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.
Local
Most D.C.-area cities receive highest score in HRC Equality Index
‘Record breaking’ 132 jurisdictions nationwide receive top ranking
The Human Rights Campaign Foundation on Nov. 18 released its 14th annual Municipal Equality Index report showing that a record number of 132 cities across the country, including nine in Virginia and seven in Maryland, received the highest score of 100 for their level of support for LGBTQ equality through laws, policies, and services.
Among the D.C.-area cities and municipalities receiving a perfect score of 100 were Alexandria, Arlington County, Fairfax County in Virginia and College Park, Bowie, Gaithersburg and Rockville in Maryland.
The city of Rehoboth Beach is listed as the only city or municipality in Delaware to receive a score of 100. Rehoboth city officials released a statement hailing the high score as a major achievement over the previous year’s score of 61, saying the improvement came through a partnership with the local LGBTQ advocacy and services group CAMP Rehoboth.
The HRC Foundation, which serves as the educational arm of the Human Rights Campaign, the nation’s largest LGBTQ advocacy organization, includes the District of Columbia in a separate State Equality Index rating system under the premise that D.C. should be treated as a state and receive full statehood status.
In its 2024 State Equality Index report, D.C. and 21 states, including Maryland, Virginia, and Delaware, were placed in the “highest rated category” called Working Toward Innovative Equality, which does not use a numerical score.
“The 2025 MEI shows a record breaking 132 cities scoring the highest possible marks on the index, representing a combined population of approximately 49 million people,” the HRC Foundation said in a statement announcing the 2025 report.
“This high-water mark is critical as pressure continues from states that pass laws and policies that seek to shut transgender people – particularly trans youth – out of public life,” the statement continues. It adds that many cities that have put in place trans supportive laws and policies, including health insurance benefits, “are in many cases no longer able to provide that coverage in a meaningful way as a result of discriminatory decisions made by state legislatures.”
The statement goes on to say, “However, more cities than ever are doing what the MEI characterizes as ‘testing the limits of restrictive state laws’ – pushing back against various checks on municipal power or discriminatory state laws – with nearly 70 cities doing so.”
The HRC statement notes that this year’s Municipal Equality Index rated a total of 506 cities. It says that number includes the 50 state capitals, the 200 largest cities in the U.S., the five largest cities or municipalities in each state, the cities that are home to the state’s two largest universities, and the 75 cities or municipalities that have high proportions of same-sex couples.
The report shows this year’s index rated 11 cities or municipalities in Virginia with the following rating scores: Alexandria, 100; Arlington County,100; Fairfax County, 100, Richmond, 100; Charlottesville, 100; Chesapeake, 80; Hampton, 100; Newport News, 100; Norfolk, 91, Roanoke, 100, and Virginia Beach, 100.
In Maryland a total of 10 cities were rated: Annapolis, 100; Baltimore, 100; Bowie, 68; College Park, 100; Columbia, 100; Frederick, 100; Gaithersburg, 100; Hagerstown, 75; Rockville, 100 and Towson in Baltimore County, 85.
A total of eight cities were rated in Delaware: Rehoboth Beach, 100; Bethany Beach, 51; Milford, 83; Dover, 69; Wilmington, 76; Newark, 72; Smyrna, 59; and Middletown, 64.
The full 2025 HRC Foundation Equality Index Report can be accessed at hrc.org.
Virginia
Repealing marriage amendment among Va. House Democrats’ 2026 legislative priorities
Voters approved Marshall-Newman Amendment in 2006
Democrats in the Virginia House of Delegates on Monday announced passage of a resolution that seeks to repeal a state constitutional amendment that defines marriage as between a man and a woman is among their 2026 legislative priorities.
State Del. Mark Sickles (D-Fairfax County) has introduced the resolution in the chamber. State Sen. Adam Ebbin (D-Alexandria) is the sponsor of an identical proposal in the state Senate.
Both men are gay.
Voters approved the Marshall-Newman Amendment in 2006.
Same-sex couples have been able to legally marry in Virginia since 2014. Republican Gov. Glenn Youngkin last year signed a bill that codified marriage equality in state law.
A resolution that seeks to repeal the Marshall-Newman Amendment passed in the General Assembly in 2021. The resolution passed again this year.
Two successive legislatures must approve the resolution before it can go to the ballot.
Democrats on Election Day increased their majority in the House of Delegates. Their three statewide candidates — Gov.-elect Abigail Spanberger, Lt. Gov.-elect Ghazala Hashmi, and Attorney General-elect Jay Jones — will take office in January.
“Virginians elected the largest House Democratic Majority in nearly four decades because they trust us to fight for them and deliver real results,” said House Speaker Don Scott (D-Portsmouth) on Monday in a press release that announced his party’s legislative priorities. “These first bills honor that trust. Our agenda is focused on lowering costs, lifting wages, expanding opportunity, protecting Virginians rights, and ensuring fair representation as Donald Trump pushes Republican legislatures across the country to manipulate congressional maps for partisan gain. House Democrats are ready to meet this moment and deliver the progress Virginians expect.”
National
213 House members ask Speaker Johnson to condemn anti-trans rhetoric
Letter cites ‘demonizing and dehumanizing’ language
The Congressional Equality Caucus has sent a letter urging Speaker of the House Mike Johnson to condemn the surge in anti-trans rhetoric coming from members of Congress.
The letter, signed by 213 members, criticizes Johnson for permitting some lawmakers to use “demonizing and dehumanizing” language directed at the transgender community.
The first signature on the letter is Rep. Sarah McBride of Delaware, the only transgender member of Congress.
It also includes signatures from Leader Hakeem Jeffries (NY-08), Democratic Whip Katherine Clark (MA-05), House Democratic Caucus Chair Pete Aguilar (CA-33), every member of the Congressional Equality Caucus, and members of every major House Democratic ideological caucus.
Some House Republicans have used slurs to address members of the transgender community during official business, including in committee hearings and on the House floor.
The House has strict rules governing proper language—rules the letter directly cites—while noting that no corrective action was taken by the Chair or Speaker Pro Tempore when these violations occurred.
The letter also calls out members of Congress—though none by name—for inappropriate comments, including calls to institutionalize all transgender people, references to transgender people as mentally ill, and false claims portraying them as inherently violent or as a national security threat.
Citing FBI data, the letter notes that 463 hate crime incidents were reported due to gender identity bias. It also references a 2023 Williams Institute report showing that transgender people are more than four times more likely than cisgender people to experience violent victimization, despite making up less than 2% of the U.S. population.
The letter ends with a renewed plea for Speaker Johnson to take appropriate measures to protect not only the trans member of Congress from harassment, but also transgender people across the country.
“We urge you to condemn the rise in dehumanizing rhetoric targeting the transgender community and to ensure members of your conference are abiding by rules of decorum and not using their platforms to demonize and scapegoat the transgender community, including by ensuring members are not using slurs to refer to the transgender community.”
The full letter, including the complete list of signatories, can be found at equality.house.gov. (https://equality.house.gov/sites/evo-subsites/equality.house.gov/files/evo-media-document/letter-to-speaker-johnson-on-anti-transgender-rhetoric-enforcing-rules-of-decorum.pdf)
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