The story of Christa Allen is all too common. In 2002, Christa Allen underwent male-to-female gender reassignment surgery. In 2006, she was sentenced to time in Indiana’s Rockville Correctional Facility. Later, she was moved to the Indiana Women’s Prison.

When Christa Allen entered prison, she explained her medical needs: female hormones and a vaginal stent. Allen explained the stent was medically necessary to prevent closure and loss of tissue. Without the stent, she would most likely suffer medical complications that could necessitate a second, and extremely expensive, operation.

At first, the prison authorities agreed to the stent. Then they found is a security issue, and told Allen to use a vibrator. Then they found that a security issue, and told Allen to use a tampon.

Allen complained of pain and vaginal bleeding. She argued that she needed the stent, and the prison doctors and authorities refused. Christa Allen spent one and a half years in prison, leaving in 2007. At that point, she was unable to continue her treatment, and so would need new reconstructive surgery. She sued the prison doctors for medical malpractice.

Christa Allen’s case is going through the court system now. In the most recent hearing, the Indiana Court of Appeals sided with Allen, stating [a] there was no reason to prevent the use of stent or vibrator, and [b], and most importantly, prison doctors should follow the standard of care that all doctors are meant to follow.

Prisoners are people. Women prisoners are people. Transgender women prisoners are people.

The doctors have asked the appellate judges to rehear the case.

In jails and prisons and immigrant detention facilities across the United States, the most vulnerable are women, and the most vulnerable women are juveniles; women with drug addictions; lesbians and transgender women; women with a history of mental illness, physical or sexual abuse; and women convicted of sexual offenses. Each one of these groups is meant to suffer their own particular form of hell, composed of a particular category of extra violence.

For the transgender woman, the extra violence stems from a claimed failure of `being real’. Deprivation is the program response: denial of gender self-definition, preferred names, pronouns, underwear, hair length, or appropriate and necessary medical care. It’s always the same: your needs cost too much. For the prison economy, being transgender woman is deemed inefficient, and so cost-cutting measures must be put in place.

Repeatedly, transgender women prisoners have organized and sued for their rights to decent medical treatment as transgender women. Repeatedly, these women have won: Kari Sundstrom and Andrea Fields; Vanessa Adams; Michelle Kosilek. In each case, the court ruled that transgender women are people, transgender women prisoners are people, and prison doctors are doctors.

The legal arguments will continue as will prison authorities’ and prison doctors’ claims that taking care of the special needs of women is just too much. Christa Allen provides us all with a mirror. When asked, “Where is your sister?” will we hide behind “Am I my sister’s keeper?” Will we cover over the violence, or will we act to keep our sisters out of prison and then, finally, to close the prisons themselves? What is your sister’s name? Christa Allen.

(Photo Credit: Indiana Department of Corrections)