A transgender man incarcerated at a Virginia prison filed a federal lawsuit against state corrections officials Wednesday, claiming he faces cruel and unusual punishment because the prison will not allow him to have surgery to remove his breasts.

Jason Yoakam is a transgender man living at the Fluvanna Correctional Center for Women, according to a lawsuit filed in U.S. District Court for the Western District of Virginia. The prison is in Troy, about 110 miles southwest of the District.

On Wednesday, Yoakam, 42, sued Virginia Department of Corrections officials, saying prison medical staff diagnosed him with gender dysphoria four years ago but denied him mental health treatment and “gender confirmation chest surgery” similar to a double mastectomy.

Yoakam, who lived as a man before he was imprisoned, has felt his body “was a mistake” from an early age, according to the suit, and finds his breasts a source of “shame and disgust.” When he showers, he becomes physically ill, the suit said.

The prison issued Yoakam a “chest binder” so he can compress his chest, but the suit said he has suffered depression, anxiety, panic attacks and sleep disturbances because the prison will not allow the breast removal. He also sleeps in the binder, which has caused scars, rashes and acne, according to the suit.

Although the suit said Yoakam has been on hormone therapy since 2017, prison officials ruled that breast removal was “elective and not medically necessary” despite two doctors’ recommendations that Yoakam receive it. Failing to get surgery after filing numerous complaints, Yoakam remains in “profound physical pain and emotional distress,” according to the suit.

“He has considered self-treatment by removing some of his female identifiers, such as his breasts,” the suit said, but has refrained from doing so “only from the hope that one day this nightmare he has endured of being in the wrong body will be corrected.”

The court should direct Fluvanna to provide Yoakam chest surgery, the suit said, and declare that the prison violated the Eighth Amendment’s prohibition of cruel and unusual punishment, among other violations.

In an email, corrections spokeswoman Lisa E. Kinney said 86 of about 24,000 people in the department’s custody across the state identify as transgender, and 60 have been diagnosed with gender dysphoria.

Kinney also provided the department’s guidelines for assessment and treatment of inmates diagnosed with gender dysphoria dated January 2019. The guidelines mention the “Risks and benefits of pursuing hormonal therapy and/or surgical reassignment” among “Possible Areas of Focus” for treatment but do not appear to directly address the possibility of offering inmates surgery.

“All medically necessary treatment is available,” Kinney said. “Treatment decisions are made on a case-by-case basis. In addition to medical treatment, individual and group therapy is also available. We follow the community standard of care.

The suit said decisions about Yoakam’s care were made by Fluvanna’s “Transgender Committee,” which includes the prison’s warden and other “non-medical administrators.”

The Corrections Department has never approved surgery for a transgender man in its custody to treat gender dysphoria, according to the suit, and does not have a policy requiring correctional staff to use inmates’ correct pronouns. Fluvanna correctional staff also do not consistently use Yoakam’s correct name or pronouns, the suit said.

In an interview, Richard Saenz, an attorney for the LGBT advocacy group Lambda Legal, which represents Yoakam, said the suit was one of the first, if not the first, brought on behalf of an incarcerated transgender man.

The organization previously represented a transgender woman imprisoned in Missouri who won the right to hormone treatment. In that lawsuit, Missouri’s “freeze frame” policy — denying hormone treatment to people not receiving it before their incarceration — was declared cruel and unusual punishment.

Lambda receives hundreds of requests for assistance from transgender inmates each year, Saenz said.

“We think the law is clear: Medical treatment should not be denied because someone is transgender,” he said. “Gender dysphoria is a serious medical condition, and for incarcerated people it means the Constitution requires they be provided with adequate health care.”

In a statement, Yoakam, who has been incarcerated at Fluvanna since 2004 after he was convicted of murder, said it “has been traumatizing, isolating, and stigmatizing to be denied health care services to treat the gender dysphoria that [Virginia’s] own providers have diagnosed.”

“The only thing I am asking is to be treated fairly and have access to the same standard of healthcare that other incarcerated people receive,” the statement said.