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.
Congress
Bill seeks to block global gag rule expansion
Policy now bans US foreign aid to groups promoting ‘gender ideology’
Lawmakers on Wednesday introduced a bill that would block the expansion of the global gag rule.
President Ronald Reagan in 1985 implemented the global gag rule, also known as the “Mexico City” policy, which bans U.S. foreign aid for groups that support abortion and/or offer abortion-related services.
Trump reinstated the rule during his first administration. The Biden-Harris administration shortly after it took office in 2021 rescinded it.
The Trump-Vance administration earlier this year expanded the global gag rule to ban U.S. foreign aid for groups that promote “gender ideology.” The expansion took effect on Feb. 26.
U.S. Sens. Jeanne Shaheen (D-N.H.) and Jacky Rosen (D-Nev.) introduced the Protecting Human Rights and Public Health in Foreign Assistance Act in the U.S. Senate. U.S. Reps. Grace Meng (D-N.Y.), Lois Frankel (D-Fla.), Diana DeGette (D-Colo.), Pramila Jayapal (D-Wash.), Sara Jacobs (D-Calif.), and Gregory Meeks (D-N.Y.) introduced it in the U.S. House of Representatives.
“Using taxpayer money to export the Trump administration’s anti-trans, anti-science, and anti-abortion ideological agenda isn’t just immoral — it’s antithetical to efficient, effective, and rights-based foreign assistance,” said Council for Global Equality Senior Policy Fellow Beirne Roose-Snyder on Wednesday in a press release.
Meng in a Congressional Equality Caucus press release added the Trump-Vance administration’s “crusade against healthcare and global aid is putting millions of lives at risk worldwide.”
“No one will flourish under the new expanded global gag rule,” said the New York Democrat. “These policies weaponize foreign aid and will result in greater harm, particularly for women and girls, marginalized communities, and LGBTQI+ individuals.”
“They should never have been implemented at all, let alone without even a basic public comment process,” she added. “This legislation will reverse these dangerous policies.”
District of Columbia
Both sides propose revised orders in Capital Pride stalking case
Defendant Darren Pasha agreed to accept less restrictive directive
An evidentiary hearing in D.C. Superior Court on April 29 in which the Capital Pride Alliance presented three of four planned witnesses to testify in support of its civil complaint that D.C. gay activist Darren Pasha engaged in a year-long effort to harass, intimidate, and stalk its staff, board members, and volunteers ended abruptly at the direction of the judge.
Judge Robert D. Okun announced from the bench that the hearing, which was intended provide Capital Pride an opportunity to present evidence in support of its request to reinstate an anti-stalking order against Pasha that the judge temporarily rescinded on April 17, was no longer needed because Pasha stated at the hearing that he is willing to accept a revised, less restrictive temporary restraining order.
Pasha made that statement after two Capital Pride witnesses — June Crenshaw and Vincenzo Volpe — each testified in support of the stalking allegations against Pasha for over an hour under questioning from Capital Pride attorney Nick Harrison and under cross-examination from Pasha, who is representing himself without an attorney.
After Capital Pride’s third witness, Tifany Royster, testified for just a few minutes, and after the judge called a recess for lunch and to attend to an unrelated case, Pasha announced that after obtaining legal advice he determined that he was unsuited to continue cross-examining the witnesses. He said he would be willing to accept a significantly less restrictive temporary restraining order.
Okun then ruled that the evidentiary hearing was no longer needed and directed Capital Pride and Pasha to submit to him their version of a revised stay away order. He said he would use their proposed revisions to help him develop his own order, which he would issue after deliberating over the matter.
He also scheduled a mandatory remote mediation session for July 23, in which efforts would be made to resolve the case without going to trial. He then adjourned the hearing at 3:50 p.m.
The online Superior Court docket for the case stated after the hearing ended that the judge would issue “a new modified Temporary Protective Order,” but it did not say when it would be issued.
Shortly before the April 29 hearing began at 11 a.m., Harrison filed a “Draft Temporary Anti-Stalking Order” that included a list of 34 “Protected Persons” that Harrison said during the hearing were affiliated with Capital Pride Alliance as staff and board members, volunteers, and others associated with the group.
The proposed order stated, “The defendant shall not contact, attempt to contact, harass, threaten, or otherwise communicate with any protected person, directly or indirectly, including through third parties, social media, electronic communications, or any other means.”
