Lawsuit asks state to pay for inmate's sex-change operation- What do you think?

[AtLast]

Interesting controversy- Something that came to my mind are transpeople I know that have footed all of the costs for their transitions personally.

Yet, I can see the safety issues and also, state prison systems are responsible for the medical needs of inmates. Insurance reimbursements are made based upon Gender Identity Disorder (as it is currently d3scribed in the DSM-IV which is under discussion for changes).

If an inmate is attacked and injured, no matter gender identification- these costs are paid via the correctional system along with dental care, etc.

What do other people think? This is really complex to me with many variables. I'm sure political conservative tax rights organizations pile this onto the transphobic/queer pile and cost cutting.

Should these inmates have to wait until released to fully transition? And what about those with life sentences or on death row?

My head is spinning with issues involved with this!!
--------

http://www.latimes.com/news/local/la...,57568.storyBy Jack Dolan, Los Angeles Times

Lawsuit asks state to pay for inmate's sex-change operation

Lyralisa Stevens says she is harassed and sexually assaulted by male prisoners, and needs surgery to be assigned to a women's prison. State officials say they aren't required to provide that level of care.



April 20, 2011
Reporting from Vacaville— Lyralisa Stevens, who was born male but lives as a female, is serving 50 years to life in a California prison for killing a San Bernardino County woman with a shotgun in a dispute over clothes.

Stevens is one of more than 300 inmates in the state prison system diagnosed with Gender Identity Disorder, a psychiatric condition addressed in free society with hormone replacement therapy and, in some cases, sex reassignment surgery.

Prison officials have provided female hormones for Stevens since her incarceration in 2003. But now she is asking the 1st District Court of Appeal in San Francisco to require the state to pay for a sex-change operation.

Stevens, 42, and her expert witnesses say that surgery is medically necessary, and that removal of her penis and testicles and transfer to a women's prison are the best way to protect her from rape and abuse by male inmates.

As prison officials have struggled to address chronic overcrowding, the constant threat of gang violence and a health system that federal judges have equated with "cruel and unusual" punishment, they have also gone to court multiple times to answer allegations that they failed to properly treat and protect transgender inmates.

Judges have sided with transgender prisoners — who according to a UC Irvine study are 13 times more likely to suffer sexual assault than other inmates — on some significant cases. In 2009, the California Supreme Court ruled that an inmate could sue guards for failing to protect her from repeated rapes and beatings by her cellmate. In 1999, an appeals court ordered prison officials to provide hormone therapy to inmates who were already taking them when they arrived. The treatments cost about $1,000 a year per prisoner.

A ruling in Stevens' favor would make California the first place in the country required to provide reassignment surgery for an inmate, according to lawyers for the receiver appointed to oversee California's troubled prison health system. They argue that the state should be required to provide only "minimally adequate care," not sex-change operations that cost $15,000 to $50,000.

Stevens, who has a slight build — 5-foot-6 and about 115 pounds — and entered prison with silicon injections in her breasts and hips to feminize her physique, said in a court filing that she feels like she's under threat of sexual assault in the men's facility and wants the surgery, in part, so she'll be sent to a women's institution.

"The male inmate is not expecting to see breasts … in the shower next to him," Stevens wrote. The situation can lead to violent disputes among the men and sparks attacks against transgender inmates, who may have less upper body strength because of the hormone therapy, Stevens said.

In a court filing supporting Stevens' petition, psychotherapist Lin Fraser said she has "grave concerns" for Stevens' safety because she "had been put alone in cells all night long with men who threatened and abused her."

California law requires prison administrators to assign the state's nearly 162,000 inmates to men's or women's institutions based on "gender," which officials determine solely by a prisoner's genitals. Richard Masbruch, who tried multiple times to castrate himself while in a Texas prison and eventually succeeded, is in the California Institution for Women inChino. Masbruch, who goes by the name Sherri, was transferred from Texas to serve 40 years for a 1991 rape in Fresno.

While confronting complaints and lawsuits by transgender inmates challenging their housing assignments during the mid-2000s, the California prison system commissioned a study by UC Irvine sociologists to help them understand the small, uniquely vulnerable population. The study found that 59% of transgender inmates said they had been raped or otherwise sexually assaulted behind bars, compared with 4.4% of the general prison population, lead researcher Valerie Jenness told the state Senate Public Safety Committee.

