News
Court: Trans inmate must receive gender reassignment surgery
Panel says denying procedure to prisoner cruel and unusual punishment

The First Circuit Court of Appeals ruled a trans inmate must receive gender reassignment surgery. (Image via wikimedia)
A federal appeals court ruled on Friday that a transgender inmate incarcerated for murdering her spouse must receive taxpayer-funded gender reassignment surgery that was prescribed by her doctors.
In a 2-1 decision, a three-judge panel on the First Circuit Court of Appeals ruled that denying the procedure to Michelle Kosilek, who was sentenced to life in prison for murdering his spouse in 1990, amounts to cruel and unusual punishment under the Eight Amendment to the U.S. Constitution.
The 90-page ruling was written by U.S. Circuit Judge Ojetta Rogeriee Thompson, an Obama appointee, who asserted the Massachusetts Department of Corrections denied Kosilek essential medical care by withholding from her gender reassignment surgery.
“Those findings — that Kosilek has a serious medical need for the surgery, and that the DOC refuses to meet that need for pretextual reasons unsupported by legitimate penological considerations — mean that the DOC has violated Kosilek’s Eighth Amendment rights,” Thompson writes.
The ruling upholds a decision from U.S. District Judge Mark Wolf in 2012 asserting Kosilek has a right to gender reassignment surgery. The decision was controversial — even among progressive leaders. Then-U.S. Senate candidate Elizabeth Warren (D-Mass.) said she didn’t think the surgery was a good use of taxpayer dollars.
Transgender rights groups lauded the decision from the First Circuit on the basis that prisoners — even those who are transgender — have a right to medical care during their incarceration.
Mara Keisling, executive director of the National Center for Transgender Rights, said the ruling “affirms the increasing consensus among the courts” that transgender-related health care is a right protected under the Constitution.
“Prisoner or not, people should have access to the healthcare they need,” Keisling said. “For some of us, that means sex reassignment surgery. While we celebrate today’s ruling, we know there’s more advocacy needed to ensure that all transgender people have access to basic and necessary healthcare.”
Ilona Turner, legal director for the Transgender Law Center, said the First Circuit ruling upholds a constitutional right to essential medical treatment in prison.
“It is well established that the failure to provide essential medical care to people in prison is unconstitutional and amounts to torture,” Turner said. “This decision affirms that we as a society do not allow people to be tortured when they are in government custody.”
Afflicted with drug and alcohol problems at an early age, Kosilek in 1992 was sentenced to life in prison after strangling her spouse Cheryl McCaul, a volunteer counselor at a drug rehabilitation facility. The incident took place after McCaul caught Kosilek wearing her clothing.
Kosilek is serving her sentence in MCI-Norfolk, a medium security male prison, where she legally changed her name from Robert to Michelle. She must receive gender reassignment surgery through taxpayer-provided funds because, as an inmate in prison, she lacks access to her own finances for the procedure.
The estimated cost for male-to-female reassignment is $7,000 to $24,000. A footnote in the First Circuit decision notes that figure “pales in comparison to the amount of money it seems the state will be expending to defend this lawsuit.”
U.S. Circuit Judge Juan Torruella, a Reagan appointee who wrote the dissent in the decision, said he doesn’t find any reason to require Massachusetts to provide gender reassignment surgery to Kosilek when other treatments are available.
“[G]iving due consideration to countervailing security concerns and based on a review of the record that shows the DOC’s proposed care was not outside the realm of professionalism, I cannot say that the DOC has failed to adequately care for Kosilek’s GID or callously ignored her pain,” Torruella writes.
The decision could be appealed to the full First Circuit or the U.S. Supreme Court. The office of Massachusetts Attorney General Martha Coakley declined to comment on the next steps in the lawsuit.
Cara Savelli, a spokesperson for the Massachusetts Department of Correction, said the court ruling is under review.
“We are closely reviewing the lengthy decision issued today by the First Circuit Court of Appeals on this matter to determine next steps,” Savelli said.
Rehoboth Beach
Women’s FEST returns to Rehoboth Beach next week
Golf tournament, mini-concerts, meetups planned for silver anniversary festival
Women’s+ FEST 2026 will begin on Thursday, April 9 at CAMP Rehoboth Community Center.
The festival will celebrate a remarkable milestone in 2026: its silver anniversary. For 25 years, Women’s+ FEST has brought fun and entertainment for all those on the spectrum of the feminine spirit. There will be a variety of events including a golf tournament, mini-concerts and happy hour meetups.
For more information, visit Camp Rehoboth’s website.
