Judge orders inmate's taxpayer-funded sex change

Michelle Kosilek / CBS/WBZ (file image)

Updated 2:57 PM ET

(AP) BOSTON - A federal judge on Tuesday ordered state prison officials to provide taxpayer-funded sex-reassignment surgery to a transgender inmate serving life in prison for murder.

Michelle Kosilek was born male but has received hormone treatments and now lives as a woman in an all-male prison. Robert Kosilek was convicted of murder in the killing of his wife in 1990.

U.S. District Judge Mark Wolf is believed to be the first federal judge to order prison officials to provide sex-reassignment surgery for a transgender inmate.

Kosilek first sued the Massachusetts Department of Correction 12 years ago. Two years later, Wolf ruled that Kosilek was entitled to treatment for gender-identity disorder but stopped short of ordering surgery. Kosilek sued again in 2005, arguing that the surgery is a medical necessity.

In his ruling Tuesday, Wolf found that surgery is the "only adequate treatment" for Kosilek's "serious medical need."

"The court finds that there is no less intrusive means to correct the prolonged violation of Kosilek's Eighth Amendment right to adequate medical care," Wolf wrote in his 126-page ruling.

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.

But Wolf, who was appointed to the federal bench by President Ronald Reagan in 1985, found that the security concerns are "either pretextual or can be dealt with." He said it would be up to prison officials to decide how and where to house Kosilek after the surgery.

Diane Wiffin, a spokeswoman for the prisons department, said the agency would have no immediate comment on the ruling.

"We are reviewing the decision and exploring our appellate options," Wiffin said.

In a telephone interview last year with The Associated Press, Kosilek said the surgery is 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."

Wolf noted in his ruling that the Department of Correction's own medical experts testified that they believe surgery was the only adequate treatment for Kosilek.

The department's ex-commissioner Kathleen Dennehy testified that providing Kosilek the surgery would present insurmountable security concerns, but Wolf said Kosilek had proven that those purported concerns masked the real reason for denying surgery: "a fear of controversy, criticism, ridicule and scorn."

Kosilek's lawsuit has become fodder for radio talk shows and lawmakers who say the state should not be forced to pay for a convicted murderer's sex-change operation — which can cost up to $20,000 — especially since many insurance companies reject the surgery as elective.

Inmates in Colorado, California, Idaho and Wisconsin have sued unsuccessfully to try to get the surgery, making similar arguments that denying it violates the U.S. Constitution's protection against cruel and unusual punishment.

Wolf noted that Kosilek's gender-identity disorder has caused Kosilek such anguish that she has tried to castrate herself and twice tried to commit suicide, including once while on Prozac.

Kosilek's lead attorney, Frances Cohen, called the decision courageous and thoughtful.

"We feel very grateful that the judge listened very carefully to the medical experts and has given Michelle Kosilek what the prison doctors had recommended," Cohen said.

[Nualaan]

So many blatantly wrong and misinformed opinions, along with total misunderstanding of how the criminal justice system works, the facts of the case, and a whole lot of transphobia and hate thrown in for good measure. Being ignorant of the facts will never stop the masses from having an opinion on something I guess. *sigh*

1. You do not withhold medically necessary treatment from a ward of the state according to the type of crime they committed which resulted in their incarceration.

2. This inmate offered to pay the cost of the medically necessary surgery themselves initially and state officials refused.

3. Punishment for the crime is imprisonment, for natural life barring a commutation. That IS the punishment the state has determined fits this crime.

4. The state could have avoided the majority of costs initially, but insists on stalling against the advice of knowledgeable experts worldwide, their own attorneys and doctors, and against the courts who had no choice but to uphold the law and the Constitution in the matter.

[BlakeLemoi]

This is wrong on so many levels I can't even begin !!!! We need to change the way our prison system and judical system work b/c the have been broken for YEARS!

[linfinster]

SOOOO WRONG!! As a convicted murderer the only thing, I suppose, we should have to do is ensure his physical health. A reassignment should not be considered medically needed! That judge needs to be removed!!

[askagain]

Unbelievable. As self-employed people, my wife and I pay $22,000 per year for health insurance. In addition, we pay pay over $40,000 in income taxes and $5,200 in property taxes. This guy sits in prison for life at the expense of tax payers and a judge delares that he is entitled to a sex change operation. Forget me. There are many hard working people barely getting by in life and this guy is better taken care of than they are by the government. Talk about insanity.

[easez1]

You are 100% correct, President Reagan made a huge mistake thinking a liberal, because he was a judge, would or could be anything else. Lawrence was a horrible appointee, and this decision proves it.

[shenboe]

Senators from the state normally make recommendations as to the judge. From Mass., we can thank killer and alcoholic Ted Kennedy. Reagan should have left the seat vacant.

[lonestar9000]

So he (she) "tried" to castrate himself and "tried" to commit suicide twice? Nobody "tries" to commit suicide. They either do or they don't. This thing was just putting on an act to get sympathy. Obviously, it worked. Not liking who you are or how you look is not a disease or a mental condition. Did this judge ask this thing's deceased wife's family for their opinion?

[gnimelf1968]

Agreed, and how is wanting to be another sex a "serious medical condition"? Also why would they do anything like this for someone serving a life sentence for murder?

[do_japan]

As a hedonistic liberal who loves sodomy, I disagree with this judgement's argument that sexual reassignment surgery is a "medical necessity". How is it "medically" necessary? From a medical perspective it is invasive and unnecessary. You would be hard-pressed to find anyone more open-minded about sexuality than myself, but I strongly disagree with transgender people who argue that their reassignment surgery should be covered by their insurance provider or the government. Considering that there are millions of people in this country who can't even afford basic medical care, I say we'll pass on the opportunity to pay for your boob job for now, but thanks for trying to foot me with the bill!

[HdMorph]

Wrong, wrong, wrong, this is the biggest mis-carriage of justice for all times.
We have people homeless, suffering real issues, and this is needed, I think not.

[nohater]

stupid judge, stupid legal system. execute him. why make him a female then put him in a prison for females? what's next, granting him/her conjugal visits with a regular male. so called medical experts recommending the surgery should lose their license and be imprisoned themselves. brainless, brainless people seem to be everywhere in these United States.

[gnimelf1968]

Typical government, they don't care because it's not their money they are spending, or maybe the judge is sympathetic because they want the same surgery done!

[johnw2k]

This IS INSANE!!!
.
Life without parole: Lock 'em up, feed them, provide uniforms, let them do aerobic exercise (no weight training- they're strong enough already) and if they get sick with a physical disease try to cure them...
.
otherwise they should have nothing...
.
this is my opinion as an avowed Liberal...
.
(this kind of cr*p gives Liberals a bad name!)