Court rules state should pay for sex change of transgender prisoner

A federal appeals court upheld a Massachusetts court's finding that a sex change constitutes necessary medical care

In this Jan. 15, 1993 file photo, Michelle Kosilek sits in Bristol County Superior Court, in New Bedford, Mass.

A Massachusetts prisoner suffering from gender identity disorder should be provided a sex-change operation paid for by the state's prison system, according to a federal appeals court decision issued on Friday.

The U.S. First Circuit Court of Appeals in Boston, in a ruling by a panel of three judges, said it agreed with a lower court ruling from 2012 that the Massachusetts Department of Corrections was obligated to provide the surgery as treatment for the inmate, who is serving a life sentence for murder.

"Having carefully considered the relevant law and the extensive factual record, we affirm the judgment of the district court," Judge Rogeriee Thompson wrote for the court.

The 63-year-old inmate, who legally changed her name to Michelle Kosilek from Robert Kosilek, sued the Department of Corrections more than a decade ago trying to force it to pay for gender reassignment surgery.

Kosilek was convicted in 1992 of murdering her wife, a counselor she had met while she was in drug rehabilitation, after she caught Kosilek wearing her clothes.

Judge Mark Wolf of the U.S. District Court in Boston ruled in 2012 that the state had violated Kosilek's rights by denying the procedure, noting that Corrections Department medical personnel had recommended it as necessary treatment for gender identity disorder.

The Department of Corrections challenged the decision, claiming that denying sex-change surgery does not constitute inadequate medical care.

Prison officials have repeatedly cited security risks in the case, saying that allowing Kosilek to have the surgery would make her a target for sexual assaults by other inmates.

In a telephone interview in 2011 with The Associated Press, Kosilek said the surgery was a medical necessity, not a frivolous desire to change her appearance.

"Everybody has the right to have their health care needs met, whether they are in prison or out on the streets," Kosilek said. "People in the prisons who have bad hearts, hips or knees have surgery to repair those things. My medical needs are no less important or more important than the person in the cell next to me."

The National Center for Transgender Equality hailed the decision.

"Today's decision affirms the increasing consensus among the courts that transgender-related healthcare is just healthcare and that people behind bars, including transgender people, have a constitutional right to healthcare," said NCTE director Mara Keisling in a statement. "Decisions about treating serious healthcare decisions like sex reassignment surgery need to be made by doctors and patients, not prison authorities."

Al Jazeera and wire services

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