Despite those numbers, 59% of transgender inmates said they did not want to move to a women's institution.

"The advantages of being in a men's prison include the pursuit of sex and the possibility of securing a male partner," Jenness said. "Concern about safety is not a main factor in predicting [housing] preferences."

Stevens declined to join a group of transgender inmates interviewed by The Times recently at the prison system's main medical facility in Vacaville. But six others — of the 30 to 50 transgender inmates housed there at any given time — spoke candidly about their lives in prison.

Thomas Strawn, 52, who uses the name Lisa and is serving a life sentence after a third-strike conviction for burglary, said she is in a committed relationship with the man in the next cell and would not want to move.

"I stayed single for an entire year when I got here," Strawn said. "But now I got with somebody and I've been with him now two years."

Others, such as convicted killer David, or Bella, Birrell, 58, who said she had been raped in prison, would like to be transferred to a women's facility. "You don't have to worry about the constant harassment like you get from the men here," she said.

Only two of the six said they would be interested in a sex change operation if a court order compelled the state to pay the costs.

"I had made plans to try to get [the surgery] done before I committed the crime that I did," said Steve Alamillo, 39, who goes by Nikkas and is serving life for first-degree murder. "If the state can do that stuff, absolutely."

Willie Murphy, 47, who is also known as Mena and is serving life on a third-strike conviction for burglary, was among the majority, preferring to "keep what I got."

Surgery is where the California Department of Corrections and Rehabilitation draws the line.

"A prison is not required by law to give a prisoner medical care that is as good as he would receive if he were a free person, let alone an affluent free person," attorney Steven J. Bechtold, who represents the receiver, wrote in the state's response to Stevens' petition for the operation.

The prison system has lost on a similar point before. The state provides hormone therapy today because a federal court found in a 1999 case that failing to continue treatment for inmates who were on hormones before coming to prison amounted to cruel and unusual punishment.

"We regularly get questions about why we are treating these patients," said Dr. Joseph Bick, chief medical officer at Vacaville. "The bottom line is, not only is it appropriate, but it's mandated by federal courts."

Stevens, who has fathered three children, argues in her court case that the cocktail of estrogen and testosterone-blockers the state has provided since her incarceration in 2003 are no longer adequate to combat her emotional distress. Failing to provide surgery could increase her "risk of future self-harm," wrote Dr. Denise Taylor, a medical expert who filed a brief on Stevens' behalf.

Taylor also argued that leaving Stevens on estrogen therapy could lead to the reemergence of a benign tumor removed from her brain in 2005.

Bick, who filed a declaration with the court in January defending the state's position, said the previous tumor was not believed to be caused by estrogen therapy. He said Stevens' treatment in prison has been "adequate and successful."

Perhaps the biggest threat to Stevens' case is the state's budget crisis, in the view of several transgender inmates interviewed. They worried that a judge might be reluctant to rule in her favor with the state facing hard times.

"If I were out there, I wouldn't understand, especially if I was unemployed or trying to support a family," Birrell said.

"But if you could only go into our heads for a day or two to see what we go through internally," she said, "you would get a greater appreciation of how devastating it is to be a transgender individual locked up in a man's prison."

jack.dolan@latimes.com

[Luckydwg07]

I understand the arguement. I think she is lucky to get continuing hormone treatments.(If to continue or not continue hormone treatments is seen as a life threating possibility thats understood.)
She is incarcerated for a reason- I say 3 hots & a cot. we have people on the outside that need tax money for just getting 1 or 2 hots a day and a shelter bed to rest on for a minimal amount of time and that includes children. When you break laws(murder- not respecting someone else right to life) don't ask for handouts from the govt to make you as you see yourself thats up to the individual. Normal citizen rights & to act freely are revoked when they are a prisoner-thats the whole idea.
Sorry but its just not All About Her.
Should be interesting to see what the ruling is

[AtLast]

Originally Posted by Luckydwg07

I understand the arguement. I think she is lucky to get continuing hormone treatments.(If to continue or not continue hormone treatments is seen as a life threating possibility thats understood.)
She is incarcerated for a reason- I say 3 hots & a cot. we have people on the outside that need tax money for just getting 1 or 2 hots a day and a shelter bed to rest on for a minimal amount of time and that includes children. When you break laws(murder- not respecting someone else right to life) don't ask for handouts from the govt to make you as you see yourself thats up to the individual. Normal citizen rights & to act freely are revoked when they are a prisoner-thats the whole idea.
Sorry but its just not All About Her.
Should be interesting to see what the ruling is

It will be interesting. California is in a major financial mess as many states are. Education is facing further cuts as well as all social services. This on top of what the federal cut backs will be.

