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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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District of Columbia

‘No Kings’ protests set for D.C.

Anti-Trump demonstrations to take place across country on Saturday

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A 'No Kings' protest took place in D.C. on Oct. 18, 2025. (Washington Blade photo by Michael Key)

As President Donald Trump and his administration escalate rhetoric targeting transgender youth and student athletes, push efforts to restrict voting access for millions of Americans, and pursue foreign policy decisions that critics say bypass congressional authority, organizers across the country are once again mobilizing in protest.

For many LGBTQ advocates, the moment feels especially urgent.

In recent months, activists have pointed to a surge in anti-trans legislation, attacks on gender-affirming care, and efforts to roll back nondiscrimination protections as direct threats to the safety and visibility of queer and trans communities. Organizers say the demonstrations are not just about policy, but about defending the right of LGBTQ people — particularly trans youth and people of color — to live openly and safely.

Thousands of “No Kings” protests are planned nationwide, with multiple demonstrations set to take place in D.C.

One of the primary events, “No Kings Washington,” will be held in Anacostia, an overwhelmingly Black area of D.C. that is often at the center of conversations around racial justice, policing, and access to resources in the nation’s capital.

The protest in Anacostia is focused on what organizers describe as the “power behind the throne,” specifically Stephen Miller, the White House Deputy Chief of Staff for Policy and Homeland Security Advisor. Miller has been closely associated with the administration’s “zero tolerance” immigration policy, including the family separation practice that resulted in thousands of children being separated from their parents at the Southern border.

Activists have also linked immigration enforcement policies to broader concerns about LGBTQ migrants, including queer asylum seekers who often face heightened risks of violence and discrimination both in their home countries and within detention systems.

Anacostia protest details:

Participants are asked to gather starting at 1:30 p.m. on the southeast side of the Frederick Douglass Bridge. The closest Metro station is Anacostia on the Green Line, about an 8-minute walk from the starting point. Organizers strongly encourage attendees to use public transportation, as street parking is limited.

The march will proceed past Fort McNair and conclude near the Waterfront Metro station.

D.C. icon and LGBTQ activist Rayceen Pendarvis is set to speak at the protest around 2 p.m.

Kalorama protest details:

A separate protest will take place earlier in the day in Kalorama, a neighborhood long associated with political power and home to presidents, cabinet officials, and foreign ambassadors. Demonstrators are expected to gather at 10 a.m., with a march running until approximately noon near the intersection of Connecticut Avenue and Kalorama Road.

Arlington/National Mall protest details:

Another group is expected to assemble at Memorial Circle near Arlington National Cemetery at 10 a.m. before crossing the Memorial Bridge into D.C., passing the Lincoln Memorial and continuing on to the Washington Monument. Organizers say the march is intended to defend “American democracy, the rule of law, and a healthy planet.”

Unlike last June — when organizers discouraged large-scale demonstrations in D.C. due Trump’s military/birthday parade — activists are now explicitly calling on people to show up in the nation’s capital and surrounding areas.

The protests also coincide with Transgender Day of Visibility weekend, which includes additional gatherings and celebrations on the National Mall. At the same time, peak bloom for the National Cherry Blossom Festival is expected to draw large crowds to the city. With multiple major events happening simultaneously, officials and organizers anticipate significant congestion, increased traffic, and crowded public transit throughout the weekend.

Organizers are urging participants to plan ahead and come prepared.

“Bring your signs, noisemakers, music, and creative ideas, and gather in joyful, nonviolent protest,” they said. “Children are very welcome.”

For more information, visit nokings.org.

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Pennsylvania

Pa. House passes bill to codify marriage equality in state law

Governor supports gay state Rep. Malcolm Kenyatta’s measure

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Pennsylvania Capitol Building (Washington Blade file photo by Michael Key)

The Pennsylvania House of Representatives on Wednesday passed a bill that would codify marriage equality in state law.

House Bill 1800 passed by a 127-72 vote margin. Twenty-six Republicans voted for the measure.

The Republican-controlled Pennsylvania Senate will now consider the bill that state Rep. Malcolm Kenyatta (D-Philadelphia), who is the first openly gay person of color elected to the state’s General Assembly, introduced. Democratic Gov. Josh Shapiro supports the measure.

“Here in Pennsylvania, we believe in your freedom to marry who you love,” said Shapiro on Wednesday. “Today, the House has stepped up to protect that right.”

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Florida

DeSantis signs emergency bill that restores Fla. ADAP funding

Temporary funds to last through June 30

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Republican Florida Gov. Ron DeSantis (Screen capture/NBC News)

After the Florida Department of Health made huge cuts to the AIDS Drug Assistance Program in January, Republican Gov. Ron DeSantis has signed emergency legislation restoring HIV access to more than 12,000 Floridians.

Two months ago, as the Washington Blade reported, the Sunshine State cut the vast majority of those in ADAP by shifting the income levels required for eligibility — without following standard procedure when changing government policy outside of legislative or executive action.

The bill, signed by DeSantis on Tuesday, passed both chambers of the Florida Legislature unanimously and appropriates $30.9 million in emergency bridge funding through June 30, 2026. It restores Florida’s ADAP income eligibility to 400 percent of the Federal Poverty Level — the level it was prior to the January cuts. The legislation also requires the FDOH to submit detailed monthly financial reports to legislative leadership beginning April 1.

Under the old policy, eligibility would have been limited to those making no more than 130 percent of the federal poverty level, or $20,345 per year.

“For 10 weeks, 12,000 Floridians living with HIV did not know if they could fill their next prescription. Today, they can,” Esteban Wood, director of advocacy and legislative affairs at AIDS Healthcare Foundation, said in a statement.

The detailed reports now required to be sent to legislative leadership must include all federal revenues and expenditures, including manufacturer rebates; enrollment figures by county and insurance status; prescription utilization by drug class; and any projected funding shortfalls. This is the first time the Legislature has required this level of financial transparency from the program.

DeSantis signed the legislation one day after a Leon County Circuit Court judge denied AIDS Healthcare Foundation’s request for an injunction to block the significant changes the DeSantis administration is making to the program, which it claims faces a $120 million shortfall for calendar year 2026.

AIDS Healthcare Foundation, a national organization focused on protecting and expanding HIV healthcare access and prevention methods, filed a lawsuit over the change in eligibility, arguing the Florida Department of Health did not follow the laid out path for formally changing policy and was acting outside established procedures.

Typically, altering eligibility for a statewide program requires either legislative action or adherence to a multistep rule-making process, including: publishing a Notice of Proposed Rule; providing a statement of estimated regulatory costs; allowing public comment; holding hearings if requested; responding to challenges; and formally adopting the rule. According to AIDS Healthcare Foundation, none of these steps occurred.

The long-term structure of ADAP will be determined by the 2026–2027 fiscal year state budget, something that lawmakers have until June 30 to finish.

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