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During the 16 months Jessica Sunderland was incarcerated at the Riverside Correctional Facility in Suffolk County, New York, jail officials refused to give her the hormones she had been taking for two years. In response, in August 2013, Sunderland filed a federal civil rights lawsuit against Suffolk County, arguing that the jail’s failure to provide her hormones violated her constitutional rights.

In October of this year, Sunderland won her case. As reported by Melissa Gira Grant at the Appeal, a jury agreed that Sunderland’s constitutional rights had been violated, and awarded her $280,000 in damages, plus an additional $75,000 in punitive damages against Vincent Geraci, the jail’s medical director. It’s a groundbreaking decision, according to Sunderland’s attorney Joel Wertheimer.

From the Appeal:

This is the first case, to his knowledge, “where a jury of eight peer citizens found, unanimously, that failure to provide hormone therapy to a transgender inmate violated her constitutional rights and entitled her to money damages.”

Wertheimer said that by awarding punitive damages, the jury sent a strong message. “Not only did those eight peers find that hormone therapy was necessary medical treatment, they found it was malicious to consciously deny it, indicating how seriously they took transgender health.”

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One change that’s already occurred: after Sunderland filed her lawsuit, the Suffolk County jail began providing hormone treatment for other trans people in its custody.

Sunderland, an Army veteran, was convicted of burglary in 2012. When she arrived at the Long Island jail, Geraci refused to continue her hormone treatment, which had been prescribed by a doctor from a VA hospital.

According to the New York Times, which reported on Sunderland’s lawsuit in 2017, Geraci was also found to have posted several anti-trans messages on Facebook:

One of them was a photo posted by a user named Trump Wall depicting a bathroom sign with a caption reading, “Men DO NOT belong in the bathrooms with girls!” Another was an article posted by the conservative commentator Allen West about a movement to boycott Target for its transgender-friendly bathroom policy. In the comment section, Mr. West had written, “It looks like we’re not the only ones who have a problem with liberals pushing their transgender bathroom agenda.”

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Jail and prison officials regularly deny hormone treatment to incarcerated trans people. In 2017, Richard Saenz, a Lambda Legal attorney, described it to the Times as an “ongoing problem,” and estimated that the organization had fielded almost 100 calls to its help desk over a two-year period from people in jails and prisons who had been denied hormones.

Sunderland described the experience of having her hormone treatment abruptly terminated to the Appeal. “I had been transitioning for two years prior, and to have everything reverse itself… it was horrible,” she said. In an interview with the Times, she likened it to climbing a mountain. “You get halfway to the top and someone tries to pull you back down,” she said.

The outcome of Sunderland’s suit may help change that. “When jails are sued by people they think have no one on their side, and they start losing, there are practical changes that happen,” ACLU attorney Chase Strangio told the Appeal.