has had four of the six characteristics for gender dysphoria for at least six

months (only two are required) and experienced “significant distress or impairment in

social, occupational, or other important areas of functioning.” (Sealed Doc. 1112-6).

However, the evaluator did not confirm a diagnosis of gender dysphoria, noting:

At this time, there is insufficient information to determine whether the

patient meets DSM-5 criteria for Gender Dysphoria. This was the provider’s

initial encounter with the patient, and the evaluation is limited by lack of

prior records and collateral information. [The evaluator’s final sentence is

cut off and unreadable.]

Id.

C.H. wants to take hormones to connect with her feminine side. She allows her

facial hair to grow in hopes she will be left alone if she looks like a “manly man.”

However, that forces her to be something she is not and causes her distress, and she

continues to be targeted. She was mocked for trying to purchase gender affirming items

at commissary, which staff refused to sell to her, so she stopped asking. Her unit

counselor has not responded to her letters requesting access to those commissary items.

She has never been allowed a private shower at Menard despite many written requests

to the unit counselor. She washes up in her cell when her cellmate is asleep.

C.H. has not been transferred out of Menard and has not received a response to

her transfer request. The list of transgender inmates at Menard for January 28, 2026

(Doc. 1112-7), produced by Defendants pursuant to the December 2025 injunction, shows

C.H. as “REMOVED (no GD).”

C.H. wants to transfer because the threats, harassment, and bullying put her in

fear for her life and it seems nobody takes her requests for protection seriously.

2. S.J.7

S.J., who uses they/them pronouns, testified via video from Pontiac Correctional

Center, where they have resided since a transfer from Menard on January 21, 2026.

S.J. identifies as transgender and non-binary. They knew they were transgender since

they were about 13 years old.

S.J. informed staff at Menard that they were transgender when they first assigned

there in 2014, but they were not evaluated for gender dysphoria at that time. They raised

the issue again in October 2025 as part of a grievance and in letters to mental health staff

and Menard’s transgender coordinator and followed up multiple times after failing to

receive a timely evaluation. When they met with the transgender coordinator in

December 2025, she informed S.J. that a person cannot be both transgender and non-

binary, which caused S.J. confusion. S.J. ultimately received a confirmatory diagnosis for

gender dysphoria and was transferred to Pontiac on January 21, 2026, pursuant to the

December injunction. Presently, they are not seeking hormone therapy out of concern

that it could make them vulnerable in the prison setting, but they might be interested in

that treatment if they are transferred to a facility with a lower security classification.

S.J. stated that while housed at Menard, guards denied their requests for a private

shower and directed them either to shower with other inmates or wash up in their cell.

They ultimately opted for the latter. They also testified that staff would not sell them

7 S.J.’s legal first name begins with an R, but their chosen name begins with an S.

gender-affirming commissary items, even though they requested panties, a sports bra,

and makeup. They expressed discomfort about being unable to present publicly in a

manner consistent with their gender identity.

S.J. also reported concerning experiences of verbal and physical abuse by prison

guards at Menard. They testified that guards referred to them as a “fucking faggot” on

one occasion and on another, they heard a guard describe transgender inmates as “bitch-

ass pussies.” They also noted a January 2024 incident where a guard punched them in the

face, sprayed them with mace, and hit them. According to R.J, several other correctional

officers then became involved. S.J. says the guards took them to a blind spot in the

prison’s infirmary where they beat them until another correctional officer intervened.

S.J. believes the assault was connected to their transgender identity because the guards

used the word “faggot” during the beating, and the incident took place after they had

reported being trans to staff members. S.J. also described an incident that took place on

October 26, 2025, when S.J. asked to be placed on crisis watch. S.J. says guards entered

their cell, hog-tied them, and carried them out of the building in freezing weather. By that

point, multiple staff members were aware that they identified as transgender.

At Pontiac, where S.J. now resides, they are housed in a single cell, can take

individual showers, and are able to procure gender affirming items from the commissary.

They also have met with mental health providers and can elect the gender of the prison

officer conducting a body search. S.J. said they would rather kill themself than return to

Menard.

C. Defendants’ Evidence

1. Officer Angel Lepinske

Defendants presented testimony from one witness: Officer Angel Lepinske. Mr.

