Transgender inmates who sought gender reassignment surgery in California prisons won a pair of victories on Friday that down the line could lead to improved conditions across the board for prisoners consistent with their gender identity.
Attorneys for Shiloh Quine, a transgender women incarcerated in a men’s prison, and the California Department of Corrections & Rehabilitation reached a settlement granting her gender reassignment surgery prescribed by medical experts as well as clothing and items consistent with her gender identity.
“After so many years of almost giving up on myself, I will finally be liberated from the prison within a prison I felt trapped in, and feel whole, both as a woman and as a human being,” Shiloh in a statement. “I’m just overwhelmed, especially knowing that this will help so many other people. I know I can never truly make amends for what I’ve done in the past, but I am committed to making myself a better person, and to helping others so they don’t have to struggle the way I have.”
According to the California Department of Corrections & Rehabilitation, Shiloh is serving a term of life without the possibility of parole. Admitted on Aug. 4, 1981, Shiloh was convicted in Los Angeles County for first-degree murder, kidnapping and robbery.
Much of the background information on Quine is redacted in the public version of the settlement agreement, but an attached declaration from psychologist Randi Ettner concludes without gender reassignment surgery Quine “will succumb to feelings of hopelessness and despair” and be at risk of suicide given her prior attempts at taking her life.
The California Department of Corrections & Rehabilitation has also agreed to review and revise it policies writ large for transgender inmates and medical treatment, including gender reassignment surgery, which is deemed medically necessary by major medical groups such as the American Medical Association.
Jeffrey Callison, a spokesperson for the California Department of Corrections & Rehabilitation, maintained the agreement on treatment afforded to Quine is consistent with the prohibition against cruel and unusual punishment under the U.S. Constitution.
“The Eighth Amendment of the Constitution requires that prisons provide medically necessary treatment for inmates,” Callison said. “CDCR evaluates every case individually and in the Quine case, every medical doctor and mental health clinician who has reviewed this case, including two independent mental health experts, determined that this surgery is medically necessary for Quine.”
Representing Quine in her lawsuit, which was filed before federal court last year, was the San Francisco-based Transgender Law Center along with pro bono counsel from the law firm of Morgan, Lewis & Bockius LLP.
Kris Hayashi, executive director of Transgender Law Center, said the agreement was a huge win not just for Shiloh, but all transgender people who’ve been denied transition-related care.
“This historic settlement is a tremendous victory, not just for Shiloh and transgender people in prison, but for all transgender people who have ever been denied medical care or basic recognition of our humanity just because of who we are,” Hayashi said. “After years of unnecessary suffering, Shiloh will finally get the care she desperately needs – and transgender people nationwide will hear a state government affirm that our identities and medical needs are as valid as anyone else’s.”
Janetta Johnson, executive director of the San Francisco-based Transgender Gender Variant Intersex Justice Project, also praised the settlement.
“We’re so happy for Shiloh, who’s been a friend of ours for many years,” Johnson said. “There is so much trauma in our communities, especially for those of us in prison, and the need for this kind of medically necessary care is so great. These policy changes will go a long way toward making people feel more whole and secure in their authentic selves.”
California Attorney General Kamala Harris, who’s considered an LGBT advocate and represented the state in the lawsuit, said the agreement was important in the struggle for transgender rights.
“Members of the LGBT community, especially those who are transgender, are too often subjected to discrimination and forced to live on the margins of our society,” Harris said. “In a groundbreaking settlement, the California Department of Corrections & Rehabilitation has agreed to evaluate and provide sex-reassignment surgery if recommended to Shiloh Quine, a transgender inmate. This is an important step forward in the ongoing effort to protect transgender rights in California.”
On the same day attorneys reached an agreement in this case, another trans inmate who sought gender assignment surgery and was represented by the same legal team as Shiloh, Michelle-Lael Norsworthy, received final word she will be released on parole as early as next week. She’s serving 17-years-to-life in Mule Creek State Prison in Ione, Calif., for second-degree murder.
U.S. District Judge Jon Tigar, the same judge overseeing the Shiloh case, ordered the California Department of Corrections & Rehabilitation to grant Norsworthy gender reassignment surgery in April, but the state continued to withhold the procedure and under Harris appealed the decision.
The U.S. Ninth Circuit Court of Appeals had placed the surgery on hold when the state announced Norsworthy would be eligible for parole. At the time, the Transgender Law Center said she could find support networks and services upon release, including access to the gender reassignment surgery through Medi-Cal.
Although California Gov. Jerry Brown had the option to block Norsworthy’s parole, Deborah Hoffman, a Brown spokesperson, said he’s taking no action on the Board of Parole Hearing decision.
In a nine-page filing on Friday, Harris calls on the Ninth Circuit to vacate the district court order in the Norsworthy case and remand the litigation for dismissal now that the inmate is expected to soon be on parole. The filing cities the opposing view of the state, which was not all medical experts thought gender reassignment surgery was necessary for Norsworthy.
“Happenstance — namely, an independent parole suitability review process — has rendered this case moot, and Defendants have no further opportunity to challenge the preliminary injunction,” Harris writes. “In such situations, Defendants should not have to bear the consequences of an adverse ruling that was decided on a flimsy and procedurally flawed record.”
The victories for transgender inmates in California take place as the issue of gender reassignment surgery being a necessary treatment for transgender people in prison has emerged at the forefront of the transgender rights movement.
Transgender advocates say denial of the procedure to trans inmates constitutes cruel and unusual punishment under the Eighth Amendment of the U.S. Constitution. However, the U.S. First Circuit Court of Appeals ruled against those claims in separate litigation filed on behalf of Michelle Kosilek, a transgender inmate in Massachusetts, and the U.S. Supreme Court refused to review that decision.
Nine states, including California, as well as D.C. require private insurers to cover medical care related to gender transition, including surgeries. Public insurance programs like California’s Medicaid system and in most cases Medicare also cover transition-related care.