[Luckydwg07]

Originally Posted by AtLastHome

It will be interesting. California is in a major financial mess as many states are. Education is facing further cuts as well as all social services. This on top of what the federal cut backs will be.

It keeps the lawyers in a job we aren't as affluent as we once were when that happens most of the time everyone is heard because the world is listening. but not so much any more

[Blade]

All I can say is if tax dollars are going to be used for prisoners in this manner, the someone needs to start paying for my surgeries, someone being tax dollars.

[Starbuck]

Two quick responses:
Tax dollars to pay for the sex change? No, prisoners should not have this right.
Should prisoners receive medication? Yes, they are human beings too.

[AtLast]

Originally Posted by Luckydwg07

It keeps the lawyers in a job we aren't as affluent as we once were when that happens most of the time everyone is heard because the world is listening. but not so much any more

Yes, my mind has been wondering to lawyers!

Something else I thought of that is kind of icky is that what if trans organizations that I have always felt good about and believe do a lot to fight transphobia, etc. take the stand that trans inmates should have srs paid for by the state?

My concern is about how this could play into the hands of all of the right wing taxation organizations and really be used to further promote transphobia. Some would love to use this like they did with Tranny-Care and Obama's health care reform efforts. I don't want to be associated with things like that, yet I can't back this.

Although, from a lot of the posts by trans folks here that are transitioning on their own dime, maybe this won't happen. LOL, sometimes things get pretty goofy in CA. I love my home state, but I'd rather see any public money going toward social and medical services that support transgendered people outside of the correctional system. We do have some public programs here, but they are being hit due to our very large deficit- like all social service programs.

As far as rehabilitative programs in our correctional system, I have always felt that we would be better off in the long run focusing on juvenile populations before they enter the adult system- more of a preventative focus.

Keeping my eye out for news on this here in CA. If anyone else has links/info- please post it.

[Luckydwg07]

Originally Posted by AtLastHome

Yes, my mind has been wondering to lawyers!

Something else I thought of that is kind of icky is that what if trans organizations that I have always felt good about and believe do a lot to fight transphobia, etc. take the stand that trans inmates should have srs paid for by the state?

My concern is about how this could play into the hands of all of the right wing taxation organizations and really be used to further promote transphobia. Some would love to use this like they did with Tranny-Care and Obama's health care reform efforts. I don't want to be associated with things like that, yet I can't back this.

Although, from a lot of the posts by trans folks here that are transitioning on their own dime, maybe this won't happen. LOL, sometimes things get pretty goofy in CA. I love my home state, but I'd rather see any public money going toward social and medical services that support transgendered people outside of the correctional system. We do have some public programs here, but they are being hit due to our very large deficit- like all social service programs.

As far as rehabilitative programs in our correctional system, I have always felt that we would be better off in the long run focusing on juvenile populations before they enter the adult system- more of a preventative focus.

Keeping my eye out for news on this here in CA. If anyone else has links/info- please post it.

Our community will never get a 100% A-OKAY from any part of society.
I appreciate you sentiment Atlast ...however it's a runaway train this system & I wouldn't call it corrections not by a long shot. I just think that we are too indulgent on thinking we are superior beings and the thought of rogue humans as part of our spieces starts a philisophical dialogue that has lasted since the human race has exsisted. what do we do with the ugly side of humanity? It still has a human face and familiar wants and needs (good & bad) as the rest of us ..it just went astray?
I agree you can tap into the young offenders at a higher % ( yes were are all numbers :-)

Bottom line there is no bottom the discussion will continue. this it a three ring circus headline grabber and does nothing for our community or the human race.

