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Published on 2012-09-09 and tagged for USA

Trans rights and incarceration in the US

from WPATH 

Yesterday marked a huge step forward for the rights of transgender people where a judge ordered that the Department of Corrections provide sex reassignment surgery for transgender inmate Michelle Kosilek.  

What you may not know is that WPATH members, Randi Kaufman PsyD and George Brown MD were instrumental in this victory. The Standards of Care also played an important role.

See below for a synopsis of the case, drafted by Drs. Kaufman & Brown, highlighting the most significant aspects of the decision. Please feel free to spread this information far and wide. 

This is another example of WPATH members fulfilling our mission, in this case the mission of our committee for incarcerated persons. The committee for incarcerated persons is committed to advocating for respectful, appropriate, and evidence-based treatment for gender-variant individuals living in institutional settings.  Members of the committee are WPATH providers who have experience working with inmates, attorneys, administrators, clinicians, correctional personnel, and any other individuals and/or institutions that create or implement care protocols for transgender inmates.

Congratulations to George And Randi for such an important victory!

My best,

Lin Fraser EdD
WPATH President


Here is their synopsis: 

Yesterday marked a huge step forward for the rights of transgender people.  Federal Judge Mark Wolf of the 1st Circuit in Boston ruled in favor of inmate Michelle Kosilek, who sued the Dep’t of Corrections under the 8th Amendment, Cruel and Unusual Punishment.  Judge Wolf ordered that the Dep’t of Corrections (DOC) provide Kosilek with sex reassignment surgery, following the treatment recommendation of Dr. Randi Kaufman, who put forth the clinical opinion that surgery was medically necessary.  Experts testifying on behalf of the inmate included George R. Brown, MD, of Tennessee, and Dr. Randi Kaufman of Boston and NYC.  This case, which has taken six years for a judgment to be issued, went beyond the recent victory in April in another federal case in Massachusetts, where Judge Tauro’s ruled in favor of the inmate Ms. Soneeya, but stopped short of ordering the DOC to provide sex reassignment surgery in that case.   

Yesterday’s victory is unprecedented, and is the first case in the US where a Federal judge has ordered surgery for an inmate.  Judge Wolf’s 126 page order also relied on the successes of two other cases in which Dr. Brown was the key witness (O’donnabhain v. IRS, and Battista v. MA Department of Corrections) to buttress his opinion in favor of Kosilek.  He begins by stating:  

“This case is unusual because a transsexual prisoner, plaintiff Michelle Kosilek, seeks an unprecedented court order requiring that the defendant Commissioner of the Massachusetts Dep’t of Correction provide him (sic) with sex reassignment surgery to treat his major mental illness, severe gender identity disorder.  This case is also unusual because until recently inmates suing for medical care have typically sought treatment that prison doctors were unwilling to prescribe.  In this case, however, Kosilek is seeking the treatment that has been prescribed for him by the DOC’s doctors as the only form of adequate medical care for his condition.  Such cases have recently become more common in Massachusetts because the DOC has repeatedly denied transsexual prisoner prescribed treatment for reasons that the courts have found to be improper”. 

The order details the ways in which the DOC’s resistance to providing surgery due to the “insurmountable security concern” this would pose, was “pretextual”; that the DOC’s resistance to surgery was actually due to concern that “providing such treatment would provoke public and political controversy, criticism, scorn, and ridicule”.  Judge Wolf found a “pattern of “prevarication, denial, delay and interference”, and concluded the order by ordering that the Defendant “provide Kosilek sex reassignment surgery as promptly as possible”. 

Also of note in this case is the fact that Dr. Brown testified that a “real life experience” can indeed happen in a prison environment, a position opposed by the experts for the DOC.  Brown’s position was accepted by Judge Wolf, establishing for the first time in a major decision that the RLE (as it was known in Version 6) can occur in prison, clearing the way for readiness and eligibility for SRS for inmates if clinically appropriate.

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