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[DO NOT PUBLISH]
In the
United States Court of Appeals
For the Eleventh Circuit
____________________
No. 22-10801
Non-Argument Calendar
____________________
AKEEM MUHAMMAD,
Plaintiff-Appellant,
versus
JULIE JONES,
Individually,
M.D. OLUGBENGA OGUNSANWO,
Individually as former director of Medical and
Mental Health Services for the Fla. Dept. of Corr.,
THOMAS REIMERS,
Individually and officially as Director of Health Services
for the Fla. Dept. of Corr.,
SECRETARY, FLORIDA DEPARTMENT OF CORRECTIONS,
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2 Opinion of the Court 22-10801
Defendants-Appellees,
M.D. E. PEREZ,
Chief Health Officer, Union Corr. Inst.,
In his individual and official capacities,
Defendant.
____________________
Appeal from the United States District Court
for the Middle District of Florida
D.C. Docket No. 3:16-cv-01436-MMH-PDB
____________________
Before JORDAN, JILL PRYOR, and BRANCH, Circuit Judges.
PER CURIAM:
Akeem Muhammad, a Florida prisoner proceeding pro se,
sued several prison officials, alleging that they violated his consti-
tutional rights when they failed to provide him with a particular
medical treatment. He appeals from a district court order granting
summary judgment to the prison officials on the ground that Mu-
hammad failed to establish that the officials acted with deliberate
indifference. After careful consideration, we affirm.
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22-10801 Opinion of the Court 3
I.
Muhammad suffers from a paraphilic disorder, a psychiatric
disorder characterized by persistent urges, fantasies, or behavior in-
volving coercive sexual acts toward nonconsenting persons.1
While incarcerated, Muhammad sought treatment for his condi-
tion. Although prison officials have provided treatment to Muham-
mad, including medication in the form of selective serotonin
reuptake inhibitors (“SSRIs”) and regular counseling sessions, they
have refused to provide him with his preferred course of treatment,
antiandrogen therapy. Muhammad believes that this form of hor-
mone treatment, which reduces the level of testosterone in the
body, would control his sexual urges.
Muhammad sued several prison officials pursuant to
42 U.S.C. § 1983, alleging that by failing to provide him with anti-
androgen therapy the prison officials had been deliberately indiffer-
ent to his serious medical needs in violation of the Eighth Amend-
ment. He sought damages as well as an injunction.
After the parties engaged in a lengthy period of discovery,
the prison officials moved for summary judgment. In a thorough
1 Because we write for the parties and assume their familiarity with the record,
we set out only what is necessary to explain our decision.
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4 Opinion of the Court 22-10801
order, the district court granted the summary judgment motion.
This is Muhammad’s appeal. 2
II.
We review de novo a district court’s grant of summary judg-
ment, viewing all evidence and drawing all reasonable inferences
in favor of the nonmoving party. Hurlbert v. St. Mary’s Health
Care Sys., Inc.,
439 F.3d 1286, 1293 (11th Cir. 2006). Summary judg-
ment is appropriate only “if the movant shows that there is no gen-
uine dispute as to any material fact and the movant is entitled to
judgment as a matter of law.” Fed. R. Civ. P. 56(a).
We read liberally briefs filed by pro se litigants. See Timson
v. Sampson,
518 F.3d 870, 874 (11th Cir. 2008). We also construe
liberally pro se pleadings. See Tannenbaum v. United States,
148 F.3d 1262, 1263 (11th Cir. 1998).
III.
The Eighth Amendment forbids the “inflict[ion]” of “cruel
and unusual punishments.” U.S. Const. amend. VIII. It prohibits,
among other things, “deliberate indifference to serious medical
needs of prisoners.” Estelle v. Gamble,
429 U.S. 97, 103–04 (1976).
Under the Eighth Amendment, “[f]ederal and state governments
2 We note that the prison officials did not file a brief in this appeal. See 11th
Cir. R. 42-2(f) (“When an appellee fails to file a brief by the due date . . . the
appeal will be submitted to the court for decision without further delay[.]”).
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22-10801 Opinion of the Court 5
. . . have a constitutional obligation to provide minimally adequate
medical care to those whom they are punishing by incarceration.”
Harris v. Thigpen,
941 F.2d 1495, 1504 (11th Cir. 1991).
“To show that a prison official acted with deliberate indiffer-
ence to serious medical needs, a plaintiff must satisfy both an ob-
jective and a subjective inquiry.” Farrow v. West,
320 F.3d 1235,
1243 (11th Cir. 2003). To meet the first prong, a plaintiff must
demonstrate an “objectively serious medical need,” meaning “one
that has been diagnosed by a physician as mandating treatment or
one that is so obvious that even a lay person would easily recognize
the necessity for a doctor’s attention,” and, in either instance, “one
that, if left unattended, poses a substantial risk of serious harm.”
Id.
(alteration adopted) (internal quotation marks omitted).