Belarus
Belarusian lawmakers approve bill to crackdown on LGBTQ rights
Country’s president known as ‘Europe’s last dictator’
Lawmakers in Belarus on Thursday approved a bill that would allow the government to crack down on LGBTQ advocacy.
The Associated Press notes the bill would punish anyone found guilty of “propaganda of homosexual relations, gender change, refusal to have children, and pedophilia” with fines, community labor, and 15 days in jail.
The House of Representatives, the lower house of the Belarusian National Assembly, last month approved the bill. The Council of the Republic, which is the parliament’s upper chamber, passed it on Thursday.
President Alexander Lukashenko is expected to sign it.
Belarus borders Poland, Ukraine, Russia, Latvia, and Lithuania. Lukashenko — known as “Europe’s last dictator” is a close ally of Russian President Vladimir Putin.
Kazakhstan is among the countries that have enacted Russian-style anti-LGBTQ propaganda laws in recent years.
Vika Biran, a Belarusian LGBTQ activist, is among those arrested during anti-Lukashenko protests that took place in 2020 after he declared victory in the country’s presidential election.
District of Columbia
How new barriers to health care coverage are hitting D.C.
Federally qualified health centers bracing for influx of newly uninsured patients
Washington, D.C. has the second-lowest rate of people who lack health insurance in the country, but many residents are facing new barriers to health care due to provisions of the sweeping federal law passed in July, which threatens access for thousands.
Changes to insurance eligibility and the rising cost of premiums, which kicked in for some in October and others more recently, are expected to leave many more patients uninsured or unable to afford medical care. Federally qualified health centers, including D.C.’s Whitman-Walker Health, where 10 to 12 percent of patients are uninsured, are bracing for an influx of newly uninsured patients while facing their own financial challenges.
Even in D.C., where uninsured rates have been among the lowest in the country, changes brought on by the passage of the Republican mega bill (known as the “Big Beautiful Bill”) will have major effects.
The changes from the bill affect Medicaid, which is free to low-income patients, and subsidies for insurance that people buy on the health insurance exchanges that were started under the Affordable Care Act, which were allowed to expire on Dec. 31.
Erin Loubier, vice president for access and strategic initiatives at Whitman-Walker Health, says some Whitman-Walker Health patients have received notices about premium increases, including several who say the increases are up to 1,000 percent more than they were paying.
“That is like paying rent,” she says. “We live in an expensive city, so any increases are going to be really, really hard on people.”
Whitman-Walker Health and other healthcare providers are expecting the changes to have multiple effects — some patients may not be able to afford coverage or may avoid going to the doctor and allow health conditions to worsen because they can’t afford care, and many more will be seeking care who don’t have insurance.
“I’m worried that we’re going to not just have people who can’t get care, but that they delay care until they’re really sick, and then the care is not as effective because they might have waited too long, and then we may have a less healthy population,” Loubier says.
Loubier says delaying care, and serving more people without insurance has major implications for Whitman-Walker Health and other health centers serving the community.
“There’s going to be a lot of pressure on us to try to find and raise more money, and that’s going to be harder, because I think all organizations who provide health care are going to be facing this,” she says.
The U.S. health care system is the most expensive in the world, and has much higher out-of-pocket costs for individuals. But in other countries like the United Kingdom, Australia, Canada, and many others, health care is much less expensive — or even free.
Even though the U.S. has a high-priced healthcare system, critics say there are still ways to bring down costs by forcing insurance and pharmaceutical companies to absorb more of the costs, rather than transferring the costs to patients.
“In the U.S., they end up trying to cut costs at the person’s level, not at the level of the different corporations or structures that are making a lot of money in healthcare,” said Loubier. “Our system is so complicated and there is probably waste in it, but I don’t think that that cost and waste is at the ‘people’ level. I think it’s higher up at the system level, but that is much, much harder to get people to try to make cuts at that end.”
Ultimately at Whitman-Walker Health, healthcare providers and insurance navigators are planning to help with everyday necessities when it comes to healthcare coverage and striving to provide healthcare in partnership with patients, said Loubier.
“The key here is we’re going to have a lot of people who may lose insurance, and they’re going to rely on places like Whitman-Walker Health and other community health centers, so we have to figure out how we keep providing that care,” she said.
(This article was written by a student in the journalism program at Bard High School Early College DC. This work is part of a partnership between the Washington Blade Foundation and Youthcast Media Group, funded through the FY26 Community Development Grant from the Office of D.C. Mayor Muriel Bowser.)
