National
9th Circuit: Gender reassignment surgery must be granted to trans inmates
Court rules denying procedure violates 8th Amendment
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.”
National
Medical groups file lawsuit over Trump deletion of health information
Crucial datasets included LGBTQ, HIV resources
Nine private medical and public health advocacy organizations, including two from D.C., filed a lawsuit on May 20 in federal court in Seattle challenging what it calls the U.S. Department of Health and Human Services’s illegal deletion of dozens or more of its webpages containing health related information, including HIV information.
The lawsuit, filed in the United States District Court for the Western District of Washington, names as defendants Robert F. Kennedy Jr., secretary of the Department of Health and Human Services (HHS) and HHS itself, and several agencies operating under HHS and its directors, including the Centers for Disease Control and Prevention, the National Institutes of Health, and the Food and Drug Administration.
“This action challenges the widespread deletion of public health resources from federal agencies,” the lawsuit states. “Dozens (if not more) of taxpayer-funded webpages, databases, and other crucial resources have vanished since January 20, 2025, leaving doctors, nurses, researchers, and the public scrambling for information,” it says.
“These actions have undermined the longstanding, congressionally mandated regime; irreparably harmed Plaintiffs and others who rely on these federal resources; and put the nation’s public health infrastructure in unnecessary jeopardy,” the lawsuit continues.
It adds, “The removal of public health resources was apparently prompted by two recent executive orders – one focused on ‘gender ideology’ and the other targeting diversity, equity, and inclusion (‘DEI’) programs. Defendants implemented these executive orders in a haphazard manner that resulted in the deletion (inadvertent or otherwise) of health-related websites and databases, including information related to pregnancy risks, public health datasets, information about opioid-use disorder, and many other valuable resources.”
The lawsuit does not mention that it was President Donald Trump who issued the two executive orders in question.
A White House spokesperson couldn’t immediately be reached for comment on the lawsuit.
While not mentioning Trump by name, the lawsuit names as defendants in addition to HHS Secretary Robert Kennedy Jr., Matthew Buzzelli, acting director of the Centers for Disease Control and Prevention; Jay Bhattacharya, director of the National Institutes of Health; Martin Makary, commissioner of the Food and Drug Administration; Thomas Engels, administrator of the Health Resources and Services Administration; and Charles Ezell, acting director of the Office of Personnel Management.
The 44-page lawsuit complaint includes an addendum with a chart showing the titles or descriptions of 49 “affected resource” website pages that it says were deleted because of the executive orders. The chart shows that just four of the sites were restored after initially being deleted.
Of the 49 sites, 15 addressed LGBTQ-related health issues and six others addressed HIV issues, according to the chart.
“The unannounced and unprecedented deletion of these federal webpages and datasets came as a shock to the medical and scientific communities, which had come to rely on them to monitor and respond to disease outbreaks, assist physicians and other clinicians in daily care, and inform the public about a wide range of healthcare issues,” the lawsuit states.
“Health professionals, nonprofit organizations, and state and local authorities used the websites and datasets daily in care for their patients, to provide resources to their communities, and promote public health,” it says.
Jose Zuniga, president and CEO of the International Association of Providers of AIDS Care (IAPAC), one of the organizations that signed on as a plaintiff in the lawsuit, said in a statement that the deleted information from the HHS websites “includes essential information about LGBTQ+ health, gender and reproductive rights, clinical trial data, Mpox and other vaccine guidance and HIV prevention resources.”
Zuniga added, “IAPAC champions evidence-based, data-informed HIV responses and we reject ideologically driven efforts that undermine public health and erase marginalized communities.”
Lisa Amore, a spokesperson for Whitman-Walker Health, D.C.’s largest LGBTQ supportive health services provider, also expressed concern about the potential impact of the HHS website deletions.
“As the region’s leader in HIV care and prevention, Whitman-Walker Health relies on scientific data to help us drive our resources and measure our successes,” Amore said in response to a request for comment from the Washington Blade.
“The District of Columbia has made great strides in the fight against HIV,” Amore said. “But the removal of public facing information from the HHS website makes our collective work much harder and will set HIV care and prevention backward,” she said.
The lawsuit calls on the court to issue a declaratory judgement that the “deletion of public health webpages and resources is unlawful and invalid” and to issue a preliminary or permanent injunction ordering government officials named as defendants in the lawsuit “to restore the public health webpages and resources that have been deleted and to maintain their web domains in accordance with their statutory duties.”