To satisfy the second, subjective prong, a plaintiff must
prove that the prison officials “acted with deliberate indifference to
[his serious medical] need.” Harper v. Lawrence Cnty.,
592 F.3d
1227, 1234 (11th Cir. 2010) (internal quotation marks omitted). A
plaintiff must demonstrate that “prison officials (1) had subjective
knowledge of a risk of serious harm; (2) disregarded that risk; and
(3) acted with more than gross negligence.” Hoffer v. Sec’y, Fla.
Dep’t of Corr.,
973 F.3d 1263, 1270 (11th Cir. 2020) (internal quo-
tation marks omitted). This standard “is far more onerous than nor-
mal tort-based standards of conduct sounding in negligence and is
in fact akin to subjective recklessness as used in the criminal law.”
Id. at 1271 (internal quotation marks omitted). Medical care vio-
lates the Eighth Amendment “only when it is so grossly
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6 Opinion of the Court 22-10801
incompetent, inadequate, or excessive as to shock the conscience
or to be intolerable to fundamental fairness.” Harris,
941 F.2d at
1505 (internal quotation marks omitted). “[A] simple difference in
medical opinion between the prison’s medical staff and the inmate
as to the latter’s diagnosis or course of treatment” does not estab-
lish deliberate indifference.
Id.
Here, the district court properly granted summary judg-
ment to the prison official defendants. The evidence, even when
viewed in the light most favorable to Muhammad, does not estab-
lish a genuine dispute as to whether the prison officials acted with
deliberate indifference. This is not a case where the prison officials
utterly failed to treat Muhammad’s medical condition. Instead, the
record demonstrates that they provided Muhammad with treat-
ment for paraphilia in the form of medication, including SSRIs, and
counseling. The record also reflects that this course of treatment
was an accepted standard of care for treating paraphilia. And the
record shows that the SSRIs were somewhat effective in control-
ling Muhammad’s sexual desires. 3
Muhammad nevertheless argues that the prison officials
acted with deliberate indifference because they refused to provide
him with antiandrogen therapy. Certainly, the record includes evi-
dence that antiandrogen therapy may be effective in treating para-
philia. But the record reflects that antiandrogen therapy is one of
3 Although there is no indication that the counseling helped Muhammad, the
record reflects that he at times refused to participate in his counseling sessions.
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22-10801 Opinion of the Court 7
several options available to treat this condition. The fact that Mu-
hammad was not provided with his preferred treatment out of a
range of options does not establish that the prison officials acted
with deliberate indifference. See Hamm v. DeKalb Cnty.,
774 F.2d
1567, 1575 (11th Cir. 1985) (“Although [the plaintiff] may have de-
sired different modes of treatment, the care the jail provided did
not amount to deliberate indifference.”); see also Hoffer, 973 F.3d
at 1272 (explaining that when a “prisoner has received some medi-
cal attention and the dispute is over the adequacy of the treatment,
federal courts are generally reluctant to second guess medical judg-
ments and to constitutionalize claims which sound in state tort
law” (internal quotation marks omitted)). 4
We emphasize that under the deliberate indifference stand-
ard, the relevant question is not whether “in the best of all possible
worlds,” a person with paraphilia “should receive treatment with”
antiandrogen therapy. Hoffer, 973 F.3d at 1271–72. Rather, because
Muhammad has invoked the Eighth Amendment, “the sole
4 Muhammad argues that the evidence, when viewed in the light most favor-
able to him, shows that the prison mental health officials adopted a policy that
prohibited the use of antiandrogen therapy to treat paraphilia. Even assuming
for purposes of this appeal that Muhammad is correct and such a policy ex-
isted, Muhammad still must show that the prison officials acted with “more
than gross negligence” when they refused to provide him with this treatment.
Hoffer, 973 F.3d at 1270 (internal quotation marks omitted). Because, as we
explained above, he cannot show that the failure to provide him with anti-
androgen therapy was more than gross negligence, we conclude that the dis-
trict court properly granted summary judgment.
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8 Opinion of the Court 22-10801
question before us is whether the [prison officials’] approach to”
treating Muhammad with medication and counseling, as opposed
to antiandrogen therapy, was “so reckless” or “conscience-shock-
ing” that it violated the Constitution. Id. at 1272. And even viewing
the evidence in the light most favorable to Muhammad, we cannot
say that this choice of treatment was reckless or conscience shock-
ing.
IV.
For the reasons set forth above, we affirm the district court. 5
AFFIRMED.
5 Muhammad raises several other issues on appeal, challenging orders that the
district court entered prior to granting summary judgment. He argues that the
district court abused its discretion when it permitted his appointed counsel to
withdraw from the case, denied his motion to appoint new counsel for a lim-
ited purpose, denied his motion seeking appointment of a medical expert, de-
nied his motion to reinstate a motion to compel, denied five motions to com-
pel, and refused to extend the deadline for discovery. We have carefully con-
sidered each of these issues and cannot say that the district court abused its
discretion.
