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.
District of Columbia
Whitman-Walker Health to present ‘Pro Bono Excellence’ award to law firm
Health center set to celebrate 40th anniversary of legal services program
Whitman-Walker Health, the D.C.-based community healthcare center that specializes in HIV/AIDS and LGBTQ-related health services, announced it will present its annual Dale Edwin Sanders Award for Pro Bono Excellence to the international law firm McDermott Will & Schulte at a May 6 ceremony.
“This year’s award is especially significant as it coincides with the 40th anniversary of Whitman-Walker Health’s Legal Services Program, marking it as the nation’s longest running medical-legal partnership,” a statement released by Whitman-Walker says.
“As a national leader in public health, Whitman-Walker celebrates our partnership with McDermott to strengthen the health center and to enable Whitman-Walker to reach more medical and legal clients,” the statement adds.
“McDermott’s firm-wide commitment to Whitman-Walker’s medical-legal partnership demonstrates a shared vision to serve those most in need,” Amy Nelson, Whitman-Walker’s director of Legal Services, says in the statement. “Our work protects individuals and families who face discrimination and hostility as they navigate increasingly complex administrative systems,” Nelson said.
“Pro bono legal services – like that of McDermott Will & Schulte – find solutions for people who have no place else to turn in the face of financial and health threats,” she added.
“Our partnership with Whitman-Walker Health is a treasured commitment to serving our neighbors and communities,” Steven Schnelle, one of the law firm’s partners said in the statement. “We are deeply moved by Whitman-Walker’s unwavering dedication to inclusion, respect, and equitable access to health care and social services,” he said.
The statement notes that the award for Pro Bono Excellence honors the legacy of the late gay attorney Dale Edwin Sanders. It says Sanders’s pro bono legal work for Whitman-Walker clients “shaped HIV/AIDS law for more than four decades by securing key victories on behalf of individuals whose employment and patient rights were violated.”
It says the Whitman-Walker Legal Services program began during the early years of the AIDS epidemic in the 1980s at a time when people with AIDS faced widespread discrimination and often needed legal assistance. According to the statement, the program evolved over the years and expanded to advocate for transgender people and immigrants.
Noticias en Español
La X vuelve al tribunal
Primer Circuito examina caso del reconocimiento de personas no binarias en Puerto Rico
Hace ocho meses escribí sobre este tema cuando todavía no había llegado al nivel judicial en el que se encuentra hoy. En ese momento, la discusión se movía entre decisiones administrativas, debates públicos y resistencias políticas. No era un asunto cerrado, pero tampoco había alcanzado el punto actual.
Hoy el escenario es distinto.
La organización Lambda Legal compareció ante el Tribunal de Apelaciones del Primer Circuito en Boston para solicitar que se confirme una decisión que obliga al gobierno de Puerto Rico a emitir certificados de nacimiento que reflejen la identidad de las personas no binarias. La apelación se produce luego de que un tribunal de distrito concluyera que negar esa posibilidad constituye una violación a la Constitución de Estados Unidos.
Este elemento marca la diferencia. Ya no se trata de una discusión conceptual. Existe una determinación judicial que identificó un trato desigual.
El planteamiento de la parte demandante se sostiene en el propio marco legal vigente en Puerto Rico. Los certificados de nacimiento de identidad no son registros históricos inmutables. Son documentos utilizados para fines actuales y esenciales. Permiten acceder a empleo, educación y servicios, y son requeridos en múltiples gestiones ante el Estado. Su función es operativa.
En ese contexto, la exclusión de las personas no binarias no responde a una limitación jurídica. Puerto Rico permite la corrección de marcadores de género en certificados de nacimiento para personas trans binarias desde el caso Arroyo González v. Rosselló Nevares. Además, el Código Civil reconoce la existencia de certificados que reflejan la identidad de la persona más allá del registro original.
La diferencia radica en la aplicación.
El reconocimiento se concede dentro de categorías específicas, mientras que se excluye a quienes no se identifican dentro de ese esquema. Esa exclusión es el eje de la controversia actual.
El argumento presentado por Lambda Legal es preciso. Obligar a una persona a utilizar documentos que no reflejan su identidad implica someterla a una representación incorrecta en procesos fundamentales de la vida cotidiana. Esto puede generar dificultades prácticas, exposición innecesaria y situaciones de vulnerabilidad.
Las personas demandantes, nacidas en Puerto Rico, han planteado que el acceso a documentos precisos no es una cuestión simbólica, sino una necesidad básica para poder desenvolverse sin contradicciones impuestas por el propio Estado.
El hecho de que este caso se encuentre en el sistema federal introduce una dimensión adicional. No se trata de un proyecto legislativo ni de una política pública en discusión. Es una controversia constitucional. El análisis gira en torno a derechos y a la aplicación equitativa de las leyes.
Este proceso tampoco ocurre en aislamiento.
