Taxpayer-funded sex-reassignment surgery for murderer

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GloriaInTX's picture
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Taxpayer-funded sex-reassignment surgery for murderer

Do you agree with the judge that sugery must be provided as medical necessity?

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

U.S. District Judge Mark Wolf ruled in the case of Michelle Kosilek, who was born as a man but has received hormone treatments and lives as a woman in an all-male prison. Robert Kosilek was convicted of murder in the killing of his wife in 1990.

Wolf is believed to be the first federal judge to order prison officials to provide the 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 her to have the surgery would make her a target for sexual assaults by other inmates.

But Wolf found that the DOC's security concerns are "either pretextual or can be dealt with by the DOC." He said it is up to prison officials to decide how and where to house Kosilek after the surgery.

Read more: Mass. judge OKs sex change for inmate - Boston News, Weather, Sports | FOX 25 | MyFoxBoston

Joined: 05/23/12
Posts: 680

This is a messed up ruling. I do NOT think it's a serious medical need. Medical needs in prison for murder to me are for like, controlling diabetes, blood pressure, heart related problems, and the like. That man killed his wife. I don't care what kind of gender id problem he has, he can sit in his cell all alone til he dies with that disorder. There are good, non murdering and non criminal people who don't get normal health care needs met. Give me a break.

Joined: 12/10/05
Posts: 1681

"myyams" wrote:

This is a messed up ruling. I do NOT think it's a serious medical need. Medical needs in prison for murder to me are for like, controlling diabetes, blood pressure, heart related problems, and the like. That man killed his wife. I don't care what kind of gender id problem he has, he can sit in his cell all alone til he dies with that disorder. There are good, non murdering and non criminal people who don't get normal health care needs met. Give me a break.

I agree.

And who wants to bet that as soon as the surgery is complete he petitions to be moved to a women's correctional facility.

Alissa_Sal's picture
Joined: 06/29/06
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"myyams" wrote:

This is a messed up ruling. I do NOT think it's a serious medical need. Medical needs in prison for murder to me are for like, controlling diabetes, blood pressure, heart related problems, and the like. That man killed his wife. I don't care what kind of gender id problem he has, he can sit in his cell all alone til he dies with that disorder. There are good, non murdering and non criminal people who don't get normal health care needs met. Give me a break.

What about schizophrenia, or bipolar disorder, or depression? Would you treat those or just let the inmate rot in jail?

To be clear, I'm not sure about the ruling because I'm not knowlegeable enough on the subject to say whether or not gender reassignment surgery is considered a medical neccessity in someone diagnosed with gender identity disorder. If there are other treatments that are proven to be equally effective, then I could be convinced that this was a bad call on the part of the judge.

But I do think that mental disorders are a bit more complicated than high blood pressure or diabetes, and if a prison approved doctor ordered the surgery as a best treatment option, then that holds weight with me, just as I would trust a doctor that ordered a gull bladder removal, or whatever. If their doctor thinks it's medically necessary, I'm not sure who I am to disagree.

Alissa_Sal's picture
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"kris_w" wrote:

I agree.

And who wants to bet that as soon as the surgery is complete he petitions to be moved to a women's correctional facility.

As he probably should be. Can you imagine the chaos it would cause to have a woman in a male prison?

Joined: 05/23/12
Posts: 680

You know, when it comes to someone who killed another human life, I really don't care that much about his quality of life. This person has lived with his pieces and parts for ever how long and suddenly because he's in prison thinks it's the time? Again, I don't care and I don't see why it's a medical necessity to have a wah wah now. Waste of money on a thug when good people are out there and the tax payer money could be better spent. Again, gotta love our health care and govt spending.

"Alissa_Sal" wrote:

What about schizophrenia, or bipolar disorder, or depression? Would you treat those or just let the inmate rot in jail?

To be clear, I'm not sure about the ruling because I'm not knowlegeable enough on the subject to say whether or not gender reassignment surgery is considered a medical neccessity in someone diagnosed with gender identity disorder. If there are other treatments that are proven to be equally effective, then I could be convinced that this was a bad call on the part of the judge.

But I do think that mental disorders are a bit more complicated than high blood pressure or diabetes, and if a prison approved doctor ordered the surgery as a best treatment option, then that holds weight with me, just as I would trust a doctor that ordered a gull bladder removal, or whatever. If their doctor thinks it's medically necessary, I'm not sure who I am to disagree.

Joined: 12/10/05
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"Alissa_Sal" wrote:

As he probably should be. Can you imagine the chaos it would cause to have a woman in a male prison?

Or a male in a womens prisons. There really will be no appropriate place to him.

He is currently living as a woman (using the name Michelle) in a mens facility.

wlillie's picture
Joined: 09/17/07
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waste

Alissa_Sal's picture
Joined: 06/29/06
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"myyams" wrote:

You know, when it comes to someone who killed another human life, I really don't care that much about his quality of life. This person has lived with his pieces and parts for ever how long and suddenly because he's in prison thinks it's the time? Again, I don't care and I don't see why it's a medical necessity to have a wah wah now. Waste of money on a thug when good people are out there and the tax payer money could be better spent. Again, gotta love our health care and govt spending.

Well at that point you could as easily say "Why bother treating Prisoner X's high blood pressure?" He's a killer!

Kris - True enough that someone will be uncomfortable no matter where he is.

Joined: 12/10/05
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I think my main objection is that the procedure is essentially an elective surgery.