It also calls on the court to require defendant government officials to “file a status report with the Court within twenty-four hours of entry of a preliminary injunction, and at regular intervals, thereafter, confirming compliance with these orders.”
The health organizations that joined the lawsuit as plaintiffs include the Washington State Medical Association, Washington State Nurses Association, Washington Chapter of the American Academy of Pediatrics, Academy Health, Association of Nurses in AIDS Care, Fast-Track Cities Institute, International Association of Providers of AIDS Care, National LGBT Cancer Network, and Vermont Medical Society.
The Fast-Track Cities Institute and International Association of Providers of AIDS Care are based in D.C.
U.S. Federal Courts
Federal judge scraps trans-inclusive workplace discrimination protections
Ruling appears to contradict US Supreme Court precedent
Judge Matthew Kacsmaryk of the U.S. District Court for the Northern District of Texas has struck down guidelines by the U.S. Equal Employment Opportunity Commission designed to protect against workplace harassment based on gender identity and sexual orientation.
The EEOC in April 2024 updated its guidelines to comply with the U.S. Supreme Court’s ruling in Bostock v. Clayton County (2020), which determined that discrimination against transgender people constituted sex-based discrimination as proscribed under Title VII of the Civil Rights Act of 1964.
To ensure compliance with the law, the agency recommended that employers honor their employees’ preferred pronouns while granting them access to bathrooms and allowing them to wear dress code-compliant clothing that aligns with their gender identities.
While the the guidelines are not legally binding, Kacsmaryk ruled that their issuance created “mandatory standards” exceeding the EEOC’s statutory authority that were “inconsistent with the text, history, and tradition of Title VII and recent Supreme Court precedent.”
“Title VII does not require employers or courts to blind themselves to the biological differences between men and women,” he wrote in the opinion.
The case, which was brought by the conservative think tank behind Project 2025, the Heritage Foundation, presents the greatest setback for LGBTQ inclusive workplace protections since President Donald Trump’s issuance of an executive order on the first day of his second term directing U.S. federal agencies to recognize only two genders as determined by birth sex.
Last month, top Democrats from both chambers of Congress reintroduced the Equality Act, which would codify LGBTQ-inclusive protections against discrimination into federal law, covering employment as well as areas like housing and jury service.
The White House
Trump travels to Middle East countries with death penalty for homosexuality
President traveled to Saudi Arabia, Qatar, and United Arab Emirates
Homosexuality remains punishable by death in two of the three Middle East countries that President Donald Trump visited last week.
Saudi Arabia and Qatar are among the handful of countries in which anyone found guilty of engaging in consensual same-sex sexual relations could face the death penalty.
Trump was in Saudi Arabia from May 13-14. He traveled to Qatar on May 14.
“The law prohibited consensual same-sex sexual conduct between men but did not explicitly prohibit same-sex sexual relations between women,” notes the State Department’s 2023 human rights report, referring specifically to Qatar’s criminalization law. “The law was not systematically enforced. A man convicted of having consensual same-sex sexual relations could receive a sentence of seven years in prison. Under sharia, homosexuality was punishable by death; there were no reports of executions for this reason.”
Trump on May 15 arrived in Abu Dhabi, the capital of the United Arab Emirates.
The State Department’s 2023 human rights report notes the “penalty for individuals who engaged in ‘consensual sodomy with a man'” in the country “was a minimum prison sentence of six months if the individual’s partner or guardian filed a complaint.”
“There were no known reports of arrests or prosecutions for consensual same-sex sexual conduct. LGBTQI+ identity, real or perceived, could be deemed an act against ‘decency or public morality,’ but there were no reports during the year of persons prosecuted under these provisions,” reads the report.
The report notes Emirati law also criminalizes “men who dressed as women or entered a place designated for women while ‘disguised’ as a woman.” Anyone found guilty could face up to a year in prison and a fine of up to 10,000 dirhams ($2,722.60.)
Trump returned to the U.S. on May 16.
The White House notes Trump during the trip secured more than $2 trillion “in investment agreements with Middle Eastern nations ($200 billion with the United Arab Emirates, $600 billion with Saudi Arabia, and $1.2 trillion with Qatar) for a more safe and prosperous future.”
Former President Joe Biden traveled to Saudi Arabia in 2022.
Saudi Arabia is scheduled to host the 2034 World Cup. The 2022 World Cup took place in Qatar.
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