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9th Circuit: Gender reassignment surgery must be granted to trans inmates

Court rules denying procedure violates 8th Amendment

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transgender health, gay news, Washington Blade
The Ninth Circuit affirmed an order granting gender reassignment surgery to trans inmate.

Denying gender reassignment surgery to transgender prison inmates is prohibited under the U.S. Constitution, a federal appeals court ruled Friday.

A three-judge panel on the U.S. Ninth Circuit Court of Appeals issued the per curiam decision on the basis that gender reassignment surgery is medically necessary, so denying the procedure to prison inmates violates the Eighth Amendment.

“We hold that where, as here, the record shows that the medically necessary treatment for a prisoner’s gender dysphoria is gender confirmation surgery, and responsible prison officials deny such treatment with full awareness of the prisoner’s suffering, those officials violate the Eighth Amendment’s prohibition on cruel and unusual punishment,” the decision says.

The three-judge panel that issued the ruling consists of U.S. Circuit Judge Mary Margaret McKeown, a Clinton appointee; U.S. Circuit Judge Ronald Gould, another Clinton appointee; and U.S. District Judge Robert Lasnik, another Clinton appointee sitting by designation on the Ninth Circuit.

The ruling affirms taxpayer funds will be used to provide gender reassignment surgery to Adree Edmo, who’s transgender and has been an inmate in the Idaho State Correctional Institution since 2012. Edmo has been ever since she pleaded guilty to sexual abuse of a 15-year-old male at a house party.

Edmo doesn’t have access to her personal funds while she’s incarcerated. The estimated cost of male-to-female gender reassignment surgery can be more than $100,000.

Medical providers have documented Edmo’s feminine presentation since 2012 and she has testified she “continues to actively think about self-castration” in prison, according to the Ninth Circuit decision.

“I am relieved and grateful the court recognized my right to necessary medical treatment, and that I will get the surgery I need,” Edmo said in a statement. “I hope my case helps the State of Idaho understand that they can’t deny medical care to transgender people.”

The case came to the Ninth Circuit upon appeal after U.S. Chief District Judge B. Lynn Winmil in Idaho issued a decision ordering the state to grant gender reassignment surgery to Edmo, who sued the state in 2017 after the Idaho Department of Corrections refused to great her the procedure.

“Although we addressed this appeal on an expedited basis, it has been more than a year since doctors concluded that GCS is medically necessary for Edmo,” the Ninth Circuit decision says. “We urge the state to move forward. We emphatically do not speak to other cases, but the facts of this case call for expeditious effectuation of the injunction.”

The Ninth Circuit affirmed Winmill’s order with respect to granting gender reassignment surgery to Edmo, but remanded to the trial court a separate with respect to whether Corizon, Inc., a private for-profit corporation that provides health care to inmates in Idaho prisons, should be included in the injunction.

The Ninth Circuit is now the only federal appeals court with a standing ruling ordering gender reassignment surgery. Although a three-judge panel on the U.S. First Circuit Court of Appeals ordered the procedure in 2014, the full court later reversed that decision.

Representing Edmo in the case was the National Center for Lesbian Rights, which noted the significance of the decision after it was handed down.

“One of the foundational principles of our Constitution is that the State cannot subject people in its custody to cruel and unusual punishment, including by failing to treat serious medical conditions,” NCLR Senior Staff Attorney Amy Whelan said in a statement. “This ruling is in line not only with long-standing medical evidence, but also with legal rulings across the country that it is dangerous and unconstitutional to deny transgender people access to medically necessary care in prison.”

The Washington Blade has placed a request in with the Boise-based law firm Moore Elia Kraft & Hall, LLP, which is representing the Idaho Department of Corrections, to seek comment on whether the state will seek an “en banc” rehearing before the Ninth Circuit or take up the matter before the U.S. Supreme Court.

The issue of whether transgender inmates are entitled to gender reassignment surgery has been percolating for some time and has dogged Democratic presidential candidate Kamala Harris, who as attorney general represented the California Department of Corrections in seeking to deny the procedure to two inmates.

As media scrutiny of the cases grew, Harris helped the California Department of Corrections reach an agreement in which to set up a process where transgender inmates could obtain transition-related care, including gender reassignment surgery. Both of the transgender inmates in those cases were able to obtain gender reassignment surgery, one through the state health care system after obtaining parole.

It should be noted Harris didn’t seek to the agreement to grant transgender inmates gender reassignment surgery until after a court already ordered one the transgender inmates be granted the procedure. At least one transgender advocate in California has also said the California Department of Correction has built a reputation for not fulfilling the agreement reached on behalf of transgender inmates.

Harris, in a statement provided to the Washington Blade from her presidential campaign, said she supports the Ninth Circuit decision in the Edmo case.