Lepinske has worked as an intelligence officer at Menard since December 2025. Before

then, he was a corrections officer at Menard for about one year. As an intelligence officer,

his responsibilities include monitoring messages, phone calls, and conducting cell

searches to investigate and mitigate security concerns in the prison, such as gang activity

or contraband. He testified that inmates frequently pass hand-written letters, or “kites,”

among one another, which may be considered contraband. His testimony focused on two

such letters that he recovered during his investigations.

On January 16, 2026, Officer Lepinske searched the cell of inmates X.L. and J.H.

During the search, he located a two-page letter containing instructions for how to obtain

a gender dysphoria diagnosis. The Court received the exhibit into evidence over

Plaintiffs’ objection. (Defdts’ Ex. 1). The letter, which is unsigned, discusses the questions

mental health care providers may ask during an assessment for gender dysphoria and

provides a “cheat code” for how to answer the questions to ensure a diagnosis is

confirmed. For instance, the letter instructs the unnamed recipient to indicate that they

are open to hormone therapy even if they are not and to decline interest in “gender

reassignment surgery,” citing a desire to have kids in the future. The letter also instructs

recipients to request the evaluator to use they/them pronouns.

On cross-examination, Officer Lepinske conceded that he did not know who wrote

the letter or how it came to be in the cell. He also noted that J.H. was evaluated for gender

dysphoria and did not receive a confirmed diagnosis; both J.H. and X.L. still are housed

at Menard.

Officer Lepinske also located another letter during a cell search on February 18,

2026. That letter, signed by an individual using the moniker “Twitch,” also was received

into evidence over Plaintiffs’ objection. (Defdts’ Ex. 2). The writer advised the unnamed

recipient to “lie [and] say you[‘re] trans in a grievance” and “tell them you need to be

transferred to [a] facility that will accommodate to your gender identity.” On cross-

examination, Officer Lepinske identified “Twitch” as inmate T.B. and confirmed that he

still was housed at Menard awaiting evaluation for gender dysphoria.

LEGAL STANDARDS

A. Injunctive Relief

The Court’s December 2025 preliminary injunction expires automatically 90 days

after its entry, “unless the court makes the findings required under subsection (a)(1) for

the entry of prospective relief and makes the order final before the expiration of the 90-

day period.” 18 U.S.C. § 3626(a)(2).

Notwithstanding that deadline, courts have concluded that “[n]othing in the

[PLRA] limits the number of times a court may enter preliminary relief.” Mayweathers v.

Newland, 258 F.3d 930, 936 (9th Cir. 2001); Alloway v. Hodge, 72 F. App’x 812, 817 (10th Cir.

2003); see also Catherine T. Struve, Allowing the Courts to Step in Where Needed: Applying the

PLRA’s 90-Day Limit on Preliminary Relief, 19 U. St. Thomas L.J. 407, 425 (2023) (observing

that “neither the text nor the legislative history of the PLRA compels the conclusion that

Section 3626(a)(2) forecloses effective preliminary relief—as it would do, in some cases,

if it actually closed off all possibility of preliminary relief past an initial 90-day limit.”).

Indeed, the Seventh Circuit, in a prior decision in this case, cited approvingly to the Ninth

Circuit’s holding in Mayweathers. See Monroe, 122 F.4th at 697 (citing Mayweathers, 258 F.3d

at 936). And district courts in this circuit expressly have contemplated the issuance of

successive preliminary injunctions. See Peacher v. Conyers, No. 20-02997, 2022 WL 499893,

at *3 (S.D. Ind. Feb. 17, 2022) (noting that a party “may request that [the preliminary

injunction] be renewed no later than 14 days before the injunction expires.”); Jackson v.

Wexford of Indiana, LLC, No. 19-03141, 2019 WL 5566442, at *3 (S.D. Ind. Oct. 29, 2019)

(similar); Farnam v. Walker, 593 F. Supp. 2d 1000, 1004 (C.D. Ill. 2009) (“[N]othing in § 3626

prohibits the entry of successive orders for preliminary injunction if needed.”). Thus, as

the Court held previously, the PLRA does not restrict its authority to issue successive

preliminary injunctions until the matter proceeds to trial on the merits.

Having established that the Court can issue a subsequent preliminary injunction,

the burden falls to Plaintiffs to “continue to prove that preliminary relief is warranted.”

Mayweathers, 258 F.3d at 936. As the Seventh Circuit has cautioned, “new injunctive relief

will need to address the current situation.” Monroe, 122 F.4th at 697.

