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Sep 05 2012

This is an important step

A judge has ruled that Massachusetts prison officials must provide genital surgery for a transgender inmate, Michelle Kosilek, currently serving life in prison for murder. This is an entirely logical conclusion. Prisoners are entitled to health care, the established standards of care for trans people indicate that genital surgery is appropriate for those who need it, therefore trans prisoners who require genital surgery should have access to it. But this obvious answer has evaded many, like Senator Scott Brown:

“We have many big challenges facing us as a nation, but nowhere among those issues would I include providing sex change surgery to convicted murderers,” Brown said in a statement. “I look forward to common sense prevailing and the ruling being overturned.”

Denying that prisoners should receive any kind of health care quickly becomes untenable – physically preventing a group of people from even attempting to access the medical treatment they require, and simply leaving them to suffer or die, is clearly inhumane. The fact of them having been convicted of murder or other crimes is irrelevant to this; sentencing someone to imprisonment is not equivalent to sentencing them to medical neglect and the consequences thereof.

After denying this first point, those who reject this conclusion move on to denying the next one: that genital surgery and other transsexual treatments are indeed medically necessary. Instead, these are often trivialized as merely cosmetic and not essential to one’s health. This attitude has cropped up elsewhere, such as in the FRC’s contention that trans people detained by ICE should be denied access to their prescribed hormone therapy. The ruling in the Kosilek case explicitly refutes this, finding that surgical treatment is a “serious medical need”. It correctly concludes that the medical needs of trans people are no less crucial, important and valid than the medical needs of everyone else. Would Scott Brown, and others who deny this, pretend that they’re just as qualified as medical experts to decide which treatments someone should receive for cancer, heart disease or any other condition? So why do they think they know better when it comes to transitioning?

30 comments

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  1. 1
    Nothing

    Goes to show that electing moronic fucks to positions of power was never a good idea at any point in history.

  2. 2
    Pierce R. Butler

    Would Scott Brown, and others who deny this, pretend that they’re just as qualified as medical experts to decide which treatments someone should receive for cancer, heart disease or any other condition?

    You think they wouldn’t?

  3. 3
    A Lowly Apprentice

    The FRC is not my reverse executive decision maker.

  4. 4
    SweetShot

    Bad incentive. Commit some carefully selected crimes, get caught, serve a few months in county prison, get “free” (for the criminals, not so much for the taxpayers) surgery, PROFIT!

    1. 4.1
      eric

      LOL, Sweet, did you even bother to read the first link? This court case and the decision to perform the surgery has taken 12 years. Your scenario is laughably unrealistic.

      AIUI, these tend to be carefully thought out and long-term decisions. The medical lead-up to it is years and the window for doing it is probably months or years. I don’t see any reasonable scenario where your fear could come to pass. But please, prove me wrong. Describe a reasonable scenario in which (1) the person can expect to get out of jail in a couple of months and go on with their life as per normal, while (2) their need for genital surgery is so immediate and so unexpected that the state cannot either grant them leave to do it beforehand or delay it to after they serve their sentence?

    2. 4.2
      Jesse

      Perhaps, but then this has nothing to do with trans issues. Any person with a medical problem could do the same thing.

      For instance, robbing a bank for $1 to get care. http://abcnews.go.com/Health/Wellness/nc-man-allegedly-robs-bank-health-care-jail/story?id=13887040#.UEg0NrSPW6w

  5. 5
    Zinnia Jones

    The problem with the incentive structure isn’t that prisoners have guaranteed access to healthcare. It’s that the rest of society doesn’t.

    1. 5.1
      SweetShot

      Still, completely wrong place to start. The horse goes in front of the cart. (Rhyme unintentional)

      1. Zinnia Jones

        I’m having trouble seeing the ethical case for denying healthcare to prisoners.

        1. SweetShot

          Well, I’m having trouble seeing through your “free stuff for everybody” scheme.

          1. sc_fa62dd936b9798228f7085a2476046dc

            So you’re for denying prisoners any health care at all or is it just the health care you disagree with?

          2. shockna

            So you actually don’t support healthcare for all, then? Still not seeing a defense of your case, BTW.

          3. doubtthat

            I love this line of reasoning. I sincerely hope that you tipped back your tri-corn hat and gazed fondly at your “Don’t Tread on Me” poster before typing that.

            Universal health care is not about making medical coverage “free,” it’s a reallocation of costs to 1) cover everyone and 2) make it cheaper and more efficient. You are already paying for the uninsured via your insurance premiums (assuming you have insurance), so…didn’t most thinking people get through this several years ago?

            As for the prisoner, we would give them a heart transplant, we would give them chemotherapy, we would spend money undertaking all manner of medical procedures, I’m not sure why, if the medical community has deemed it necessary, we would treat this any differently.

