Federal judge orders Mass. to give prisoner gender-reassignment surgery

Citing her right to be free from cruel and unusual punishment as guaranteed by the Eighth Amendment of the U.S. Constitution, Chief Judge Mark Wolf of the U.S. District Court for Massachusetts has ordered that an inmate serving time for murder be given gender reassignment surgery “promptly as possible.” This is the first time a federal court has made such an order.

“(Michele) Kosilek is serving a life sentence, without possibility of parole, for murdering his wife,” wrote Wolf. “Kosilek suffers from a gender identity disorder, which is recognized as a major mental illness by the medical community and by the courts. Kosilek is, therefore, a transsexual –– a man who truly believes that he is a female cruelly trapped in a male body. This belief has caused Kosilek to suffer intense mental anguish. This anguish has caused Kosilek to attempt to castrate himself and to attempt twice to kill himself while incarcerated, once while he was taking the antidepressant Prozac.”

The order was handed down today to the Massachusetts Dept. of Corrections.

The Supreme Court has ruled that the Eighth Amendment requires that prison authorities not exhibit “deliberate indifference” to inmates’ serious medical conditions and that they provide adequate care as defined by accepted professional standards.

Some cases of gender identity disorder can be adequately treated through psychological counseling, while others require hormone therapy in support of body modifications to conform to an individual’s gender identity.

“There are, however, some cases in which sex reassignment surgery is medically necessary and appropriate,” wrote Wolf, observing that in this case the Massachusetts DOC medical staff agrees that Kosilek needs this treatment.

According to Wolf’s opinion, a series of DOC commissioners stubbornly resisted medical recommendations, as they had done regarding hormone therapy in this and other cases.

“Such cases have recently become more common in Massachusetts because the DOC has repeatedly denied transsexual prisoners prescribed treatment for reasons that the courts have found to be improper,” Wolf wrote.

Among the ploys used to avoid providing gender reassignment surgery, past DOC commissioners have discharged doctors who prescribed it and hired new doctors categorically opposed to it. Commissioners have also argued that prison security concerns justified refusal to provide hormone therapy –– including at an earlier stage of Kosilek’s lawsuit –– but Wolf found the evidence belies that argument. After Wolf ordered that Kosilek be given hormone therapy and allowed to adopt feminine dress and grooming, she continued to live unmolested, despite continuing to be detained in an all-male prison.