The parties are familiar with the standard governing the issuance of preliminary

equitable relief. The moving party must demonstrate:

(1) they are likely to succeed on the merits of their claims (a strong

showing, not simply a mere possibility, but also not as strong as

proof by a preponderance);

(2) there is no adequate legal remedy; and

(3) they are likely to suffer irreparable harm if injunctive relief is not

granted before final resolution of the claims.

See Winter v. Nat. Res. Defense Council, Inc., 555 U.S. 7, 20 (2008); DM Trans, LLC v. Scott,

38 F.4th 608, 617 (7th Cir. 2022).

If the moving party makes that showing, then the Court must balance the potential

harm to the moving party if the preliminary injunction were wrongfully denied against

the potential harm to the non-moving party if the injunction were wrongfully granted,

and the Court must consider the effect, if any, on the public of granting or denying the

injunction. Life Spine, Inc. v. Aegis Spine, Inc., 8 F.4th 531, 539 (7th Cir. 2021); DM Trans,

LLC, 38 F.4th at 622.

The PLRA adds a component to the analysis. That statute requires any injunctive

relief to be narrowly drawn, extend no further than necessary to correct the violation of

a federal right, and be the least intrusive means necessary to correct the violation. Brown

v. Plata, 563 U.S. 493, 530 (2011); 18 U.S.C. § 3626(a)(2). Courts must give substantial

weight to any adverse impact on public safety or the operation of a criminal justice system

caused by the preliminary relief and must respect principles of comity in tailoring the

relief. 18 U.S.C. § 3626(a)(2).

B. Eighth Amendment

The Eighth Amendment prohibits cruel and unusual punishment and “imposes a

duty upon states to provide adequate medical care to incarcerated individuals.” Boyce v.

Moore, 314 F.3d 884, 888-89 (7th Cir. 2002). Deliberate indifference to the “serious medical

needs of a prisoner constitutes the unnecessary and wanton infliction of pain forbidden

by the Constitution.” Rodriguez v. Plymouth Ambulance Serv., 577 F.3d 816, 828 (7th Cir.

2009) (citing Estelle v. Gamble, 429 U.S. 97, 104 (1976)). Deliberate indifference has two

elements. The first is whether the prisoner has an “objectively serious medical condition.”

Arnett v. Webster, 658 F.3d 742, 750 (7th Cir. 2011); Greeno v. Daley, 414 F.3d 645, 653 (7th

Cir. 2005). The second element requires a showing that a prison official has subjective

knowledge of—and then consciously disregards—an excessive risk to inmate health.

Greeno, 414 F.3d at 653; see also Petties v. Carter, 836 F.3d 722, 728 (7th Cir. 2016). Deliberate

indifference involves “intentional or reckless conduct, not mere negligence.” Berry v.

Peterman, 604 F.3d 435, 440 (7th Cir. 2010).

Plaintiffs’ original and supplemental complaints allege pervasive deficiencies in

delivery of medically necessary care and treatment on a systemic, statewide level in IDOC

correctional institutions. See, e.g., Wellman v. Faulkner, 715 F.2d 269, 272 (7th Cir. 1983);

Cleveland–Perdue v. Brutsche, 881 F.2d 427, 430–31 (7th Cir. 1989) (recognizing claims of

systemic health care deficiencies as a distinct category of deliberate indifference claims,

as opposed to one based on “isolated instances of indifference to a particular inmate’s

medical needs”). Plaintiffs’ prior motions for injunctive relief claimed that class members

at Menard are experiencing, and being harmed by, these deficiencies to an extreme

degree, and the present motion alleges that these conditions have persisted.

In this context, deliberate indifference can be demonstrated by “proving there are

such systemic and gross deficiencies in staffing, facilities, equipment, or procedures that

the inmate population is effectively denied access to adequate medical care[,]” or by

showing “repeated examples of negligent acts which disclose a pattern of conduct by the

prison medical staff” that result in an excessive risk of serious harm. Wellman, 715 F.2d at

272; Ollison v. Gossett, 136 F.4th 729, 736 (7th Cir. 2025); see also Rasho v. Jeffreys, 22 F. 4th

703, 710 (7th Cir. 2022) (explaining that “persistence in a course of action known to be

ineffective” can support an inference of deliberate indifference) (citing Whiting v. Wexford

Health Sources, Inc., 839 F.3d 658, 662–63 (7th Cir. 2016); Phillips v. Sheriff of Cook Cnty.,

828 F.3d 541, 554 (7th Cir. 2016)).

DISCUSSION

A. Are Plaintiffs Entitled to Injunctive Relief?8

In its September and December orders, the Court concluded that Plaintiffs were

entitled to a preliminary injunction because they had established a likelihood of success

on their Eighth Amendment claim (particularly as it pertained to the conditions at

Menard), were subject to irreparable harm, and the equities favored relief.