[Chancie]

Originally Posted by Luckydwg07

I understand the arguement. I think she is lucky to get continuing hormone treatments.(If to continue or not continue hormone treatments is seen as a life threating possibility thats understood.)
She is incarcerated for a reason- I say 3 hots & a cot. we have people on the outside that need tax money for just getting 1 or 2 hots a day and a shelter bed to rest on for a minimal amount of time and that includes children. When you break laws(murder- not respecting someone else right to life) don't ask for handouts from the govt to make you as you see yourself thats up to the individual. Normal citizen rights & to act freely are revoked when they are a prisoner-thats the whole idea.
Sorry but its just not All About Her.
Should be interesting to see what the ruling is

I'm curious. Do you think people who are living in jail should get prescription medicine?

[Apocalipstic]

It's a difficult question.

I agree that many prisoners do in effect have better health care coverage than many working people not in prison, which I agree seems very unfair.

I think it depends on how the courts see being Transgender and if not paying for sex reassigment surgery is seen as cruel and usual....

I really don't know where I fall on the subject, but for me a murder change would be very different than a 3 strikes drug or burglary charge....but you can't provide medical care based on whar crime was committed?

Slippery slope.
Either way.

[Gemme]

I didn't even finish the article. I got to the section that describes how she arrived into the pen. 'nuff said for me.

Does she really think that having the surgery and being moved to a woman's prison means she won't be raped? REALLY? It just means it will be with a pipe or fist instead of a penis.

I say no. I know of many, many folks here who bust their asses to make it through life towing the line and they don't commit stupid ass crimes over CLOTHES, for Christ's sake! They pay for the surgeries that are to correct nature's mistakes on their own or at least using their own energy (if they receive donations, etc). My partner and I are trying to design 1, 3, 5, and 10 year plans so that he can have the necessary surgeries that this woman wants.

So what message would this send out? If you are trans and you still need surgery, go commit a crime in CA and they'll pay for it. Nice.

This really and truly pisses me off to my very core.

[Daywalker]

Most folks are pretty skeptical about our Rehabilition methods,
or lack thereof...within the walls of our Prison systems.

And with good damn reason. There have been folks who have paid
for their debt to society, although I doubt their victims would agree.

With that said, would we still deny this request if they had robbed a bank,
or ran a finincial scheme on a childrens charity, or drunk drove themselves
behind bars? I think it is interesting how the perspective changes according
to the crime commited. Frankly, if we're gonna feed Death Row Inmates
for 20+ years, why would this expense be deemed as unacceptable?

Thinking Out Loud.

The Inmate commited a heinous crime; who is going to weigh
the crime and punishment on a scale and draw the lines?

[AtLast]

Originally Posted by Gemme

I didn't even finish the article. I got to the section that describes how she arrived into the pen. 'nuff said for me.

Does she really think that having the surgery and being moved to a woman's prison means she won't be raped? REALLY? It just means it will be with a pipe or fist instead of a penis.

I say no. I know of many, many folks here who bust their asses to make it through life towing the line and they don't commit stupid ass crimes over CLOTHES, for Christ's sake! They pay for the surgeries that are to correct nature's mistakes on their own or at least using their own energy (if they receive donations, etc). My partner and I are trying to design 1, 3, 5, and 10 year plans so that he can have the necessary surgeries that this woman wants.

So what message would this send out? If you are trans and you still need surgery, go commit a crime in CA and they'll pay for it. Nice.

This really and truly pisses me off to my very core.

Good point about rape in prison- no matter the gender.

You bring up my initial feelings when this story hit our CA news waves. I know a lot of transpeople that do exactly this- do a financial plan for surgeries- totally out of pocket. These are tax paying people here in CA. In some situations, insurance coverage is utilized- but damn few. The hormone treatment also needs doc visits, blood work, follow-ups, etc. Then there can be individual problems to work through.

I have no problem with basic medical care for inmates- and I don't distinquish between the crimes they committed. I do, however, as you state- don't give a flying hooray about sexual predators that kill and torture. I worked too long in victim's rights advocacy and with sexually abused kids and 99.9% of those cases in which I did expert whitness work, the perp was not new to the criminal justice system. He or she had perpetrated before.

I think a diabetic ought to get insulin, etc. and chemo therapy for inmates with cancer- essential medical treatment. Food and shelter.

Until or unless the state of CA is going to pay for these kinds of services for all transgendered people, or there are changes in insurance coverage for everyone, I am opposed to this.

