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Court: Trans inmate must receive gender reassignment surgery

Panel says denying procedure to prisoner cruel and unusual punishment

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National LGBT Bar Association, Gay News, Washington Blade

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.

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Federal Government

Gay Venezuelan man ‘forcibly disappeared’ to El Salvador files claim against White House

Andry Hernández Romero had asked for asylum in US

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Andry Hernández Romero (Photo courtesy of the Immigrant Defenders Law Center)

A gay Venezuelan asylum seeker who the U.S. “forcibly disappeared” to El Salvador has filed a claim against the federal government.

Immigrant Defenders Law Center, who represents Andry Hernández Romero, on Friday announced their client and five other Venezuelans who the Trump-Vance administration “forcibly removed” to El Salvador under the Alien Enemies Act of 1798, filed “administrative claims” under the Federal Tort Claims Act.

The White House on Feb. 20, 2025, designated Tren de Aragua, a Venezuelan gang, as an “international terrorist organization.”

President Donald Trump less than a month later invoked the Alien Enemies Act of 1798, which the Associated Press notes allows the U.S. to deport “noncitizens without any legal recourse.” The White House then “forcibly removed” Hernández, who had been pursuing his asylum case in the U.S., and more than 250 other Venezuelans to El Salvador.

Immigrant Defenders Law Center disputed claims that Hernández is a Tren de Aragua member.

Hernández was held at El Salvador’s Terrorism Confinement Center, a maximum-security prison known by the Spanish acronym CECOT, until his release on July 18, 2025. Hernández, who is back in Venezuela, claims he suffered physical and sexual abuse while at CECOT.

“As a Venezuelan citizen with no criminal record anywhere in the world, I would like to tell not only the government of the United States but governments everywhere that no human being is illegal,” said Hernández in the Immigrant Defenders Law Center press release. “The practice of judging whole communities for the wrongdoing of a single individual must end. Governments should use their power to help every person in the nation become more aware and informed, to strengthen our cultures and build a stronger generation with principles and values — one that multiplies the positive instead of destroying unfulfilled dreams and opportunities.” 

Immigrant Defenders Law Center filed claims on behalf of Hernández and the five other Venezuelans less than three months after American forces seized then-Venezuelan President Nicolás Maduro and his wife, Cilia Flores, at their home in Caracas, the Venezuelan capital.

Maduro and Flores have pleaded not guilty to federal drug charges. Delcy Rodríguez, who was Maduro’s vice president, is Venezuela’s acting president.

‘Due process and accountability cannot be optional’

Immigrant Defenders Law Center on Friday also made the following demands: 

  • The Trump administration must officially release the names of all people the United States sent to CECOT to ensure that everyone has been or will be released. 
  • The federal government must clear the names of the 252 men wrongfully labeled as criminal gang members of Tren de Aragua.  
  • DHS (Department of Homeland Security) must end the practice of outsourcing torture through third‑country removals, restore humanitarian parole, and rebuild a functioning, humane asylum system.  
  • DHS must reinstate Temporary Protected Status for all individuals who cannot safely return to their home countries, halt mass deportations and unlawful raids and arrests, and guarantee due process for everyone navigating the immigration system.  
  • Congress must pass the Neighbors Not Enemies Act, which would repeal the Alien Enemies Act.   

“In all my years as an immigration attorney, I have never seen a client simply vanish in the middle of their case with no explanation,” said Immigration Defenders Legal Fund Legal Services Director Melissa Shepard. “In court, the government couldn’t even explain where he was — he had been disappeared.” 

“When the government detains and transfers people in secrecy, without transparency or access to the courts, it tears at the basic protections a democracy is supposed to guarantee,” added Shepard. “What this experience makes painfully clear is that due process and accountability cannot be optional. They are the only safeguards standing between people and the kind of lawlessness our clients suffered. We must end third country transfers, restore the asylum system, and humanitarian parole, and reinstate temporary protective status so this nightmare never happens again.” 

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The White House

Trump proclamation targets trans rights as State Dept. shifts visa policy

Recent policy actions from the White House limit transgender rights in sports, immigration visas, and overarching federal policy.