  6. 6
    smrnda

    I seriously doubt that in any but some very extreme cases has anyone *decided* to commit a crime to go to prison to get easy access to health care. Don’t know where you happen to be from SweetShot, but prison isn’t a place that anybody would really voluntarily go if they had the choice. Prisons are rough places.

  7. 7
    Rob Miller

    From the articles that I have read in the past and even in some of my own suffering as a person with gender dysphoria, if a person has been diagnosed, professionally by more than one psychologist, with GID then if they do not receive the treatment for such a “disorder” they likely go into heavy states of depression and even suicidal thoughts. In a prison, if I’m not mistaken, if you become suicidal they put you in a special wing of the hospital with all the other mentally ill people and are put on suicide watch until the problem is fixed, normally with medication. So, what kind of medication will they use to fix a problem like this? What if the medication doesn’t work? Are they going to keep her on suicide watch for the rest of her sentence(until she dies in this case)?

    First of all, why do we have people in the position of power that makes our laws who do not understand the issues they make laws about? You’d figure that the best person to make legal decisions and pass laws should at least have a basic general knowledge of the subject that the decision and/or law deals with. You don’t want a pizza delivery man who hasn’t graduated from high school managing a nuclear power plant do you? No, you’d want somebody who has been educated and certified to manage such a facility. Same thing should go for those who make our laws. To many people are making decisions about the rights of other people, prisoners or not, based on personal bias and not on fact of the matter.

  8. 8
    abusedbypenguins

    Doctors wanting to learn certain procedures need to practice, and what better way than an inmate who wants the procedure. Have it done at a teaching hospital to keep the costs down.

    1. 8.1
      lochaber

      I don’t even know how to respond to this. Do you people sincerely think a trans individual is going to willing get caught committing a felony just so the state can foot the medical bills for SRS? Trans people already have a hard enough time getting jobs and housing – being a convicted felon isn’t going to make that easier, and will make it nearly impossible in many areas. Also, prison isn’t a terribly nice place to be for cis folks, and from what I’ve heard, it is a whole lot less nice for trans folks.

      so, anyways…

      1 – If you take away an individual’s autonomy and freedom, you have an obligation (moral, if not legal) to care for and protect that person. Even in war, if you take an enemy prisoner, it doesn’t matter if they were trying to kill you and your companions minutes prior; once you take control of them you are obligated to care for and protect them (including medical attention). If you take someone out of society and lock them up in a building and restrict their ability to make their own decisions and take care of themselves, then it is your responsibility to see that they are taken care of.

      2 – If you people are really so damned concerned about the cost, push for prison/justice system reform. The US has the largest prison population per capita (or even absolute number) of any country. Prison is damned expensive. If you are truly concerned about costs, look at decriminalizing the ‘victim-less crimes’ (prostitution, drug use, etc.), establishing more thorough social programs, better education, and lessening income inequality – these are all correlated with lower crime rates.

      I haven’t read any hard data on this, but I’m willing to bet that a lot of the trans folk that end up in prison are going to be there on charges relating to either drug use or prostitution (neither of which should be a crime, imho). As Rob Miller stated above, trans people are at a higher risk of depression, which would make someone more prone to substance abuse. So does being part of a marginalized population.
      I don’t think it’s uncommon for a trans person to have significant troubles finding employment (hell, in the current economy, even cis white heterosexual males are having trouble, how do you think a member of any under-privileged group is going to do, let alone one a member of one of the few groups that have no legal protections), so some individuals may turn to sex-work as a matter of survival.

    2. 8.2
      lochaber

      abused>

      apologies, I hit the wrong ‘reply’ button, and meant mine to be a general comment, not a specific response to your comment.

  9. 9
    brandyspears

    I don’t know about Zinnia, but I have met just as many transsexual persons who are just as despondent over having male-pattern baldness as those who desperately seek SRS. Would Zinnia also advocate for prisoners (convicted of spousal abuse and murder) free hair plugs? How about those severely unhappy with breast development?

    1. 9.1
      Natasha

      How about we let medical professionals who are actually trained to evaluate this sort of thing decide? As Zinnia pointed out this is the recognized treatment for transsexual individuals.

      1. brandyspears

        How about allowing transsexual persons THEMSELVES tell you whether they are transsexual or not. You seem to be implying that transsexual suffer from some sort pathological disorder that need a diagnoses.

        1. lochaber

          And maybe I’m misreading your post, but it looks like you are making the claim that GID issues are about on the same level as insecurities about hairloss.

          I really hope I’m misreading it, but even so, I kinda doubt I’m the only person doing so, so please do elaborate/explain.

          1. brandyspears

            Yeap. You are making a claim that I didn’t make. GID and SRS are not the same thing.

