SAN FRANCISCO (CN) - A federal judge's decision to allow a California inmate to undergo sex-reassignment surgery at public expense has drawn criticism from lawmakers and praise from transgender groups.
U.S. District Judge Jon Tigar ruled on April 2 that the California Department of Corrections and Rehabilitation violates Michelle-Lael Norsworthy's constitutional rights by denying her the surgery while she is in prison, and that it must pay for the procedure.
Tigar disagreed with the prisons' medical experts who said the surgery "is not medically necessary," and accused them of having a profound misunderstanding of gender dysphoria.
"The evidence suggests that Norsworthy's request for SRS was denied because CDCR has a blanket policy barring SRS as a treatment for transgender inmates," Tigar wrote. "The weight of the evidence demonstrates that for Norsworthy, the only adequate medical treatment for her gender dysphoria is SRS, that the decision not to address her persistent symptoms was medically unacceptable under the circumstances and that CDCR denied her the necessary treatment for reasons unrelated to her medical need."
Norsworthy, 51, was convicted of murder and sentenced to life in prison in 1987 and began living as a woman while in prison.
Norsworthy was diagnosed with gender identity disorder in 2000 and began receiving hormone therapy from the CDCR.
The Transgender Law Center, which represented Norsworthy, said the historic decision will allow essential treatment to a woman suffering from gender dysphoria.
"There is a clear medical consensus that health care related to gender transition is necessary - and life-saving - for many people," Kris Hayashi, executive director of Transgender Law Center, said. "This decision confirms that it's unlawful to deny essential treatment to transgender people."
According to Tigar's ruling, Norsworthy has been raped six times in prison, including a gang rape in 2009 from which she contracted hepatitis C.
Tigar lambasted the report of defense expert witness Dr. Stephen Levine, calling it not credible "because of illogical inferences, inconsistencies and inaccuracies."
California Republicans began issuing statements criticizing the ruling virtually as soon as it became public.
Assembly Republican Leader Kristin Olsen wrote a letter asking the state to appeal Tigar's ruling.
"I urge you not to reward a convicted murderer with $100,000 of elective surgery at taxpayer expense," Olsen wrote. "Should you deny the request to appeal Judge Tigar's ruling, I encourage you to solicit an outside source to fund Mr. Norsworthy's operation. Law-abiding and hard-working taxpayers should not be stuck with the tab."
Republicans say the ruling could set a precedent for "elective procedures."
"This ruling is proof that our prison system is no longer a deterrent to criminal behavior, instead it has become a retreat at taxpayers' expense," Rep. Devon Mathis, R-Visalia, said in a statement. "For a judge to even entertain the request from a convicted murderer to receive this elective medical procedure, shows a complete dishonor to our justice system, the victim's family and the taxpayers of California."
But Hayashi said that in denying the surgery, the state has already spent valuable resources and time in court. The Transgender Law Center also disputes the $100,000 price tag of the surgery.
"The estimate provided by California Department of Corrections grossly exaggerates the cost of the life-saving care Michelle needs, which is more in the range of $15,000-$30,000," Hayashi said. "In the meantime, the state is spending significant money and resources on trying to deny Michelle care."
In 2012 a federal judge in Massachusetts ruled that that state must provide sexual-reassignment surgery to one of its inmates. That case is on appeal to the U.S. Supreme Court.
Nine states, including California, require private insurers to cover medical care related to gender transition, according to the Transgender Law Center.
A day after Tigar's ruling, the Justice Department filed a brief in the court fight of a transgender Georgia inmate named Ashley Diamond.
Without taking a position on the merits of the allegations, the April 3 statement of interest by the United States notes that the Eighth Amendment mandates individualized assessment and care for gender dysphoria.
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