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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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New York

Court orders Pride flag to return to Stonewall

Lambda Legal, Washington Litigation Group filed federal lawsuit

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Pride flag restored by activists at Stonewall National Monument in New York following the removal earlier this year. (Screen capture insert via Reuters YouTube)

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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Sri Lanka

Sri Lankan government withdraws support for LGBTQ tourism initiative

Prominent religious leaders criticized campaign

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(Photo by PaulCowan/Bigstock)

The Sri Lankan government has withdrawn its support for an initiative that encourages LGBTQ tourists to visit the country.

The Sri Lanka Tourism Development Authority last September partnered with Equal Ground, an LGBTQ rights group, on the initiative.

The Daily Mirror, a Sri Lankan newspaper, reported Sri Lanka Development Authority Chair Buddhika Hewawasam in a letter to Equal Ground Executive Director Rosanna Flamer-Caldera said his agency recognizes “the potential of this project to diversify our tourism markets and position Sri Lanka as a safe, inclusive, and welcoming destination for all travelers.”

Cardinal Malcolm Ranjith, the archbishop of Colombo, along other prominent Christian and Buddhist leaders criticized the initiative. Attorney General Parinda Ranasinghe on Feb. 10 indicated the Sri Lanka Tourism Development Authority had rescinded its support for the campaign.

Flamer-Caldera on April 10 acknowledged the criticism over the initiative but added “the fact that the letter has been rescinded doesn’t make any difference.”

“We’re still doing work with the tourism industry who have basically opened up to us and are willing participants in the project,” said Flamer-Caldera. “They realize the potential of the boost to our tourism industry as well as boosting our economy.”

Sections 365 and 365A of Sri Lanka’s colonial-era penal code criminalizes consensual same-sex sexual relations.

The U.N. Committee on the Elimination of Discrimination Against Women in 2022 ruled the criminalization law violated Flamer-Caldera’s rights. The Sri Lankan Supreme Court in 2023 said a bill that would decriminalize homosexuality is constitutional.

Transgender people in Sri Lanka since 2016 have been able to request a Gender Recognition Certificate that allows them to legally change their name and gender on ID cards. Flamer-Caldera noted to the Blade that LGBTQ rights opponents have challenged the Gender Recognition Certificate in the Supreme Court.

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Federal Government

Trump budget targets ‘gender extremism’

Proposed spending package would target ‘leftist’ political ideologies

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The FBI seal on granite. (Photo courtesy of Bigstock)

The White House submitted its 2027 budget request to Congress last month, outlining a push for the Federal Bureau of Investigation to “proactively” target what it describes as “extremism” related to gender — raising concerns about the potential for law enforcement to target LGBTQ people.

The Trump-Vance administration’s 2027 budget request, submitted to Congress on April 4, proposes a dramatic increase in national security and law enforcement spending, while reducing foreign aid and restructuring multiple domestic security programs. In total, the administration is requesting $2.16 trillion in discretionary budget authority (including mandatory resources), a 15.3 percent increase over the 2026 proposal.

Central to the proposal is the creation of a new “NSPM-7 Joint Mission Center,” a direct follow-up to the September 2025 National Security Presidential Memorandum 7 (NSPM-7). The directive instructs the Justice Department, the FBI, and other national security agencies to combat what the administration defines as “political violence in America,” effectively reshaping the Joint Terrorism Task Force network to focus on “leftist” political ideologies, according to reporting by independent journalist Ken Klippenstein.

The American Civil Liberties Union has characterized NSPM-7 as a way for President Donald Trump to intimidate his political enemies.

In a press release following the memorandum, Hina Shamsi, director of the ACLU’s National Security Project, said, “President Trump has launched yet another effort to investigate and intimidate his critics,” and had described the move as an “intimidation tactic against those standing up for human rights and civil liberties.”

The proposed mission center would include personnel from 10 federal agencies tasked with targeting “domestic terrorists” associated with a wide range of ideologies. Among them is what the administration labels “extremism” related to gender, alongside categories such as “anti-Americanism,” “anti-capitalism,” “anti-Christianity,” and “support for the overthrow of the U.S. government.” The document also cites “hostility toward those who hold traditional American views” on family, religion, and morality — language LGBTQ advocates have increasingly warned could be used to frame queer and transgender rights movements as ideological threats.

The mission center is one component of a proposed $166 million increase in the FBI’s counterterrorism budget.

In total, the FBI would receive $12.5 billion for salaries and expenses under the proposal, a $1.9 billion increase. Planned investments include unmanned aerial systems operations and counter-drone capabilities, counterterrorism efforts, and security preparations for the 2028 Summer Olympics in Los Angeles. The budget also cites 67,000 FBI arrests since Jan. 20, 2026, which it describes as a 197 percent increase from the prior year.

When Congress passed the USA PATRIOT Act in 2001, it also enacted 18 U.S.C. § 2331(5), which defines domestic terrorism as activities involving acts dangerous to human life that violate criminal laws and are intended to intimidate or coerce civilians or influence government policy through violence. That statutory definition has not changed.

However, federal agencies have historically categorized domestic terrorism threats into groups such as racially or ethnically motivated violent extremism, anti-government or anti-authority violent extremism, and other threats, including those tied to bias based on religion, gender, or sexual orientation.

The language in the budget suggests a shift in how those categories are interpreted and applied — particularly by explicitly linking “extremism” to gender and to perceived opposition to “traditional” views — without any corresponding change to federal law. Only Congress has the power to change the definition of domestic terrorism by passing legislation.

The budget document states:

“DT lone offenders will continue to pose significant detection and disruption challenges because of their capacity for independent radicalization to violence, ability to mobilize discretely, and access to firearms. Additionally, in recent years, heinous assassinations and other acts of political violence in the United States have dramatically increased. Commonly, this violent conduct relates to views associated with anti-Americanism, anti-capitalism, and anti-Christianity; support for the overthrow of the U.S. government; extremism on migration, race, and gender; and hostility toward those who hold traditional American views on family, religion, and morality.”

This language echoes earlier actions by the Trump-Vance administration targeting trans people.

On the first day of his second term, President Trump signed Executive Order 14168, titled “Defending Women from Gender Ideology Extremism and Restoring Biological Truth to the Federal Government.”

The order establishes a strict binary definition of sex and withdraws federal recognition of trans people.

“It is the policy of the United States to recognize two sexes, male and female,” the order states. “‘Sex’ shall refer to an individual’s immutable biological classification as either male or female. ‘Sex’ is not a synonym for and does not include the concept of ‘gender identity.’”

Appropriations committees in both chambers are expected to begin hearings in the coming weeks.

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