          2. lochaber

            Like I said, I really hope so, but please correct me.

            Is SRS not a GID issue?

            I’m well aware that they are separate things, but I’m pretty sure most people desiring SRS are doing so as part of addressing GID issues. Maybe I’m wrong, and I’m definitely open to correction, but it seems to me that SRS is a specific that would fall under the more umbrella-like GID term/classification.

            When I read your comment, it semed to me that you were equating trans folk in need of SRS with anyone unhappy with hair loss.

            To me, it reeks of the whole bit about ‘gender/sex doesn’t matter, learn to love yourself the way you are’ bit.

            Again, like I said before, I really hope I’m misunderstanding this, but if this is the case, please explain and elaborate. I’d like to think that most people who actually read Zinnia’s postings are a bit more aware of gender issues than most folk, but I’ve made glaring false assumptions in the past, and I may be doing so again…

          3. brandyspears

            I’m just stating a fact: some transsexual persons are also equally despondent over male-pattern baldness. I am not including the general population. I am talking about transsexual issues.

            Do you agree with the ruling? “It is not permissible for prison officials to [deny treatment] just because the fact that a gender identity disorder is a major mental illness is not understood by much of the public and the required treatment for it is unpopular,” Wolf wrote.

            This is a ruling on mental illness. I don’t consider it a trans victory. Do you?

        2. lochaber

          Alright, please allow me to back down on the hostilities.

          First off, thank you for elaborating, and I do think I did misunderstand you. I think it was this specific statement:

          “Would Zinnia also advocate for prisoners (convicted of spousal abuse and murder) free hair plugs?”

          I can see hair loss being an important issue for trans individuals (and, I don’t have any links/evidence to back this up, but I’d be willing to bet that most people prioritize ‘long hair’ and ‘having boobs’ as defining visual characteristics of women), but since this statement lacked any specifiers for trans individuals, I thought it was a blanket statement that anyone unhappy with hair loss had equivalent medical need as someone with GID.

          I’m not sure what to make of the statement of it as a mental illness. I think it is definitely a medical condition, and should be covered by insurance, but I realize there are many issues with having it officially classified as a ‘disorder’. Unfortunately, I’m under the impression that a lot of trans individuals are denied basic hormone prescriptions, mostly because the general populace doesn’t view them as ‘necessary’ or some such. I don’t think such individuals should be given the stigma of mentally ill, but at the same time, our current system may require a diagnosis of a mental ‘disorder’ before allowing the prescription of medications (hormones, in this case).
          -side note, I do feel there is an issue with our society’s treatment of mental disorders, but, well, that’s another argument that I’m not ready for right now.

          I don’t know. I can’t remember where, or from whom, but a few years back I had read some statement about how GID was the only psychological disorder that could be ‘cured’ by ‘cosmetic’ surgery.

          -A bit of an aside, but I thought male-pattern baldness was primarily due to hormones (testosterone, I’m guessing?), and wouldn’t be as much of an issue for trans individuals undergoing hormone therapy and such.

          Anyways, brandyspears, thanks for elaborating, I’m hoping I just made a bad assumption from an ambiguous statement, and that we both have similar goals/desires. Apologies if I misread your comment.

          1. brandyspears

            Another hair-related tidbit from this case: “Kosilek’s lawyers argued that having facial hair is “intensely personally stressful to her” and that she has a “serious medical need” for electrolysis.”

            Read more: http://www.sfgate.com/news/article/Inmate-pushes-judge-to-order-electrolysis-3209698.php#ixzz25iJymtiu

  10. 10
    BBoo

    Great that this happened now when the conservatives can use it as grist for their mill. Just great. Thanks Massholes.

  11. 11
    mimi

    Normally I would NOT agree with reassignment surgery for the transexual person in prison for emotional reasons(tough noogies, pal- not a necessary treatment for life, IMO-wait till your out of jail)

    HOWEVER-In order for this individual to be placed in the proper prison for the proper sex, reassignment surgery is the safest and only real option. It is inhumane to expect a trans female to be in a jail with men. Absolutely unsafe situation-and may fall under “cruel and unusual punishment.”

  12. 12
    doubtthat

    In all honesty, this situation isn’t even really a tough one from a moral perspective. If the medical community has deemed it a necessary sort of surgery, it should be done.

    Here’s a hard question, organ transplants for death row inmates:

    http://abcnews.go.com/US/story?id=90611&page=1#.UE1vh45br6E

    Giving an inmate genital surgery will not cause a non-felon to go without necessary medical treatment. Putting inmates, especially those we’re prepared to kill, on the organ transplant list gives them priority over others. That is a much more difficult question. The only thing to whine about with genital surgery is cost.

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