“This ruling rightly reaffirms the right to adequate and comprehensive health care, including transition-related care for those at correctional facilities,” Harris said. “Everyone deserves access to compassionate and comprehensive care.”

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The White House

Trump tells Fox News he won the ‘gay vote’ — but polls tell a different story

Trump falsely claims LGBTQ support on Fox despite polling showing overwhelming opposition.

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President Donald Trump at the State of the Union in February 2025. (Washington Blade photo by Michael Key)

President Donald Trump claimed he won the “gay vote” in 2024, despite evidence showing otherwise.

While appearing by phone on Fox News’s panel show “The Five” on Thursday, Trump falsely claimed he performed particularly well among gay voters while discussing the ongoing war in Iran — a conflict he initiated without formal congressional approval.

“Now I think I did very well with the gay vote, OK? I even played the gay national anthem as my walk-off, OK?” Trump said on air.

“And I think it probably helped me. But I did great. No Republican’s ever gotten the gay vote like I did and I’m very proud of it, I think it’s great. Perhaps it’s because I’m from New York City, I don’t know…”

His claim contradicts 2024 polling from NBC News, which found that the GOP presidential ticket captured fewer than 1 in 5 LGBTQ male voters — a figure that may also include bisexual and transgender men. Trump’s support among LGBTQ female voters was even lower, at just 8%.

White LGBTQ voters favored Vice President Kamala Harris over Trump by a margin of 82% to 16%, while LGBTQ voters of color backed Harris by an even wider 91% to 5%.

Trump also used the appearance to criticize “Gays for Palestine,” saying: “Look at ‘Gays for Palestine’… they kill gays, they kill them instantly, they throw them off buildings, and I’m saying, ‘Who are the gays for Palestine?’”

He further pointed to his campaign’s use of the song “Y.M.C.A.” by the Village People — which he has repeatedly described as a “gay national anthem” — noting that it was frequently used as a walk-off song at rallies, as an indication that he and his campaign were supported by the gay community. The track, long associated with camp and hyper-masculine gay imagery, became a staple of Trump campaign events.

The Village People were later booked to perform at Turning Point USA’s inaugural ball celebrating Trump’s second inauguration. Lead singer Victor Willis previously criticized Trump’s use of the song dating back to 2020 and considered legal action to block it, but ultimately said there was “not much he can do about it.” He later acknowledged the renewed exposure was “beneficial” and “good for business,” boosting the song’s popularity and chart performance.

Despite Trump’s claims of strong support from gay voters, polling has consistently shown otherwise — even as several prominent gay men have held roles in or around his orbit, sometimes dubbed the “A-gays.” These include Richard Grenell, former executive director of the Kennedy Center and Special Presidential Envoy for Special Missions; Treasury Secretary Scott Bessent; Under Secretary of State Jacob Helberg; Department of Energy official Charles T. Moran; and longtime supporter Peter Thiel, co-founder and CEO of Palantir.

His efforts to portray himself as aligned with the gay community stand in conflict with policies advanced under his leadership. These include removing LGBTQ-related data from State Department reports, attempting to narrowly redefine gender identity in federal policy, restricting access to gender-affirming health care, and rolling back anti-discrimination protections. His administration also rescinded initiatives focused on LGBTQ health equity, data collection, and nondiscrimination in health care and education — moves advocates say contribute to stigma and worsen mental health outcomes.

Additionally, some HIV programs and community health centers have lost funding from the federal government after supporting initiatives inclusive of transgender people as a direct result of Trump-Vance policies.

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National

Anti-trans visa ruling echoes Nazi regime destroying trans documents

Trump administration escalates attacks on queer community

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The Trump administration has moved from identifying trans people as as threat to the family to claiming that trans people are a threat to the spiritual health of the nation. (Washington Blade photo by Michael Key)

The Lemkin Institute for Genocide Prevention and Human Security earlier this month released its third Red Flag Alert for the United States about the Trump administration’s anti-trans legislation. As the Lemkin Institute shared in the press release, “the Administration has moved from identifying transgender people as as threat to the family and to the nation’s military prowess to claiming that transgender people constitute a cosmic threat to the spiritual health of the nation and the great direct threat to the US national security in the world.”

The news came the same day that the State Department issued a new rule, “Enhancing Vetting and Combatting Fraud in the Immigrant Visa Program.” Under this new guidance, all visa applicants are required to disclose their “biological sex at birth” during all stages of the process, “even if that differs from the sex listed on the applicant’s foreign passport or identifying documentation.” 