As they did in December, Plaintiffs seek the continuation of that relief for an

additional 90 days, but to prevail they must “continue to prove that preliminary relief is

warranted.” Mayweathers, 258 F.3d at 936. The Court concludes that the evidence adduced

by Plaintiffs during the recent hearing, when considered alongside the parties’ factual

stipulations, is more than sufficient to justify continued relief.

To start, Plaintiffs have demonstrated that they are likely to succeed on the merits

of their claim that prison officials were deliberately indifferent to their medical needs.

Defendants conceded early in this case that Plaintiffs’ gender dysphoria is a serious

medical condition. (Doc. 186, pp. 29-30). The present motion focuses on the alleged

serious, pervasive, and longstanding mistreatment of those members of the Plaintiff class

8 The Court incorporates by reference its prior holding that Defendants’ interlocutory appeal does not

divest it of jurisdiction to adjudicate Plaintiffs’ pending motion to re-issue the injunction. (Doc. 1070, pp. 21-

23).

who were, are, or may be held at Menard. Over the history of this case, Defendants have

been well-informed of the harms experienced by class members at Menard (and

elsewhere) when their treatment for gender dysphoria, including medical treatment and

necessary social transition, has been denied, delayed, or both. The persistence and

pervasiveness of these unconstitutional conditions, particularly at Menard, indicates

deliberate indifference by the responsible officials.

During the hearing, Plaintiffs put on evidence from two class members — one is

presently housed at Menard, and the other was housed at Menard as recently as January.

Both recounted in detail how the conditions at Menard remain problematic — to put it

mildly. The Court finds their testimony credible. In short, they described a facility where

access to evaluation and treatment for gender dysphoria is woefully inadequate and

social transition, a component of the accepted (and uncontested) standard of care, is

essentially impossible.

First, Menard’s responsiveness to reports of gender dysphoria by inmates remains

deficient. C.H. testified that she repeatedly reported her gender dysphoria and identity

as a transgender woman to a bevy of Menard staff, including the unit counselor,

lieutenants, and sergeants, over a several-month period in late 2025. Only after filing a

grievance did she meet with the prison’s transgender coordinator and even then, the

meeting was brief. C.H. also had a telepsych appointment in January to discuss her

gender dysphoria, but the call only lasted 5-10 minutes. During that appointment, C.H.

was told that a follow-up would be scheduled, but now, almost two months later, she has

not heard any update and remains at Menard.

S.J. shared a similar experience. They reported identifying as transgender and non-

binary to Menard staff as long ago as October 2014. They raised the issue again in October

2025 as part of a grievance and in letters to mental health staff and Menard’s transgender

coordinator, following up multiple times after failing to receive a timely evaluation.

IDOC’s own administrative directives provide that an evaluation for gender dysphoria

shall be conducted within seven working days of an inmate’s report. See IDOC

Administrative Directive No. 04.03.104(II)(F), eff. 4/1/2021. The parties’ factual

stipulations confirm that Menard has 12 vacant mental health provider (MHP) positions,

likely contributing to the ongoing delays in evaluation at that facility.

When S.J. met with Menard’s transgender coordinator in December 2025, she

questioned their identity as both transgender and non-binary. However, S.J. ultimately

received a confirmatory diagnosis and was transferred to Pontiac on January 21, 2026,

pursuant to the December injunction. In sum, the uncontroverted evidence establishes

that while some evaluations are occurring, they are difficult to obtain, and follow-up is

irregular.

The evidence at the hearing also suggested that the conditions at Menard preclude

class members from addressing their gender dysphoria by transitioning socially. At prior

hearings, class members testified that gender-affirming items were not available to

purchase from the commissary. At the most recent hearing, C.H. and S.J. said those items

exist at Menard, but prison staff rejected their requests to purchase them. C.H. even

testified that the staff member in charge of the commissary laughed at her when she asked

to buy gender-affirming items. Both class members testified that male correctional staff

persisted in conducting body searches even when they requested the search be conducted

by a female officer, and private showers were not available. As a result, both C.H. and

S.J. refrained from using the shower and washed up in their cells.