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President Donald Trump stands in the Roosevelt Room in December 2025. (Washington Blade Photo by Joe Reberkenny)

In a proclamation issued by the Trump White House Thursday night, the president said he would, among other things, “restore public safety” and continue “upholding the rule of law,” while promoting policies that restrict the rights of transgender people.

“We are keeping men out of women’s sports, enforcing Title IX as it was originally written, and ensuring colleges preserve — and, where possible, expand — scholarships and roster opportunities for female athletes,” the proclamation reads. “At the same time, we are restoring public safety and upholding the rule of law in every city so women, children, and families can feel safe and secure.”

The statement comes amid a broader series of actions by the Trump administration targeting transgender people across multiple federal policy areas, including education, health care, and immigration. A nearly complete list of policies the current administration has put forward can be found on KFF.org.

One day before the proclamation was issued, the U.S. State Department announced changes to visa regulations that could impact transgender and gender-nonconforming people seeking entry into the United States.

The policy, published March 11 and scheduled to take effect April 10, introduces changes to the Diversity Immigrant Visa Program, commonly known as the “DV Program.” The rule is framed by the department as an effort to strengthen oversight and prevent fraud within the visa lottery system, which allocates a limited number of immigrant visas annually to applicants from countries with historically low rates of immigration to the United States.

However, the updated language also standardizes the use of the term “sex” in federal regulations in place of “gender,” a change that LGBTQ advocates say could create additional barriers for transgender and gender-diverse applicants.

The policy states: “The Department of State (‘Department’) is amending regulations governing the Diversity Immigrant Visa Program (‘DV Program’) to improve the integrity of, and combat fraud in, the program. These amendments require a petitioner to the DV Program to provide valid, unexpired passport information and to upload a scan of the biographic and signature page in the electronic entry form or otherwise indicate that he or she is exempt from this requirement. Additionally, the Department is standardizing and amending its regulations to add the word ‘shall’ to simplify guidance for consular officers; ensure the use of the term ‘sex’ in lieu of ‘gender’; and replace the term ‘age’ in the DV Program regulations with the phrase ‘date of birth’ to accurately reflect the information collected and maintained by the Department during the immigrant visa process.”

Advocates say the shift toward using “sex” rather than “gender” in federal immigration rules reflects a broader push by the administration to roll back recognition of transgender identities in federal policy.

According to the National Center for Transgender Equality, an estimated 15,000 to 50,000 undocumented transgender immigrants currently live in the United States, with many entering the country to seek refuge from persecution and hostile governments in their home countries.

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Ecuador

Adolescentes trans en Ecuador podrán cambiar datos en su cédula, pero con condicionamientos

Pueden modificar el campo de género en su documento de identidad con requisitos

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Edición Cientonce es el socio mediático del Washington Blade en Ecuador. Esta nota salió en su sitio web el 12 de marzo.

Por VICTOR H. CARREÑO | En una sentencia del 5 de febrero de 2026, la Corte Constitucional declaró inconstitucional el requisito legal de mayoría de edad para modificar el campo de sexo o género en la cédula de identidad y fija lineamientos para que adolescentes trans puedan cambiar estos datos.

El máximo organismo de control e interpretación constitucional incorpora dos requerimientos: que la persona adolescente se presente al procedimiento administrativo con sus padres y que informes psicosociales acrediten un grado de madurez.

El fallo resuelve una consulta de constitucionalidad de una unidad judicial que lleva una acción de protección contra el Registro Civil presentada por la familia de un adolescente trans que solicitó, en junio de 2023, modificar el campo de género en la cédula.

La institución se negó porque la Ley Orgánica de Gestión de la Identidad y Datos Civiles establece que la rectificación de sexo o género es un procedimiento para personas mayores de 18 años.

El adolescente, cuya identidad se protege en la sentencia, cuenta con el apoyo de sus padres en su transición, que inició en 2020. En una audiencia, su madre expuso que si bien en el ámbito familiar y en el sistema educativo se respeta la identidad de su hijo, fuera de estos hay situaciones, como en consultas médicas en el Seguro Social, en que debe presentar la cédula de él y quienes la reciben preguntan si es el documento equivocado.

