HEALTH
US Court Orders Inmate Sex-Reassignment Surgery “As Promptly As Possible” California attorney general seeks stay pending trial on the merits BY ARTHUR S. LEONARD
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or only the second time, a federal district judge has ordered state prison of ficials to pr ovide sex-r eassignment surgery to a transgender inmate. On April 2, Judge Jon S. Tigar in San Francisco, relying on the recommendations of expert witnesses, ruled state officials must provide the procedure for Michelle-Lael Norsworthy “as promptly as possible” in light of her medical condition. The first such order, issued in 2012 by the federal district court in Boston on behalf of Michelle Kosilek, a Massachusetts life inmate, was reversed by the First Circuit Court of Appeals late last year. Judge Tigar acknowledged that ruling, but pointed out that it was not binding on the court in California and that there were many distinctions between the cases. On April 10, California Attor ney General Kamala D. Harris filed a motion with Tigar requesting that his preliminary injunction be stayed “pending review by the Ninth Circuit Court of Appeals.” Harris, a Democrat with strong political ties to the LGBT community, argued that providing surgery in response to a motion for preliminary injunction was effectively deciding the case on the merits before the state had any opportunity to prove at trial that the procedure was not “medically necessary” and so required under the Eighth Amendment’s ban on cruel and unusual punishment. Harris stressed that the Ninth Circuit, whose rulings are binding on federal courts in California, has never ruled on whether prison inmates are entitled to sex-reassignment surgery. Named Jeffrey Norsworthy at birth, the plaintiff was convicted of murder in the second degree with the use of a firearm in 1987 and sentenced to 17 years to life, though she’s been eligible for parole since 1998. Norsworthy did GayCityNews.nyc | April 16 - 29, 2015
not openly identify as a transgender woman until the mid-1990s, and she was diagnosed with gender dysphoria by a prison physician in January 2000 and began hormone therapy. According to expert deposition testimony, Norsworthy now lives as a “biological female,” a “pleasant looking woman, slender, and coiffed with a pony tail,” who “walks the yard as a woman.” Though prison authorities have refused her request to seek a legal name change to Michelle-Lael, Norsworthy, unlike inmates in most states, has been allowed to keep her hair long, to shower in private, and to wear a bra, and, though incarcerated in a male prison, she is housed in a “sensitive needs yard.” Still, Norsworthy has suffered several rapes in prison, and as a result of one prolonged gang rape she become infected with hepatitis C, which has damaged her liver and created complications with her hormone therapy. News of Kosilek’s initial victory in the Boston federal district gave Norsworthy hope she could obtain sex-reassignment surgery, which she began seeking even before getting a psychologist’s diagnosis of the treatment as medically necessary for her. Prison officials responded to the diagnosis by assigning Kosilek to a new psychologist, who was not supportive of her quest, though Norsworthy in time won the support of two other medical experts. By 2014, having exhausted every remedy within the prison system, Norsworthy filed suit, arguing that surgery was medically necessary not just because of her gender dysphoria but also because it would lessen the need for estrogen treatment and so relieve pressure on her liver. Norsworthy’s case ran up against strongly worded deposition testimony from Dr. Stephen Levine, who was an expert witness in the Kosilek trial and has argued
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