He feels he is a woman. Ok fine. But, why is the expensive surgery necessary?? Nice, sure, but it isn't medically necessary. Would they just to the genital portion or the breast augment as well? I just have a hard time justifying the cost from the taxpayers purse, when it isn't truly a medical need. Diabetes med, blood pressure meds, anti-psychotic meds are all necessary. But, I don't think plastic surgery is.

wlillie's picture
Joined: 09/17/07
Posts: 1796

How much sex are you supposed to be having in jail? How many people are you supposed to be making "friends" with? Seriously, why should her sex matter At All in Jail? Let her pay for gender reassignment when people let her out. It's insane that we pretend like therapy and all the money we pay towards fixing an individuals tendency to steal, rape, and murder is going to help them, but we act like therapy AND hormones aren't enough for them to be OK with the freaking gender they were born with?

Alissa_Sal's picture
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"kris_w" wrote:

I think my main objection is that the procedure is essentially an elective surgery.

He feels he is a woman. Ok fine. But, why is the expensive surgery necessary?? Nice, sure, but it isn't medically necessary. Would they just to the genital portion or the breast augment as well? I just have a hard time justifying the cost from the taxpayers purse, when it isn't truly a medical need. Diabetes med, blood pressure meds, anti-psychotic meds are all necessary. But, I don't think plastic surgery is.

This is what I don't know, and why I could go either way on this one. I don't know if doctors who treat GID consider plastic surgery a medical necessity or not. Here is why I think it could be: from what I know of GID, the thought process is that the brain is "hardwired" to identify as one gender, but the body doesn't match, therefore with true cases of GID you can't just convince the brain to accept the body, which is why surgery might be the only option to resolve it. I'm probably not explaining that very well.

I definitely understand where you are coming from, and agree that in general elective plastic surgery just to make someone feel better should not be an option (like if it was a woman who was depressed because she wanted bigger breasts, would we pay for a breast augmentation? That seems ridiculous!) So I totally take your point. I just think maybe something like this is less cut and dried than that.

wlillie's picture
Joined: 09/17/07
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He's 57 Alissa.

Alissa_Sal's picture
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Posts: 6427

Oh man. I just read clicked the link, and then saw she's also suing for electrolysis. THAT certainly isn't a medical neccessity (like, join the club, sister, I'd like to have electrolysis too...) LOL I'm certain this is not objective or based on anything but my own feelings, but I think the electrolysis thing just swayed me to decide no, she shouldn't get the surgery on the tax payer dime. I can't explain why that was the straw that broke the camel's back for me, it just was. Electrolysis....sheesh!

AlyssaEimers's picture
Joined: 08/22/06
Posts: 6560

I know this is going to come as a shock, but I agree with Alyssa on this one.

I think a person is a person with basic rights whether they are still in the womb, very old and terminally ill, or in jail. I do not know all of the specifics of this person, but I have heard of people who truly do have gender issues. Such as having both a penis and breasts. I can understand needing/wanting that fixed. Now if there is not clear cut medical reasons to have it fixed (such as just identifying more with one gender), then I would think they would not be able to wait until they are out.

I am just not of the opinion that a person that is in jail should not get medical care. All life has value to me.

GloriaInTX's picture
Joined: 07/29/08
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It says life sentence, so I assume he's not getting out. At least thats what it SHOULD mean. I don't think that someone in prison should receive better treatment than someone on Medicare. Medicare does not pay for sex reassignment surgery.

AlyssaEimers's picture
Joined: 08/22/06
Posts: 6560

"GloriaInTX" wrote:

It says life sentence, so I assume he's not getting out. At least thats what it SHOULD mean. I don't think that someone in prison should receive better treatment than someone on Medicare. Medicare does not pay for sex reassignment surgery.

I would think that if Medicare did not deem it a true medical need, that prison would not either. My point is that just because someone is in prison, does not mean they are sub-human.

Joined: 12/10/05
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"AlyssaEimers" wrote:

I would think that if Medicare did not deem it a true medical need, that prison would not either. My point is that just because someone is in prison, does not mean they are sub-human.

Of course they aren't sub-human, but that doesn't mean this surgery should be paid for.

I know someone who has gone through this. The reason it is sometimes paid for is the theoretical increased risk of suicide without it. However, there isn't much research on the subject, so opinion on whether the treatments (medications, hormone therapy, counseling, multiple surgeries, electrolysis, etc) should be paid for and to what degree varies widely.

Joined: 08/17/04
Posts: 2226

I'm having a hard time with this one. I agree with Alissa that behavioral health needs need to be met too. I have a hard time with this surgery since it's not covered by Medicaid I don't believe and it's certainly not covered by private insurance unless an employer pays extra for the rider. Since he broke the law and killed someone, I don't think I support him/her getting something that law abiding residents can't generally get unless they pay for it.

Joined: 05/23/12
Posts: 680

"Alissa_Sal" wrote:

Well at that point you could as easily say "Why bother treating Prisoner X's high blood pressure?" He's a killer!

Kris - True enough that someone will be uncomfortable no matter where he is.

There is just a big difference between treating emergent life threatening issues and things like this. Sorry if i had a way to pull out my percent of tax paid money it would already have bern done.

Joined: 05/23/12
Posts: 680

"kris_w" wrote:

Of course they aren't sub-human, but that doesn't mean this surgery should be paid for.

I know someone who has gone through this. The reason it is sometimes paid for is the theoretical increased risk of suicide without it. However, there isn't much research on the subject, so opinion on whether the treatments (medications, hormone therapy, counseling, multiple surgeries, electrolysis, etc) should be paid for and to what degree varies widely.

I can understand and thought of this, but i feel like there are lots of things which can increase risk of depression and suicide. I can believe that sitting in prison could make some suicidal. I say send him or her to psychotherapy with the prison Psychologist and let him or her learn to be happy with whatever he or she is. Prison isnt a time for free extra free stuff that regular ppl dont ordinarily have access to.

Joined: 12/10/05
Posts: 1681

Oh, I agree with you (see my first post). I don't think it should be paid for at all.