An inmate in California this week became the first person in the U.S. to receive state-funded sex reassignment surgery while incarcerated.
Shiloh Heavenly Quine, a transgender woman, was convicted of first-degree murder, kidnapping and robbery in 1981. In August 2015, the state of California said it would fund the surgery as a medically necessary treatment for Quine’s gender dysphoria.
Quine received the surgery at a San Francisco hospital on Thursday. Following her discharge from the hospital, she will be moved to a women’s prison, according to Reuters.
“For too long, institutions have ignored doctors and casually dismissed medically necessary and life-saving care for transgender people just because of who we are,” Kris Hayashi, executive director of the Transgender Law Center, which represents Quine, told the Associated Press.
The 2015 settlement laid out a process for other California inmates to receive sex reassignment surgery that involves mental health and medical evaluations and a presentation to a six-member committee composed of medical professionals. The state also agreed to provide transgender inmates with gender-affirming clothing and items from commissary.
Several lawsuits in recent years have focused on the role of the state in providing hormone therapy and sex reassignment surgery to inmates. Both treatments “have been found to be medically necessary to alleviate gender dysphoria in many people,” according to guidance from the World Professional Association for Transgender Health. In a 2015 survey by prison abolitionist group Black and Pink, of more than 1,100 prisoners, 44 percent of respondents who requested hormones said they had been denied access to them.
Quine’s case was preceded by another transgender inmate, Michelle Norsworthy, who in April 2015 successfully obtained a federal court order mandating the state of California to pay for sex reassignment surgery. Norsworthy was placed on parole in August before she could receive the surgery.
In February 2016, inmate Ashley Diamond, a transgender woman, settled a lawsuit she had filed the previous year against the Georgia Department of Corrections seeking access to hormone therapy. She was released last August.
The U.S. Department of Justice filed a statement of interest supporting Diamond in April 2015, asserting that failure to treat gender dysphoria is unconstitutional because it violates the Eighth Amendment’s ban on cruel and unusual punishment.
Corrections spokeswoman Terry Thornton echoed that interpretation in a statement this week about Quine’s surgery. “The 8th Amendment of the U.S. Constitution requires that prisons provide inmates with medically necessary treatment for medical and mental health conditions including inmates diagnosed with gender dysphoria,” Thornton said in a statement.
Transgender inmates face particular challenges while incarcerated, including improper placement, and they are more vulnerable to violence. They are frequently placed in prisons according to their assigned sex, not their gender identity, according to a Lambda Legal survey of more than 2,300 people released in 2013. The federal Bureau of Justice Statistics estimated that more than 3,200 transgender people were incarcerated in 2011-12 and that 39.9 percent of them had reported sexual abuse that year.
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