Frankly, I'm more concerned for the safety and well being of public emplyees that work in prisons.

[Luckydwg07]

Originally Posted by Chancie

I'm curious. Do you think people who are living in jail should get prescription medicine?

I'll take a bite
Yes I suppose so but to me prescription is an umbrella term.(a control that requiers a doc's consent ~doesn't mean it's necessary) to keep a person alive ,for physical pain sure. the prisoner in question is on death row if she doesn't get what she desires then she will suffer psychologically~ in prison she should be prescribed medication for disappointment.

[Daywalker]

Originally Posted by Chancie

I'm curious. Do you think people who are living in jail should get prescription medicine?

Yes.


When I did not, it spawned a 26,000 word non-fiction story
of what happened to me when they did not.

http://sirdaywalker.com/send-the-pain-below/

[Breathless]

This is a very interesting debate. My opinion is, in regards to continuing hormone therapy, absolutely. If the decision was made prior to being convicted, and treatments were started prior, then it is an issue of continuing medical care. To make the decision to start while in prison, I don't think so. If someone was lets say to have rhinoplasty prior to being incarcerated would it not be humane to have their last check up to removed stitches? I have to ask, if these people were 'free' who would pay for their surgery then in the state of California? In my understanding, it is the individual, and they would have to save up substantial money to afford the surgery, I think the same person should be responsible for the cost despite being in prison. Now taking into consideration the fact that they are not able to go out into the community and seek consultations with different dr.'s, that is where I think the prison needs to be of assistance. Providing the options, however not footing the bill.
On another note, if you have made your declaration as being transgendered, and are being recognized as male, or female, then the option of which jail you wish to reside is not your choice. I don't feel that it is right for someone to say.. yes I am a woman, recognize me as such, but please just leave me in the men’s prison. All or nothing. Choose your battles wisely.

[EnderD_503]

Originally Posted by Breathless

This is a very interesting debate. My opinion is, in regards to continuing hormone therapy, absolutely. If the decision was made prior to being convicted, and treatments were started prior, then it is an issue of continuing medical care. To make the decision to start while in prison, I don't think so. If someone was lets say to have rhinoplasty prior to being incarcerated would it not be humane to have their last check up to removed stitches?

I really dislike these comparisons. Do you see the difference between rhinoplasty and SRS? SRS isn't for cosmetic purposes.

I have to ask, if these people were 'free' who would pay for their surgery then in the state of California? In my understanding, it is the individual, and they would have to save up substantial money to afford the surgery, I think the same person should be responsible for the cost despite being in prison. Now taking into consideration the fact that they are not able to go out into the community and seek consultations with different dr.'s, that is where I think the prison needs to be of assistance. Providing the options, however not footing the bill.

To me this comes down to the US moving toward public healthcare, and if having the state pay for SRS for trans inmates is a step in t hat direction, I don't see the problem. In Ontario, OHIP pays for SRS for those who seek a year's worth of counseling, and I'm not sure I see the problem with that. While it's not perfect (to require counseling, imo, is wrong), it shows a positive step and changing attitudes within the medical community wherein they've begun to see the importance of SRS to the basic health needs of trans individuals.

On another note, if you have made your declaration as being transgendered, and are being recognized as male, or female, then the option of which jail you wish to reside is not your choice. I don't feel that it is right for someone to say.. yes I am a woman, recognize me as such, but please just leave me in the men’s prison. All or nothing. Choose your battles wisely.

I've known a few transfolks who have been incarcerated in Ontario prisons. You don't get to choose which prison they put you in. I've known people who start off in a male prison, get shifted over to a female prison and back and forth again. Additionally, they were treated very poorly and humiliated by the guards, placed in solitary confinement away from the general population without the basic necessities (warmth, proper food, the courtesy of being told which prison they're in etc.) The prison system, at least over here (and seems to be the same in US), does not seem to know how to deal with trans inmates, and inmates have very little control over where they go. I think it's very easy for someone who isn't trans or who isn't a trans inmate to say "all or nothing," but when you're in the actual situation with your own well-being in mind (given that nobody else seems to have it in mind), and realizing that you have very little control over your own situation, it's an entirely different ball game.

[Chancie]

I gotta say, I knew I would be sorry if I reread this thread.

Some of you are very politically conservative.

