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Sophia befriends Ingalls when Litchfield medical serive switches to generic hormone tablets and reduce Burset's dosage. Sophia finds out that Sister takes HRT. She pretends to be deeply religious and tries to open up to Sister gradually. However, her plan falls apart when it is revealed that Ingalls knew from the beginning that Sophia wanted her hormones. Sister tires to tell Sophia that she did not really come to her for the hormones but felt guilty about something. The mention of Sophia's son Michael sets her off, leaving Sophia upset. Their friendship continues after this incident, and the two converse on many different topics
The two do not converse much in Season Three. Burset turns to him Sister Ingalls after Aleida spreads transphobic rumors about Burset, whereupon Burset realizes that the only true friendship she has made while at Litchfield was with Sister. They had a brief conversation before Sophia is taken to SHU for "protection" from other inmates.
When efforts to get Sophia out of SHU fail, Sister Ingalls gets herself thrown into SHU and trades notes with Sophia. Eventually, they manage to get a picture of Sophia's condition and were able to free her. Sister, however, remained in the SHU.
After the riots began, Sophia decides to walk to the front of the prison and is set to MAX. It is there that she learns that Sister Ingalls is now on compassionate release as a result of contracting pneumonia.