En el desarrollo de la sentencia, la Corte expone por qué el requisito de tener mayoría de edad para acceder a la modificación de datos en la cédula es inconstitucional.

Entre varios motivos, explica que restringe los derechos al libre desarrollo de la personalidad e identidad, que la edad no puede exigirse como “criterio determinante y único” para determinar la madurez de un adolescente, y que la medida puede generar impactos negativos en el bienestar psicológico y emocional.

Por ello, indica que existen mecanismos alternativos como la evaluación individualizada, el acompañamiento técnico y la consideración del contexto familiar.

En ese sentido, la Corte dispone al Registro Civil que debe proceder al cambio de los datos de adolescentes trans cuando acudan acompañades de sus representantes legales y con el respaldo de informes psicosociales.

Estos informes, agrega la sentencia, deben ser de profesionales acreditados o de órganos técnicos públicos competentes que sean considerados por el Registro Civil.

El fallo tiene efectos para este caso y otros similares. A diferencia de otras sentencias, la Corte no ordena una reforma a la legislación.

La organización Silueta X, que difundió el caso en un comunicado el 11 de marzo, calificó el fallo como histórico y explicó que este crea jurisprudencia de cumplimiento obligatorio.

Sin embargo, otras organizaciones cuestionan los requisitos. Fundación Pakta indica que si bien la sentencia derriba la barrera etaria de la mayoría de edad, la inclusión de informes psicosociales contradice la tendencia global y regional hacia la despatologización.

Pakta menciona, por ejemplo, la Opinión Consultiva 24/17 de la Corte Interamericana de Derechos Humanos, instrumento que reconoce la identidad autopercebida de las personas y los derechos patrimoniales de parejas del mismo sexo.

El documento, recuerda Pakta en un comunicado, establece que para el reconocimiento de la identidad de género no se debe exigir certificados médicos ni psicológicos. Además, que la Organización Mundial de la Salud reconoció que la identidad trans no es una patología psiquiátrica.

Mientras que la activista Nua Fuentes, de Proyecto Transgénero, considera que los requisitos impuestos por la Corte pueden ser problemáticos. Menciona que frente al desconocimiento y prejuicios, profesionales de salud patologizan la identidad trans.

Además, señala que puede haber casos de que la familia y psicólogos expresen rechazo a la identidad trans y limiten los derechos de adolescentes trans. O también menciona casos de abandono de niñes y adolescentes trans y pregunta cómo reconocer su identidad si no cumplen con el requisito de acudir sin representantes legales.

Los condicionamientos para el cambio del campo de sexo o género en la cédula para adolescentes trans marcan también una diferencia con el procedimiento en personas trans de más de 18 años, pues estas —desde las reformas vigentes en 2024— no deben presentar requisitos. Solo su declaración expresa de ser una persona trans que desea que los datos de su cédula estén conformes a su identidad de género.

La madurez de niñeces y adolescencias ha sido un tema abordado en convenciones o instrumentos internacionales. La Convención sobre los Derechos del Niño de la ONU del 2009 es contundente al reconocerles como seres autónomos y capaces de formar sus propias opiniones a través de la experiencia, el entorno, las expectativas sociales y culturales.

Esta convención es mencionada en una sentencia de la Corte Constitucional en que reconoció la identidad de infancias y adolescencias trans en el sistema educativo.

En las Observaciones Generales del Comité de los Derechos del Niño, documentos de interpretación para los alcances de la mencionada Convención, se explica que la madurez es “la capacidad de comprender y evaluar las consecuencias de un asunto determinado”, lo cual debe considerarse en relación con su capacidad individual, contextos, entornos, experiencias de vida y familiar, desarrollo psicológico y no únicamente con su edad biológica.

Además, que la edad cronológica no determina la evolución de las capacidades de las niñeces y adolescencias porque estas crecen a lo largo del tiempo.

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