This article originally appeared in The 19th .

Taliyah Murphy, a transgender woman living in Colorado Springs, studies accounting and finance. She co-owns two small businesses with her fiancé and eventually wants to start a financial education nonprofit for marginalized people.

For Murphy, starting her gender transition helped her focus on her education as she developed her career — but she faced near-impossible barriers at every turn. She started her transition while incarcerated with the Colorado Department of Corrections (CDOC), which repeatedly denied her gender-affirming care. She had to make multiple appeals before she could access hormone replacement therapy, she recalls, and she experienced severe depression because she was unable to treat her gender dysphoria. Even a recommendation by a CDOC psychiatrist wasn’t enough to qualify her for surgery.

Her safety was also compromised, she told The 19th. Murphy was denied transfer to a women’s prison, she said, and constantly harassed and misgendered by staff and inmates while housed in men’s facilities. She endured sexual advances from other inmates and was punished through solitary confinement for speaking out when faced with threats against her life. Survival was exhausting.

“At one point for me, if I wasn’t at my job assignment, I didn’t really come out of my room a lot,” Murphy said. “I just wanted to stay away from the drama and any type of attempt to try to victimize me.”

Murphy is one of hundreds of transgender women with similar experiences in the state. Her story is included in a class action lawsuit filed in 2019 by the law firm King & Greisen, LLP and the Transgender Law Center. According to the lawsuit, these women were frequently subjected to sexual and physical violence, and their requests for medical care were routinely ignored, in violation of the state constitution and Colorado Anti-Discrimination Act.

This March, that suit resulted in a groundbreaking legal agreement known as a “consent decree” that requires Colorado to overhaul how it houses incarcerated transgender women and provides medical care to all trans people behind bars. Now, Colorado’s prison system must provide the same gender-affirming health care covered by state Medicaid, and trans women must have the option to be housed with other women.

While other settlements may mandate specific changes without any input from the government agency involved, in this case lawyers worked with Colorado officials to outline a legally binding agreement. Experts hope it will serve as a model for comprehensive change for other states. Transgender women across the country face life-threatening circumstances behind bars — and the majority of them are forced to live with men.