This rule also orders that applicants to the green card lottery program share their passport information, so in knowingly collecting passport information that the agency knows will not match a person’s biological sex at birth, it’s creating grounds to deny trans peoples’ biases on the basis of “fraud,” Aleksandra Vaca of Transitics explains.

As is written in the new ruling, “the Department is replacing ‘gender’ with ‘sex’ in accordance with E.O. 14168, Defending Women From Gender Ideology Extremism and Restoring Biological Truth to the Federal Government, which provides that the term ‘sex’ shall refer to an individual’s sex at birth. Only male and female sex options are available for entrants completing the Diversity Visa entry form.” 

Along with outright denying the existence of nonbinary, genderqueer and gender expansive people, this policy creates a precedence for trans people to be stripped of their visas and deported because under 8 U.S.C. § 1182(a)(6)(C)(i), any foreigner found to have obtained or possess a visa “by fraud or willfully misrepresenting a material fact” will have their visa revoked and face deportation. 

By requesting information on “biological sex at birth,” the State Department is forcing a mismatch between documents and enabling officials to accuse trans, nonbinary, and gender expansive immigrants of fraud. Thus, trans and nonbinary immigrants can have their visas revoked and can be deported, and information gathered from immigrants during the visa request process can be added to federal databases and used by immigration authorities, including ICE agents. 

With the Supreme Court’s decision this past year allowing ICE officers to use racial profiling, Vaca argues that “now, The Trump administration has given ICE the reason it needs. Under this rule, ICE agents now have the enforcement rationale to assert that trans people–especially those belonging to racial minority groups–are more likely than cis people to have ‘misrepresented’ themselves during the visa process, and therefore, are more likely to enter the country ‘unlawfully.’”

This would enable ICE agents to target trans individuals specifically for being trans. If the goal of this were unclear, a day later the Trump administration released its statement for Women’s History Month 2026, writing that “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. We are restoring public safety and upholding the rule of law in every city so women, children, and families can feel safe and secure.”

And this is not the first time that ICE has targeted and harmed trans and nonbinary immigrants. Last June, Vera reported that ICE is not including trans people in detection in their public reports, and back in 2020, AFSC reported that trans people held in ICE detention faced “dreadful, ugly” conditions. 

While it seems like a new development in Trump’s anti-trans escalation, it echoes a deeply upsetting history of denying and destroying transgender people’s documents following members of the Nazi party seizing power in 1933. 

In the early 20th century, Weimar, Germany was an epicenter for gender affirming care with Maganus Hirschfeld’s Institute for Sexual Science. One of the first book burnings of the rising Nazi regime destroyed the Institute’s extensive clinical records and library on trans health and history by Nazi students and stormtroopers. In doing so, the Nazis effectively destroyed the world’s first trans health clinic and one of the richest and most comprehensive collective of information about trans healthcare. 

Similarly, the Nazi government invalidated or refused to recognize what was called “transvestite passes,” or passing certificates that allowed trans people to avoid arrest under Paragraph 175 which prohibited cross-dressing. During the Weimar Republic — the regime that preceded the Third Reich — recognized and affirmed the identities of trans people (in limited ways) with specific documentation that helped prevent them from arrest. Invalidating and disregarding these passes allowed police and Nazi officials to target trans people and harass, extort and arrest them, and the record of passes themselves helped officials target trans people. 

The changes to visa guidelines — alongside Kansas’s move to revoke trans drivers’ licenses last month — is reflective of this escalation of violence against trans people during the Nazi’s rise to power, which scholars like Dr. Laurie Marhoefer is just beginning to uncover. And along with the revocation of identification documents this past week, a recent Fourth Circuit Court ruled that states can deny Medicaid coverage for gender-affirming surgery.

The Fourth Circuit Court decision affirmed the Supreme Court’s decision in Skrmetti, which ruled that bans on gender affirming healthcare for young people are constitutional. This ruling extends this ban to include adult healthcare bans, allowing West Virginia’s exclusion of Medicaid coverage for adult gender affirming healthcare to take full effect. Even more upsetting was what the ruling itself said, calling gender affirming healthcare “dangerous.” 

As was written in the Fourth Circuit Opinion, “it’s not irrational for a legislature to encourage citizens ‘to appreciate their sex’ and not ‘become disdainful of their sex’ by refusing to fund experimental procedures that may have the opposite effect.” 

In reality, what this ruling and the opinion reflect, is the next step in government regulation and oversight over marginalized peoples’ bodies. From the overturn of Roe v. Wade, which removed federal protection of access to abortion, this next step represents the denial of people’s access to vital, lifesaving care–and to be clear, gender affirming care is not just for trans, nonbinary, and intersex people. It’s a dangerous escalation and one that echoes previous violence against trans people under fascist regimes; the Lemkin Institute is right to raise concern.

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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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