Se desarrolla en un contexto donde los debates sobre identidad y derechos han estado marcados por una mayor presencia de posturas conservadoras en la esfera pública, tanto en Estados Unidos como en Puerto Rico. En el ámbito local, esa influencia ha sido visible en discusiones legislativas recientes, donde argumentos de carácter religioso han comenzado a formar parte del debate sobre política pública. Esa intersección introduce tensiones en torno a la separación entre iglesia y Estado y tiene efectos concretos en el acceso a derechos.
Señalar este contexto no implica cuestionar la fe ni la práctica religiosa. Implica reconocer que, cuando determinados argumentos se trasladan al ejercicio del poder público, pueden incidir en decisiones que afectan a sectores específicos de la población.
Desde Puerto Rico, esta situación no se observa a distancia. Se experimenta en la práctica diaria. En la necesidad de presentar documentos que no corresponden con la identidad de quien los porta. En las implicaciones que esto tiene en espacios laborales, educativos y administrativos.
El avance de este caso abre una posibilidad de cambio en el marco legal aplicable. No porque resuelva de inmediato todas las tensiones en torno al tema, sino porque establece un punto de análisis jurídico sobre una práctica que hasta ahora ha operado bajo criterios restrictivos.
A diferencia de hace ocho meses, el escenario actual incluye una determinación judicial que ya identificó una violación de derechos. Lo que corresponde ahora es evaluar si esa determinación se sostiene en una instancia superior.
Ese proceso no define un resultado inmediato, pero sí establece un nuevo punto de referencia.
El debate ya no es teórico.
Ahora es judicial.
New York
Court orders Pride flag to return to Stonewall
Lambda Legal, Washington Litigation Group filed federal lawsuit
The Pride flag will once again fly over the Stonewall National Monument in New York following a court order requiring the National Park Service to raise it over the site.
The decision follows a lawsuit filed by Lambda Legal and the Washington Litigation Group in the U.S. District Court for the Southern District of New York, which challenged the removal as unconstitutional under the Administrative Procedure Act and argued that the government unlawfully targeted the LGBTQ community.
In February, the NPS removed the Pride flag from the Stonewall National Monument, the first national monument dedicated to LGBTQ rights and history in the U.S. The move followed a Jan. 21 memorandum issued by President Donald Trump-appointed NPS Director Jessica Bowron restricting which flags may be flown at national parks. The directive limited displays to official government flags, with narrow exceptions for those deemed to serve an “official purpose.”
Plaintiffs successfully argued that the Pride flag meets that standard, given Stonewall’s status as the birthplace of the modern LGBTQ rights movement. They also contended that the policy violated the APA by bypassing required public input and improperly applying agency rules.
The lawsuit named Interior Secretary Doug Burgum, Bowron, and Amy Sebring, superintendent of Manhattan sites for the NPS, as defendants. Plaintiffs included the Gilbert Baker Foundation, Village Preservation, Equality New York, and several individuals.
The court found that the memorandum — while allowing limited exceptions for historical context purposes — was applied unlawfully in this case. As part of the settlement, the NPS is required to rehang the Pride flag on the monument’s official flagpole within seven days, where it will remain permanently.
“The sudden, arbitrary, and capricious removal of the Pride flag from the Stonewall National Monument was yet another act by this administration to erase the LGBTQ+ community,” said Karen Loewy, co-counsel for plaintiffs and Lambda Legal’s Senior Counsel and Director of Constitutional Law Practice. “Today, the government has pledged to restore this important symbol back to where it belongs.”
“This is a complete victory for our clients and for the LGBTQ+ community,” said Alexander Kristofcak, lead counsel for plaintiffs and a lawyer with Washington Litigation Group. “The government has acknowledged what we argued from day one: the Pride flag belongs at Stonewall. The flag will be restored and it will fly officially and permanently. And we will remain vigilant to ensure that the government sticks to the deal.”
“Gilbert Baker created the Rainbow Pride flag as a symbol of hope and liberation,” said Charles Beal, president of the Gilbert Baker Foundation. “Today, that symbol is restored to the place where it belongs, standing watch over the birthplace of the modern LGBTQ+ rights movement.”
“The government tried to erase an important symbol of the LGBTQ+ community, and the community said no,” said Amanda Babine, executive director of Equality New York. “Today’s accomplishment proves that when we stand together and fight back, we win.”
“The removal of the Pride flag from Stonewall was an attempt to erase LGBTQ+ history and undermine the rule of law,” said Andrew Berman, executive director of Village Preservation. “This settlement restores both.”
With Loewy on the complaint are Douglas F. Curtis, Camilla B. Taylor, Omar Gonzalez-Pagan, Kenneth D. Upton Jr., Jennifer C. Pizer, and Nephetari Smith from Lambda Legal. With Kristofcak on the complaint are Mary L. Dohrmann, Sydney Foster, Kyle Freeny, James I. Pearce, and Nathaniel Zelinsky from Washington Litigation Group.
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