Over the past decade, there has been an increased social awareness regarding transgender issues. This has led to the transgender community achieving progress in many aspects of everyday life. However, one area in which transgender persons continue to struggle is behind bars. Medical treatment for incarcerated transgender persons has become a controversial topic both in public opinion and the law.

This Article will trace the journey of Reiyn Keohane, a transgender inmate in the Florida prison system, from her arrest to her challenge against the Florida Department of Correction’s hormone treatment and social transitioning policies. For a brief moment in time, Keohane won a major victory for transgender inmates when the trial court held that both policies were unconstitutional. This victory was short lived however, as the Eleventh Circuit Court of Appeals reversed that decision in Keohane v. Florida Department of Corrections Secretary. The author takes a critical look at the Eleventh Circuit’s opinion, specifically its analysis regarding mootness and cruel and unusual punishment.

In the end, the author suggests that the Eleventh Circuit may have gotten it wrong and highlights how there is now a split among circuits regarding what the Constitution demands when it comes to medical treatment for transgender inmates.