The proposal represented a significant change from Capital Pride’s initial civil complaint against Pasha filed in February that Pasha claimed called for him to stay away at least 200 yards from all Capital pride staff, board members, and volunteers without naming them. Okun granted that stay away request in February but reduced the stay away distance to 100 feet.
Capital Pride attorney Harrison disputes Pasha’s interpretation of the order, saying the 100-foot stay-away was for events, not for individual Capital Pride staff, volunteers, or board members. He said the order prohibited Pasha from engaging in any way with the Capital Pride staffers, volunteers or board members.
But the proposed order Capital Pride at first submitted at the April 29 hearing also called for Pasha to stay away from and to not attend as many as 25 Capital Pride events scheduled to take place this year from April 30 through June 21 and for him to say away from the Capital Pride office located at 1827 Wiltberger St., N.W., which is the building in which it shares with the DC LGBTQ Community Center.
At the April 29 hearing, at Pasha’s request, Okun called on Capital Pride to consider allowing Pasha to attend at least the two largest events — the Capital Pride Parade and Festival — which draw over 500,000 participants.
Harrison said in a follow-up message to the judge following the hearing that Capital Pride would allow Pasha to attend those two events and one other as long as he stays away from “ticketed and controlled access areas.”
At an April 17 status hearing Okun rescinded the earlier stay away order at Pasha’s request, among other things, on grounds that it was too vague and didn’t provide Pasha with sufficient specific information on who to stay away from. It was at that hearing that Okun scheduled the April 29 evidentiary hearing, saying it would give Capital Pride a chance to provide sufficient evidence to justify an anti-stalking order and Pasha an opportunity to challenge the evidence.
In his own response to the initial civil complaint filed in February and in subsequent court filings, Pasha has strongly denied he engaged in stalking and has alleged that the complaint was a form of retaliation against him over a dispute he has had with Capital Pride and its former board president, Ashley Smith.
Like its initial complaint filed in February, Capital Pride filed a multipage document at the start of the April 29 hearing with written testimony from staff members and volunteers who allege that Pasha did engage in stalking, harassment, and intimidating behavior toward them and others.
Like Capital Pride, Pasha following the April 29 hearing, filed his own proposed version of the stay away order with significantly less restrictions than the Capital Pride proposal. Among other things, it calls for him to restrict his contact with Capital Pride CEO Ryan Bos and Crenshaw but says it “does not by its terms restrict the defendant’s communications with any other person, entity, governmental body, or media outlet.”
“Darren Pasha sent multiple messages to us and to the court after the proceedings asking for further modifications — which we are not accepting or responding to,” Harrison told the Blade in response to a request for further comment on Judge’s request for each side to submit proposed revisions of the stay away order.
“We appreciate the court’s time and careful attention to the evidence presented today,” Harrison told the Washington Blade in a written statement after the hearing. “This process was about bringing forward the experiences of individuals who reported a pattern of conduct that caused fear, serious alarm, and emotional distress,” he said.
“Capital Pride Alliance remains committed to ensuring that our events and community spaces are safe, welcoming, and free from harassment and we will continue to take appropriate steps to support and protect our community,” his statement says.
“I am happy with what we have accomplished so far,” Pasha told the Blade after the hearing. “I’m just waiting to see what will happen next. But I want to reiterate this goes back to when someone treats you wrong you speak up,” he said. “Even if I lose this case, I am glad that I spoke up and raised concerns.”
He added, “I will just be confident that in the next couple of months the truth will come out. But for now, I am happy with the progress that we have made regarding this.”
This story will be updated when the judge issues his revised stay away order.
European Union
European Parliament backs EU-wide conversion therapy ban
More than 1.2 million people backed campaign
The European Parliament on Wednesday voted in favor of banning so-called conversion therapy across the European Union.
ACT (Against Conversion Therapy) LGBT in 2024 launched a campaign in support of the ban through the EU’s European Citizens Initiative framework. More than 1.2 million people ultimately signed it.
The proposed ban had the support of 405 MEPs. The European Commission is expected to formally respond to it by May 18.
Seven EU countries — Belgium, Cyprus, France, Malta, Norway, Portugal, and Spain — have banned conversion therapy outright.
Greece in 2022 banned the practice for minors. German lawmakers in 2020 passed a law that prohibits conversion therapy for minors and for adults who have not consented to undergoing the widely discredited practice.
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