The state this week agreed to settle a civil rights lawsuit filed by an inmate against the state prison's medical director for refusing to provide hormone therapy.
But the details of the agreement between the Nebraska Attorney General's office and Riley Shadle aren't being released by either side, citing confidentiality.
"I can tell you that Riley does have a serious medical condition that the prison is agreeing to treat as is its obligation to treat any serious medical condition," Shadle's attorney, Jeanelle Lust, said in an email Tuesday.
When asked about the state's decision to settle, Attorney General spokeswoman Suzanne Gage said: "By law, inmate medical records are private."
Neither she nor a spokeswoman for the Department of Correctional Services would say whether Shadle's case created a path for how the state's prisons will deal with medical requests by transgender inmates going forward.
Shadle, who was convicted under the name Dillon Shadle and later legally changed her name, was born male but identifies as female, according to court records.
In a lawsuit filed last year, Shadle said Dr. Randy Kohl was denying her hormone therapy treatment for gender identity disorder, "without regard to my mental and emotional pain and anguish and treatment needs."
Kohl is the deputy director of health services at the Department of Correctional Services.
In a letter dated July 13, 2015, the warden at Lincoln Correctional Center, where Shadle is serving a 37- to 66-year sentence on child sexual assault and child pornography charges out of Sarpy County, told Shadle the request was denied because it was considered an elective treatment.
Shadle asked the court to order prison officials to treat her with "feminizing hormones" and a gender reassignment surgery.
"The pain is constantly having to feel uncomfortable in a body that doesn’t match who I really am inside," she wrote last year.
In February, Chief U.S. District Judge Laurie Smith Camp allowed the case to go forward on an Eighth Amendment claim alleging prison officials had failed to provide adequate care for a serious medical need.
In April, Senior U.S. District Judge Richard Kopf appointed an attorney to represent Shadle, since it appeared Shadle was diagnosed with gender identity disorder before going to prison and since the law in the circuit appears to be uncertain "with respect to the obligation of prisons to treat the disorder with hormones and gender reassignment surgery."
On Monday, Lust and Assistant Nebraska Attorney General David Lopez signed a stipulation saying Shadle's claims against Kohl should be dismissed "pursuant to an agreed treatment plan," with each party paying their own costs.
Lust said she couldn't comment on her client's medical condition or treatment or on how they got to a settlement because that's privileged.
But she pointed to the U.S. Department of Justice's policy guide for correctional administrators and medical and mental health staff addressing the treatment of lesbian, gay, bisexual, transgender and intersex people in custodial settings.
The guide says denying inmates with gender dysphoria the ability to fully adopt a gender role that matches their gender identity can constitute a denial of necessary medical care and an Eighth Amendment violation, citing a 2010 Wisconsin federal court decision.
Medical treatment for inmates with dysphoria also cannot be denied because it is expensive or might be unpopular or controversial, according to a 2002 decision by a Massachusetts federal court.