Perhaps most problematic, and consistent with the testimony of other class

members at prior hearings, C.H. and S.J. described a culture of disrespect, harassment,

and violence by Menard correctional officers that encourages the same mistreatment by

fellow prisoners. C.H. testified that she regularly heard officers use slurs when they

walked by her cell. On one occasion, she heard an officer say, “this isn’t the time to be a

tranny. You could find yourself hanging from the bars.” S.J. was called a “fucking faggot”

by guards on one occasion and on another, S.J. heard a guard describe transgender

inmates as “bitch-ass pussies.” S.J. also detailed how the mistreatment escalated to

physical assaults. They disclosed an incident in January 2024 where a guard punched

them in the face, sprayed them with mace and hit them. S.J. says that several other guards

transported them to a blind spot in the infirmary and beat them until another correctional

officer intervened. S.J. believes the assault was connected to their transgender identity

because the guards referred to them as a “faggot” during the beating and the incident

occurred after they reported being trans to staff members. Another incident took place

on October 26, 2025, when S.J. asked to be placed on crisis watch. S.J. says guards entered

the cell, hog-tied them, and carried them out of the building in freezing weather. Multiple

staff members were aware that they identified as transgender by that point.

Defendants did not put on any evidence refuting these incidents, and the

consistency and persistence of reports of mistreatment by correctional officers at Menard

remains deeply concerning. The stipulations of fact make clear that Menard’s warden

(now Matthew Plummer) still lacks the authority to hire or fire staff, and it is not clear

what action — if any — has been taken to address these issues. During the December

hearing, Warden Wills testified that some investigations were ongoing, but he offered

few details, and he could point to no actions he had taken to improve the treatment of

transgender inmates at Menard, despite acknowledging the likelihood they could face

mistreatment. (Doc. 1070, p. 26). There is no evidence of any progress on this front. It also

remains the case that Menard’s West House lacks video cameras, a basic tool that would

protect inmates and staff alike.

To sum up, the Court finds that the conditions at Menard remain substantially the

same as they were throughout 2025, when the undersigned determined that preliminary

relief was warranted. Put simply, the facility does not allow class members to safely seek

treatment for their gender dysphoria as is their right under the Eighth Amendment. And

despite IDOC officials being aware of the deficiencies — particularly at Menard — little,

if anything, other than compliance with the Court’s prior orders transferring inmates out

of that facility has been done to rectify the underlying conditions. IDOC’s “persistence in

a course of action known to be ineffective” supports a finding of deliberate indifference.

See Rasho, 22 F.4th at 710. For these reasons, the Court concludes Plaintiffs likely will

succeed on their Eighth Amendment claim.

Little needs to be said about the remaining preliminary injunction factors. As was

the case previously, “[t]here is no adequate remedy at law to compensate for the ongoing

risks to Menard class members’ medical needs, mental health, and physical safety, so long

as they remain incarcerated under the conditions prevailing in that institution.”

(Doc. 1008, p. 68). Consistent with prior testimony of other class members, both C.H. and

S.J. expressed credible concerns that they would be killed or become suicidal if forced to

return to Menard. Cf. Whitaker by Whitaker v. Kenosha Unified Sch. Dist. No. 1 Bd. of Educ.,

858 F.3d 1034, 1046 (7th Cir. 2017) (concluding a transgender plaintiff had no adequate

remedy at law where he challenged a school policy that caused him to contemplate

suicide). Any newly identified class members forced to endure the conditions prevailing

at Menard likewise could not be adequately compensated at law for the mistreatment

Plaintiffs have demonstrated is nearly certain to occur. And continued relief is warranted

to prevent class members housed at other facilities from being transferred to Menard.

Turning to the balance of equities, a denial of injunctive relief would cause serious

and irreparable harm to class members. In contrast, the potential harm to Defendants if

the injunction were reissued is far less. As the Court observed in its prior orders, Menard

is not the only maximum-security level facility within IDOC, and some class members

may qualify for placement at lower-level facilities. (Doc. 1008, p. 68). On previous

occasions, IDOC staff testified regarding the challenges posed by finding suitable

alternative facilities for class members. By all appearances, however, IDOC has managed

successfully thus far, and Defendants largely have abandoned arguments based on

logistical difficulties in opposition to the present motion.

