It’s difficult to argue that prisoners shouldn’t be entitled to medically necessary procedures. For one thing, it’s guaranteed under the 8th Amendment. Being incarcerated within state or federal penitentiaries affords little freedom to convicts serving out their sentences, and to refuse prisoners medical treatment is to sentence them to a slow and painful death.
However, determining what’s “medically necessary” is a conundrum. Obviously, plastic surgery and having veneers installed isn’t, and shouldn’t be covered by the law. But is a sex change operation the same thing?
California’s Department of Corrections says that it isn’t, and describes sex reassignment surgery as a medically necessary treatment. New guidelines were established by the department in 2015 after the Transgender Law Center brought two cases against the state. Officials fought against paying for the treatment before it was finally put in place.
57-year-old Shiloh Heavenly Quine, a convicted killer, is to be the first inmate in the country to receive sex reassignment surgery paid for with tax dollars, via the State of California.
Quine was convicted of first-degree murder, kidnapping and robbery for ransom, and faces no possibility of parole. Quine told the prison psychologist who recommended the operation that it would provide her “drastic, internal completeness”.
Quine is expected to be moved to a women’s prison following her sex change.
Speaking to the Huffington Post, a spokesman for the California Department of Corrections cited the 8th Amendment and said treatment was necessary for inmates diagnosed with gender dysphoria.
Elsewhere in the country, Michelle Kosilek, a convicted killer in Massachusetts, was denied a sex change after a long battle in the courts.
While a court initially granted her request in 2012, the Department of Corrections successfully appealed the decision in 2014 through the First Circuit Court of Appeals.
US Senator Scott Brown and his then-opponent Elizabeth Warren both objected to the use of taxpayer dollars in paying for the procedure. Relatives of her victim argued that the surgery, if granted, could encourage others to convict crimes to receive it at the public’s expense.
Another convicted murderer in Gatesville, Scott Lynn Gibson, is currently suing the US District Court in Waco to pay for her surgery. Gibson, who goes by the name Vanessa, is serving a 20-year sentence for the murder of another inmate, on top of a 13-year sentence for the attempted murder of a corrections officer, and 18 years for aggravated robbery.
“I’ve been living as a woman for 20 years and I’m just a woman trapped in a man’s body,” said Gibson in a prison interview, who argued that prisons pay for those with life-threatening illnesses like cancer.
The most high-profile case involving sex reassignment surgery is that of Chelsea Manning, who was convicted in 2013 for leaking classified government files to WikiLeaks.
Manning, formerly known as Pfc. Bradley Manning, is currently serving 35 years for her crime in Fort Leavenworth. She attempted suicide last July due to despair that she would not be able to proceed with gender transition for many more years during her sentence.
Following the attempt, and a five-day hunger strike, the military decided to let her proceed with the sex change operation, fully paid for by the government.
In 2016, the Pentagon announced plans to pay for treatment of soldiers’ gender dysphoria. The overall treatment is estimated to as much as $50,000, which includes counseling and hormone therapy. In rare cases, it includes surgery. But prisoners are not soldiers, and some, like Quine, Kosilek, and Gibson, are serving life sentences for murder.
Should the public be paying for prisoners’ sex change operations?