Transitioning from male to female or female to male is not an easy or inexpensive process. Considered by some insurance companies as an elective or cosmetic surgery, many transpeople must pay for gender reassignment surgery out-of-pocket and draw out the process over years. In many instances the process involves hormone therapy and surgical components.
The number of insurance companies covering sex reassignment surgeries is on the rise reported Huffington Post last December. Recent court decisions in Wisconsin and Massachusetts ruled that the failure to provide hormone treatment and other services constitutes cruel and unusual punishment. So if it’s a constitutionally mandated right for our prisoners to have access to transgender surgery, shouldn’t it also be accessible to law-abiding citizens?
The related Wisconsin case concluded in March of this year, and it began with a state law barring the medical care of transgender inmates. Lambda Legal and the ACLU challenged the state law in federal court and won in 2010. After being upheld in a court of appeals, the U.S. Supreme Court turned down a subsequent appeal, securing the right for current and future transgender inmates access to appropriate medical care.
The recent decision by a federal court in Massachusetts focused on the right to surgery, discussing the medical implications of gender identity disorder. The fact that convicted murderer Michelle Kosilek (born Robert Kosilek) attempted suicide and self-castration demonstrated the gravity of the disorder and the requirement of surgical treatments. I do, however, worry about labeling all transgender people as disordered. Mental illness and trans-identities are both already stigmatized in the U.S.
Implementing these new rules will be complicated for prison systems, which operate on a strict gender binary. Officials in Massachusetts worried about the added cost and security required to care for a transfemale in a male facility. But just because an transition is difficult doesn’t mean it’s not important and necessary – just ask a transgender person.