The Court feels compelled to address the evidence from Officer Lepinske that

some individuals in custody at Menard may be attempting to take advantage of the

Court’s orders by feigning a gender dysphoria diagnosis to obtain a transfer. IDOC’s

concern is legitimate. Nonetheless, the undersigned does not believe the prospect that

some inmates are malingering counsels against continuing relief. According to Officer

Lepinske, at least one of the inmates in the cell where evidence was found already was

denied a gender dysphoria diagnosis by Menard’s mental health providers. The Court is

confident that competent mental health providers are capable of ascertaining which

inmates present with credible symptoms of dysphoria, particularly when aided by

extrinsic evidence, such as that discovered through Officer Lepinske’s investigation.

Absent evidence of a pattern of inmates successfully obtaining a transfer by feigning

gender dysphoria, the Court believes relief of the nature it has previously ordered

remains appropriate. The PLRA’s requirement that this relief be re-evaluated in 90 days

will permit Defendants to provide any newly discovered evidence that other prisoners

are abusing this Court’s order should Plaintiffs seek another reissuance.

On that note, the Court concludes that continuing the injunctive relief ordered

previously, with certain modifications discussed below, satisfies the PLRA’s requirement

that the relief “be narrowly drawn, extend no further than necessary to correct the harm

the court finds requires preliminary relief, and be the least intrusive means necessary to

correct that harm.” 18 U.S.C. § 3626(a)(2). In light of the substantial evidence regarding

the pervasive problems faced by class members at Menard, which, again, have not

improved since the prior order, continuing to preclude Defendants from housing class

members with a confirmed gender dysphoria diagnosis there remains the narrowest,

least intrusive solution available. The Court did not mandate where any particular inmate

be placed, leaving substantial discretion with IDOC to make an appropriate choice.

Defendants also have never explained how any of the prior injunctions’ other provisions

were unduly burdensome.

B. Defendants’ Arguments

Beyond their contention that Plaintiffs are not entitled to a preliminary injunction

under the PLRA and the Winter factors, Defendants offer three primary points in

opposition to further relief. None persuade.

First, Defendants argue that much of the evidence supporting Plaintiffs’ request

for injunctive relief lacks a nexus to the underlying Eighth Amendment deliberate

indifference claim that is the focus of this lawsuit. They reason that Plaintiffs focus on a

“culture of violence” at Menard rather than the lack of medical and mental health

treatment described in the complaint. Not so.

As the Court discussed above, Plaintiffs’ evidence demonstrates that the

conditions at Menard, which Defendants control, “do[] not allow class members to safely

seek treatment for their gender dysphoria as is their right under the Eighth Amendment.”

(Doc. 1070, p. 27). To the extent Defendants take aim at arguments describing a “culture

of violence,” their problem is with the standard of care for individuals experiencing

gender dysphoria, which focuses in large part on the role of social transition. Simply put,

if Defendants are deliberately indifferent to conditions hampering an inmate’s ability to

exist openly and safely in their identity, they may violate the Eighth Amendment.

Whether the harms described by Plaintiffs might also be evidence of other constitutional

violations does not detract from their Eighth Amendment theory.

Second, Defendants argue that the only remaining named Plaintiffs, Ms. Monroe

and Ms. Melendez,9 lack standing to pursue injunctive relief related to Menard on behalf

of the class because they are incarcerated at another facility and are at little risk of being

transferred to Menard. In support of that position, Defendants cite a number of cases

holding that an inmate’s facility-specific claim is moot if they are transferred from that

facility and there is no immediate threat that they will be returned there. E.g., Calhoun v.

DeTella, 319 F.3d 936, 939 (7th Cir. 2003); Knox v. McGinnis, 998 F.2d 1405, 1413 (7th Cir.

1993); Dunne v. Olson, 67 F. App’x 939, 946 (7th Cir. 2003). However, those cases do not

account for the reality that Ms. Monroe and Ms. Melendez are merely representatives of

the class. Thus, even if they face little prospect of being transferred to Menard themselves,

the entire class does not lose standing to relief. See Sosna v. Iowa, 419 U.S. 393, 402 (1975);

Payton v. Cnty. of Kane, 308 F.3d 673, 681 (7th Cir. 2002) (explaining that “where a class

has been properly certified, even the mootness of the named plaintiff’s individual claim

does not render the class action moot”). The class has standing to pursue injunctive relief

related to the conditions at Menard.

