A federal court judge on Tuesday ordered Massachusetts officials to provide sex-reassignment surgery for a transsexual prison inmate, after determining that it was the only adequate treatment for the inmate's mental illness.
The state's Department of Correction said Michelle Kosilek, previously known as Robert, who is serving a life sentence without parole for murdering his wife in 1990, has a gender identity disorder.
She attempted to castrate herself and tried to commit suicide twice while incarcerated in an all-male prison in Norfolk, according to a court order.
"We are very happy with the ruling, of course. We are still reviewing the opinion and we anticipate the Department of Corrections will follow Judge Wolf's order and promptly arrange for Michelle Kosilek to receive her treatment," Kosilek's attorney Joseph Sulman said Tuesday.
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Chief Judge Mark L. Wolf ruled that sex reassignment surgery is the "only adequate treatment" for Kosilek, and "that there is no less intrusive means to correct the prolonged violation of Kosilek's Eighth Amendment right to adequate medical care."
"This is the first decision in which the court has ordered a prison to provide sex reassignment surgery as the necessary medical treatment for a transsexual inmate," said Ben Klein, senior attorney with the Gay and Lesbian Advocates and Defenders.
But according to court documents, this ruling was not an unfamiliar case for this court.
Kosilek's case dates back two decades ago, when she was first incarcerated.
According to Francis Cohen, the lead counsel of Kosilek's initial lawsuit, Kosilek did not receive any treatment for her disorder from 1992 to 2002, even though she had repeatedly asked the prison for help.
It wasn't until 1999, when Kosilek first filed suit, that the court recognized her medical needs.
In 2002, the court found that the Department of Correction had refused to provide Kosilek with the proper medical treatment she needed as had been prescribed by the department's doctors.
In that ruling, the court found that the department's refusal was "rooted in sincere security concerns, and in fear of public and political criticism as well."
That year, Kosilek began to receive necessary medical treatments in the form of psychotherapy and hormone treatments.
"It's quite common that the denial of important medical treatments is based on a bias against transgender people rather than on science," Klein said.
A 2009 University of California, Irvine study of prison inmates in California found that a transgender inmate is 13 times more likely to be sexually assaulted than the average inmate, adding on to security concerns above medical ones.
"[Kosilek]'s very excited and very, very pleased. She's very glad the court has recognized her need for this surgery," Cohen said of her client.
According to the American Society of Plastic Surgeons, with all operations, therapy, hormone injections and electrolysis, the cost of sex reassignment surgery can range from $30,000 to $80,000.
U.S. Sen. Scott Brown, R-Massachusetts, said in a statement Tuesday that the court's decision is "an outrageous abuse of taxpayer dollars. ... I look forward to common sense prevailing and the ruling being overturned."
The court ruling left it up to the Department of Correction to decide where Kosilek will be incarcerated after the surgery.
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