Appeals court: Sex reassignment surgery must be provided

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The U.S. 1st Circuit Court of Appeals ruled today 2-1 upholding a federal district court's order that a prisoner in Massachusetts receive sex reassignment surgery:

http://www.wbur.org/2014/01/17/michelle ... -operation

The commonwealth has filed an appeal for an en banc hearing:

http://www.washingtonpost.com/national/ ... story.html

When I see this statement, "...DOC’s appeal is based on the lower court’s significant expansion of the standard for what constitutes adequate care under the Eighth Amendment," I wonder, what do they mean by that?

http://www.thesunchronicle.com/news/loc ... f887a.html

Are they talking about the 8th amendment standard? As I understand, both Judge Wolf's ruling and the majority opinion found that the case met the objective and subjective prongs of the deliberate indifference test, which satisfaction means that the 8th amendment was indeed violated and that an injunction is needed to rectify the situation. This is the standard set in place by the Supreme Court.

Do they mean the medical standards of care? As shown in the Tax Court case, O'Donnabhain v. Commissioner, numerous medical and psychiatric reference texts support sex reassignment surgery as medically necessary treatment in appropriately evaluated patients, pointing to the WPAH Standards of Care. Kosilek has long met those standards.

Were they referring to what Medicare or insurance covers? Medicare's decision to exclude sex reassignment surgery, which was based on a report written more than 30 years ago and no new information since, is currently in doubt and under review, so that's a pretty poor benchmark. As well, insurance companies have a conflict of interest in making determinations of medical necessity and what to cover; ultimately, for them, it's about the profit margin.

I guess the only thing I can think of is transgender exceptionalism, as Jennifer Levi has written of about this very case:

http://jurist.org/hotline/2012/10/jenni ... osilek.php

I wonder if some prisoners might be coerced into doing this, and then become sex slaves pimped out by gangs.

Never thought of that! LOL.

This is foolishness. The person is in prison because they committed a serious crime --murder. When one is sent to prison, one is denied the rights accorded to free citizens, due to the fact that citizenship in a free society has been curtailed do to that one's actions.

Sexual reassignment surgery should be reserved for those who have the means to pay for it, not provided at taxpayer expense for those who do not have the means to pay for it themselves.

Because this person is in prison for committing murder, they should not be given sexual reassignment surgery at taxpayer expense.

Not if they have surgery they won't. I'm pretty sure that post op trans people are put into the prison of the gender they identify as. I saw something about it in a prison documentary once.

In the U.S.A., however, there is one right they gain: The right to minimally adequate health care. Outside of prison, this right does not exist.



The courts found, looking at the medical and psychiatric literature, including position statements by the major health organizations, hearing expert witness testimony, and the fact that the prison's own doctors had ordered sex reassignment surgery be provided, that it was the only minimally adequate treatment for Kosilek's gender identity disorder. In addition, the courts found that the prison officials engaged in deliberate indifference by refusing to provide Kosilek surgery, which violates the 8th amendment and necessitated and injunction to rectify the situation.

A prisoner has a different relationship with the State than a typical citizen. A prisoner is completely reliant upon the State for all of the necessities of life, including food, clothing, shelter and medical care. The denial of necessities of life is, I suggest, cruel and unusual punishment within the ambit of the Bill of Rights, unless the prisoner has been sentenced to death, and the denial of necessities of life is immediately connected to the process of executing that sentence. Otherwise, the State has a positive obligation to care for each and every prisoner, which is an obligation that does not exist in respect of citizens, generally.

Should a prisoner be deprived of kidney dialysis? Chemotherapy? Insulin? Clearly these are life saving therapies. So let's move one step onward. Should a prisoner be deprived of medical care to set a fracture? Should a prisoner be deprived of prescription medication to control a non-lethal medical condition?

At what point does the State have the capacity to intrude into the physician-patient relationship and substitute its own opinion for what therapies are medically necessary for the patient's well being?

My feelings exactly! What's next after this; face-lifts, breast implants, tattoos and/or tattoo removal all at taxpayer expense just to make some convicts feel good about themselves? NOT!

A few facial wrinkles or a perceived lack of tattoos don't cause people the mental anguish and suffering that comes from being stuck in the wrong body, and having bits growing out of you that simply don't belong there while other parts of you are missing. The latter is more akin to refusing someone both a prosthetic limb and the treatment of a tumorous growth.

(Edited for messed-up quote tags)

Last edited by Solitudinarian on 02 Feb 2014, 2:49 am, edited 2 times in total.

The problem is the lack of universal health care outside of prisons though, not the access to adequate care inside prisons. I'm pretty sure that's what you meant too

Exactly.

You'll never sell me on that.

According to the link provided by the OP:

Not mentioned was this, from a 2012 article.
I guess lawyers charge more than doctors and insurance companies.

It seems that citizens are only granted that which is superficial, and doesn't result in real democratic power, or meaningful self actualisation. Still, this is better than nothing, I suppose.

Last edited by Stannis on 03 Feb 2014, 9:07 am, edited 4 times in total.