Finally, Defendants argue that the injunction would only benefit a subset of class

members housed at Menard rather than the class as a whole. But the Court previously

rejected that argument when it determined the conditions at Menard were such that relief

was warranted for “class members who are now or may be held at Menard.” (Doc. 1008,

p. 63) (emphasis added). Defendants also do not explain why the Court’s equitable

authority does not permit it to issue interim relief, based on evidence of particularly

9 The parties have informed the Court that the other two named Plaintiffs no longer are capable of serving

as class representatives, as one was released from custody and the other, regrettably, died by suicide.

Plaintiffs state that they will file appropriate notices on the docket in short order.

egregious conditions, before a trial on the merits can occur to determine the proper scope

of any system-wide final relief.

C. Modifications to the Injunction

At the conclusion of the hearing, Plaintiffs requested the Court modify the prior

injunction to address certain class members who have been removed from a list of

inmates with a confirmed gender dysphoria diagnosis even as their assessment by

medical providers remains is ongoing. This was of particular relevance given the

testimony of C.H.

In connection with their motion to reissue the preliminary injunction, Plaintiffs

filed the record of C.H.’s January 2026 evaluation for gender dysphoria, which was

conducted by Dr. Farzana Alam. (Doc. 1112-6). Dr. Alam reported that C.H. had at least

two of the six relevant indicators for gender dysphoria identified in the DSM-5, had

experienced those symptoms for more than six months, and had significant distress or

impairment in functionating. Nevertheless, Dr. Alam was unable to confirm a gender

dysphoria diagnosis for C.H. because it was her “initial encounter” and “the evaluation

[was] limited by lack of prior records and collateral information.” (Id.). Curiously, the list

of transgender inmates at Menard for January 28, 2026 (Doc. 1112-7), produced by

Defendants pursuant to the December 2025 injunction, shows C.H. as “REMOVED (no

GD).” And, unfortunately, Defendants offered no evidence that any of C.H.’s prior

records have been requested or other “collateral information” sought.

In its prior order, the Court directed Defendants to evaluate individuals at Menard

who sought a gender dysphoria diagnosis “within seven working days and confirm such

diagnosis in its sole discretion within 14 days of the evaluation.” (Doc. 1070, p. 32

(emphasis added)). Putting aside the issue of whether C.H.’s evaluation was timely

conducted, Dr. Alam’s note facially satisfies the December order’s requirement that an

evaluation take place by indicating that C.H.’s gender dysphoria could not be “confirmed”

as a diagnosis. This Court cannot and will not substitute its own judgment about whether

C.H., or any other inmate, meets the criteria for a gender dysphoria diagnosis for that of

IDOC’s medical professionals. To do otherwise would exceed the limitations of the PLRA

and the Court’s own competencies.

But where, as here, a provider indicates they have been unable to “confirm” a

diagnosis due to a lack of prior records or collateral information, common sense would

dictate that some effort be taken to obtain those records or arrange for a follow-up

assessment. It is not clear whether IDOC has taken those steps for C.H. or for several

other inmates whose records were attached to Plaintiffs’ motion. The Court therefore

modified the prior injunction to clarify that IDOC must timely conduct a follow-up

evaluation if an evaluator finds that they lack sufficient information to make a diagnosis

of gender dysphoria. The Court also added a provision emphasizing that its order should

not be construed to prevent any individual whose report of gender dysphoria is not

confirmed from seeking future evaluation and/or treatment for that condition. As with

any diagnosis, the fact an individual may not qualify for a gender dysphoria diagnosis at

one time does not mean they will never qualify.

The Court does not intend these changes to dictate the diagnostic conclusions of

any IDOC provider. The provider shall confirm a gender dysphoria diagnosis in their

sole discretion. Rather, the change is merely intended to ensure that uncertainty does not

become an excuse for inaction.