I certainly don't know as much as other members here about single payer health care

But I have to ask

In how many other so called civilized countries do people in need of medical care have to go without?

[AtLast]

Originally Posted by Chancie

I gotta say, I knew I would be sorry if I reread this thread.

Some of you are very politically conservative.

I certainly don't know as much as other members here about single payer health care

But I have to ask

In how many other so called civilized countries do people in need of medical care have to go without?

If I am politically "conservative" on this one- so be it, I am liberal, progressive, conservative and moderate when I look at issues depending on what is represented. This prisoner should get usual and customary health care such as annual physicals and if she developed a life threatening condition such as cancer, of course she should get medical care. Again, as in my first post, most trans people I know struggle to save for surgeries as well as hormone treatment- as well as foot the bill for counseling that they are required to have. Until or unless EVERY transgendered person is covered for medical care under a health plan in the US, I cannot support my state paying for this prisoner's. Also, the educational system in CA is a mess and in need of funds and in this Tea Party (yes, they are here in CA, too) environment, we are facing more cuts in education- even under a Democratic govenor.

I do and have supported single payer universal health care in the US for many years. So save the political stance bashing. I was quite upset with Obama not pushing for a public option during the health care reform act debate and votes- especially since at that time there was a Democratic majority in both houses of Congress.

This prisoner will be kept as safe as any other one in this facility and deserves no more than the other inmates. CA prisons provide fairly healthcare including eye care and dental. We have paid for organ transplants for prisoners as well.

Now, if you want to talk about services for minors that are in the criminal system that are serving for non-violent offenses and going through gender identity crises- I would support not only services within the system, but on going work for a time when released so that they are hooked up with support services and get care. I feel strongly that minors within our criminal justice systems could be "rehabilitated" and we do not deal effectively with how we could get them in more positive directions outside of our systems.

[Breathless]

Originally Posted by EnderD_503

I really dislike these comparisons. Do you see the difference between rhinoplasty and SRS? SRS isn't for cosmetic purposes.

It was not meant as a comparison but more as a medical treatment that should be continued once started. I meant no insult what so ever in saying that, as I am one of the biggest supporters when it somes to SRS.
To me this comes down to the US moving toward public healthcare, and if having the state pay for SRS for trans inmates is a step in t hat direction, I don't see the problem. In Ontario, OHIP pays for SRS for those who seek a year's worth of counseling, and I'm not sure I see the problem with that. While it's not perfect (to require counseling, imo, is wrong), it shows a positive step and changing attitudes within the medical community wherein they've begun to see the importance of SRS to the basic health needs of trans individuals.

I agree with you on this, I live in Ontario. However this case is not in Canada, it is in a state that does not cover the bill for the average person. Everyone else has to pay for it, why should someone who is in prision get better treatment then then tax paying working folk?I have huge issues with how we treat our criminals, and we treat our seniors like shit. Where is the fairness in that?

I've known a few transfolks who have been incarcerated in Ontario prisons. You don't get to choose which prison they put you in. I've known people who start off in a male prison, get shifted over to a female prison and back and forth again. Additionally, they were treated very poorly and humiliated by the guards, placed in solitary confinement away from the general population without the basic necessities (warmth, proper food, the courtesy of being told which prison they're in etc.) The prison system, at least over here (and seems to be the same in US), does not seem to know how to deal with trans inmates, and inmates have very little control over where they go. I think it's very easy for someone who isn't trans or who isn't a trans inmate to say "all or nothing," but when you're in the actual situation with your own well-being in mind (given that nobody else seems to have it in mind), and realizing that you have very little control over your own situation, it's an entirely different ball game.

I don't have to be trans to understand how it feels, I have loved someone with all my heart that is. To love someone that much, is to feel their pain, in the most helpless of ways. This is a human rights issue, and should be addressed as such. In the most severe of fashion. I agree that there is definately a lack of information and compassion for our transfolk in the prisions, and it is an absolute shame that there are still so many that act with this much hate towards those of which they do not understand. My all of nothing comment comes from the simple fact that in these situations, I feel that it is sometimes taken advantage of. In the article, there was someone quoted saying that she didn't want to move prisions because she had met partner and been together for 2 years, in my opinion, if you identify as a specific gender, you should be respected on that, however, all the way. I am by no means suggesting that these people be subjected to rape and beatings.