It’s not elective surgeryEditorial, Top Highlights Thursday, April 16th, 2015
Last week a Northern Federal Court Judge ruled that an inmate should be granted sexual reassignment surgery. Judge Jon S. Tigar said Michelle-Lael Norsworthy, 51, should be entitled to gender reassignment surgery because it was the “only adequate” treatment for her condition. Let the silly politicization of the issue begin.
Failed Congressional candidate Carl DeMaio said on his KOGO radio show, “Where is the [Prop. 47 prison reform] money going? Expenditures like [sexual reassignment surgery].Taxpayer funded, it is absurd.”
Why is it absurd for a medical procedure covered by California Medicaid programs to be given to an inmate? Why is it absurd to provide Norsworthy a treatment that has been endorsed by the American Medical Association, American Psychiatric Association and the American Psychological Association; the top three professional medical groups in our nation? Why is it absurd that over 30 percent of Fortune 500 companies cover the procedure for their employees? The simple answer, it is not absurd. What other medical procedures would DeMaio deny inmates? DeMaio should try to understand the issue before making uniformed, off-the-cuff comments about members of his community.
Next up, California Attorney General Kamala Harris, who is challenging Judge Tigar’s ruling in the U.S. Ninth Circuit Court of Appeals. Harris is challenging the treatment that the inmate’s doctor has recommended. You would think that Harris would have learned the lesson from the Terri Schiavo disaster; politicians should stay out of care decisions recommended by a patient’s doctor and next of kin.
Schiavo was considered brain dead by her doctor, her husband wanted to cease life support, her parents did not. It became a political circus when Republicans, led by Jeb Bush, sided with Schiavo’s parents and led the charge to prevent the husband from exercising medical decisions for Schiavo. The husband ultimately prevailed and the Republicans suffered politically.
In the Norsworthy case, California Attorney General Kamala Harris is not only appealing the ruling granting the surgery, she is also asking to delay the implementation of the judge’s ruling until the case is resolved through the legal system. In the appeal Harris wrote, “Norsworthy has been treated for gender dysphoria for over 20 years, and there is no indication that her condition has somehow worsened to the point where she must obtain sex-reassignment surgery now rather than waiting until this case produces a final judgment on the merits.”
Harris does not understand the diagnosis of gender dysphoria, which is required before sexual reassignment surgery can be performed. It does not get better or worse, it just is. The treatment for gender dysphoria is dependent upon the patient, some transgender people decide to simply take hormones to bring their physical bodies in alignment with how they perceive themselves and how they feel inside. Norsworthy’s condition has not ‘worsened’ as Harris suggests, it always has been the same diagnosis; she knows her body doesn’t align with her gender identity and Norsworthy’s doctor has said the gender dysphoria she’s experiencing won’t be fully treated until she has surgery. What has changed is the medical and legal communities now acknowledge that Norsworthy does not have a mental illness, but a medical condition that should be addressed with surgery; her doctor, the three top professional medical groups and the Federal Court of Appeals agree.
While Harris has asked that the case be adjudicated expeditiously with a decision by April 17, it is unclear whether the attorneys representing Norsworthy feel that gives them adequate time to prepare for the state driven appeal.
The Transgender Law Center’s Legal Director Ilona Turner said, “The state’s efforts will result in further waste of taxpayer money on needless attorney costs. Nevertheless, we remain confident that Judge Tigar’s decision will stand. The Department of Justice brief filed last week in another case further reinforced that blanket policies against providing health care needed by transgender inmates violate the most fundamental principles of our Constitution. The state provides essential medical care to all people being held in prison, and Michelle should not be an exception just because of who she is.” The Transgender Law Center is part of those representing Norsworthy.
What politicians, as well as some members of the LGBT and broader community, need to understand is that gender reassignment surgery is not elective. It is not like getting a nose job or liposuction, which is how many react to the concept of the procedure; gender reassignment surgery and hormone therapy is considered life extending. No one would suggest that dialysis, insulin or a mastectomy be denied to an inmate; gender reassignment surgery is no different. It is well settled law that the state takes on the medical needs of inmates beginning with the date of incarceration. The inmate has an inability to provide for their own medical needs when incarcerated and the denial of care qualifies as cruel and unusual punishment. Attorney General Harris knows that. Her actions are a blatant political move to curry favor with the right, albeit one that will be decided in an incredibly short time frame. As far as Carl DeMaio throwing the rights of transgender people under the bus, I guess he’s not currently running for anything so he does not need us. Let’s ask DeMaio’s acolyte, and prospective congressional candidate, Jacqueline Atkinson her opinion. It might be enlightening.
San Diego LGBT Weekly
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