CONCLUSION

For the reasons set forth above, Plaintiff’s second motion to reissue the preliminary

injunction (Doc. 1111) is GRANTED. The Court ORDERS as follows:

1. Defendants shall transfer any class member housed at Menard to another facility

in accordance with the provisions below. Defendants shall take into consideration

the individual’s preference(s) as to the location of the transfer, but Defendants will

make the final decision. Given the Court’s previous Order transferring class

members out of Pinckneyville Correctional Center (Doc. 680), the Court cautions

that class members not be transferred to Pinckneyville, to avoid recurrence of the

issues that came to light there.

2. In determining where each class member will be transferred, Defendants shall

consider the individual’s gender dysphoria condition (including related mental

health considerations), gender identity, related safety issues, and whether a

transfer to a facility matching the individual’s gender identity is appropriate.

Defendants shall also consider the transfer criteria they previously described to

this Court (See Doc. 680, p. 31; Doc. 668, pp. 23-24) including: the length of time

before the individual is eligible for release on MSR; their security level; any

medical/mental health issues; any substance abuse issues; any security threat

group issues; any enemy/KSF issues; any protective custody needs; the

individual’s previous adjustment at other facilities; the nature of the individual’s

commitment; the individual’s vulnerable status; and whether the individual meets

the criteria for the requested facility.

3. Defendants shall notify each individual class member of their new placement in

writing, at least seven days in advance of the physical transfer, stating where the

individual will be moved. The notice shall explain the reason(s) for the

placement/transfer decision and the consideration of each of the above criteria. A copy

of each decision shall be simultaneously forwarded to class counsel.

4. Going forward, no individual already identified as a member of the Plaintiff class

shall be transferred to Menard. If a person arrives at Menard through the reception

and classification process (intake) and is recognized by IDOC as a class member

as part of IDOC’s standard evaluation process, that class member shall not be

assigned to Menard as their permanent institution. If an individual already housed

at Menard requests an evaluation for gender dysphoria, IDOC shall conduct the

requested evaluation within seven working days.10 If an evaluator finds

insufficient information after an interview to confirm whether the individual has

gender dysphoria, a mental health provider shall conduct a follow-up evaluation

within 21 days. The provider shall confirm such diagnosis in their sole discretion

within 14 days of a completed evaluation. Each person who is confirmed with a

gender dysphoria diagnosis shall be transferred to a different facility within

21 days of such confirmation. (See IDOC Administrative Directive No. 04.03.104,

eff. 4/1/2021). Nothing in this Order shall be construed to prevent any individual

whose report of gender dysphoria is not confirmed from seeking future evaluation

and/or treatment for that condition.

5. Any class member transferred from Menard who is not moved to Logan or another

facility matching their gender identity shall be allowed to submit a transfer request

to Logan or another facility matching their gender identity within 60 days of their

initial transfer.

6. Defendants shall provide to the Court and to Plaintiffs’ counsel a monthly report,

by the last day of each month, of the status of any known class member currently

housed at Menard, including the timing and result of any pending, upcoming, or

concluded transfer decisions. Defendants also shall produce to Plaintiffs’ counsel

each month, by the last day of the month, all documentation related to class

members at Menard including transfer requests, grievances, PREA complaints and

investigations, TAC notes, and medical and mental health records including

documentation of hormone levels for those on such therapy.

7. If Plaintiffs seek a re-issuance of this injunction, they must file a motion no later

than 21 days before this Order expires, along with a list of witnesses who will

testify at a subsequent evidentiary hearing. Defendants shall respond to the

motion no later than seven days before this Order expires and shall furnish a list

of any witnesses. Plaintiffs’ motion must certify that they have conferred with

Defendants regarding the possibility of a stipulated order that would endure

through the conclusion of trial on the merits. The conference must be held

sufficiently in advance of filing the motion to allow a good faith exchange aimed

at resolving the matter. A conference is not an email exchange. If a stipulation is

not possible, the Court will schedule an evidentiary hearing on the motion.

10 The seven “working days” deadline is IDOC’s policy as provided in A.D. No. 04.03.104, “Evaluation,

Treatment, and Correctional Management of Transgender Offenders.” All other deadlines in this Order

refer to calendar days.

Pursuant to MillerCoors LLC v. Anheuser-Busch Companies, LLC, 940 F.3d 922 (7th

Cir. 2019), the Court entered the terms of the preliminary injunctive relief set forth above

in a separate document. (Doc. 1124).

IT IS SO ORDERED.

DATED: March 16, 2026

NANCY J. ROSENSTENGEL

United States District Judge

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