- Judge Fiona Fisher finds DCS violated Mokoena’s rights by denying gender expression, healthcare, and safe housing.
- Court orders full access to gender affirming clothing, hormone therapy, and housing that matches gender identity.
- Ruling confirms that transgender inmates are entitled to greater protections and specialised care under South African law.
Transgender inmate Nthabiseng Mokoena must be allowed to wear clothing, accessories, cosmetics, and toiletries that express her gender identity at all times and throughout the Johannesburg Correctional Centre. Additionally, she must be addressed using “she” and her preferred pronouns.
The Department of Correctional Services (DCS) was also ordered to enforce its own policies for transgender inmates through disciplinary action. The court also ruled that she must be housed either in a single cell or with inmates who share her gender identity. The state is required to provide gender affirming healthcare, including hormone treatment and all related support. These protections apply during imprisonment, parole, and any other limits on her freedom.
This binding order was issued by Judge Fiona Fisher on 10 November 2025 in the Johannesburg High Court, acting as the Equality Court. The court found that Mokoena faced systemic discrimination, harassment, and degrading treatment from DCS officials. The judgment confirms that the right to adequate healthcare under section 35 of the Constitution includes gender affirming therapy for transgender inmates and that denying such care constitutes unfair discrimination and harassment.
Constitutional rights apply behind bars
Judge Fisher rejected the state’s argument that gender affirming treatment was cosmetic or beyond its obligations. She stated that the distress caused by denying gender expression and treatment was clear, writing that “the profound misery and distress experienced by transgender persons when they cannot exist in a state of psychological and emotional integration is accepted by all parties in these proceedings.”
The court found that inmates diagnosed with gender dysphoria deserve a higher standard of care than transgender individuals outside prison due to their vulnerability. Judge Fisher pointed out that the denial of treatment, along with misgendering and limits on gender expression, created a hostile and humiliating environment. “The limitations placed on the areas of the prison where the applicant can dress and groom herself in feminine attire are experienced by her as hostile and unreasonably intended to force her into a condition that she finds intolerable.”
DCS excuses rejected as discriminatory and illogical
The Department of Correctional Services argued that overcrowding made it impossible to house Mokoena in a single cell. However, the court found this claim inconsistent, noting that former police officers and other high-risk inmates were already accommodated alone in the same section.
Judge Fisher dismissed the DCS’s stance as discriminatory and unsupported by facts. “It must be stated upfront that there is no merit in this contention,” she wrote, adding that the department’s affidavit contained “a low point” when it claimed that Mokoena was not a victim and had lost some of her rights.
The court also rejected the DCS’s claim that it was only required to provide primary healthcare. Judge Fisher found that gender affirming therapy, including hormone treatment, is part of the standard care for gender dysphoria and must be provided at state expense. “What is sought by the applicant is clear,” she wrote. “That the DCS be ordered to provide hormone therapy as part of its obligation to provide adequate healthcare.”
A precedent for dignity and equality in detention
Mokoena’s experience inside the Johannesburg Correctional Centre revealed deep institutional bias against transgender inmates. She was denied the use of her chosen name and pronouns, blocked from expressing her gender identity through clothing and toiletries, and faced verbal harassment and bullying.
Her requests for gender affirming healthcare were ignored, and she was forced to self-medicate with oral contraceptives. Despite being diagnosed by multiple experts, DCS refused to provide treatment until ordered by the court.
The Equality Court found that this treatment violated her rights to dignity, equality, and freedom from unfair discrimination. It confirmed that the anti-discrimination and harassment provisions of the Promotion of Equality and Prevention of Unfair Discrimination Act fully apply to transgender inmates, and that the state must show any discrimination is fair. In this case, it failed.
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