A federal judge in San Francisco on Thursday ruled that California must provide sex reassignment surgery to a transgender inmate, calling denial of the procedure a violation of constitutional rights.
U.S. District Judge Jon Tigar wrote in his 38-page order that the state was violating the constitutional rights of Michelle-Lael Norsworthy, who was convicted of second-degree murder in April 1987, by not providing the operation.
Tigar wrote that Norsworthy had attempted other treatment options but says she still experiences “excruciating pain and frustration” due to her condition, and her current hormone replacement therapy could threaten her liver function.
“Norsworthy has presented compelling evidence suggesting that prison officials deliberately ignored her continuing symptoms of gender dysphoria and the recognized standards of
care,” Tigar wrote.
Gender dysphoria occurs when a person’s gender at birth conflicts with the one they identify with, the American Psychiatric Association says.
“She is seeking access to the medical treatment prescribed by her treating provider and denied for administrative, rather than medical, reasons,” Tigar added.
Norsworthy, 51, was born Jeffrey Norsworthy. She is serving a sentence of 17 years to life at Mule Creek State Prison in Ione, California.
She began identifying as a transgender woman in the mid-1990s and was diagnosed with the condition in January 2000.
The operation would be the first in state prison history and could cost as much as $100,000, California Corrections Health Care Services spokeswoman Joyce Hayhoe told the Los Angeles Times.
Hayhoe’s office was reviewing the order to “determine the next steps,” she told the newspaper.
Prescribed treatments for gender dysphoria can range from hormones, which typically affect breast development and other secondary sex characteristics, to facial feminization and genital surgery.
Denied treatment, people with gender dysphoria can suffer anxiety, depression and suicidal thoughts, Tigar wrote. He ordered that the state provide the surgery “as promptly as possible.”
A federal judge in Boston issued a first-of-its-kind ruling in 2012, ordering the state’s prison system to pay for the sex change surgery of Michelle Kosilek, who is serving a life sentence for murder. Overturned in December, the ruling was appealed to the U.S. Supreme Court.