Transgender prisoners in the West now have tools for self-advocacy

A court ruling transforms healthcare rights for incarcerated trans people.

 

The 9th Circuit Court of Appeals wrote that in denying Adree Edmo medical services, prison authorities “were deliberately indifferent.”

In 2017, Adree Edmo, a transgender woman serving a 10-year prison sentence at the all-male Idaho State Correctional Institution, sued the Idaho Department of Correction and the prison’s health care provider, Corizon Inc. They had repeatedly denied her request for gender confirmation surgery, a procedure that would allow Edmo’s physical body to align with her female identity. When asked in court about the conflict between her biological sex and gender identity, Edmo responded, “I feel disgusting, I feel tormented, I feel hopeless.”

Edmo’s attorney argued that in order to stop these feelings and save her life, her client needed the surgery. In December 2018, the Idaho District Court ruled in Edmo’s favor. Then, this August, a three-judge panel from the 9th U.S. Circuit Court of Appeals upheld that decision: Prison authorities “were deliberately indifferent” to Edmo’s medical needs, they wrote, and that constitutes cruel and unusual punishment and is against the law. Edmo is expected to receive the surgery as soon as possible, though Idaho Gov. Brad Little has said he will appeal the decision to the Supreme Court, which could delay the procedure.

In addition to changing Edmo’s life, the ruling will expand access to medical care for prisoners across the West. The 9th Circuit’s acknowledgment of gender confirmation surgery as a medically valid treatment could encourage other prisons within its jurisdiction to offer it. Edmo’s case, lawyers say, could serve as a guide for other trans prisoners, and even advance recognition of transgender rights overall.

Edmo’s fight for gender confirmation surgery began after she entered prison in 2012, where she is serving a sentence for the sexual abuse of a 15-year-old boy when she was 21. Soon after starting her sentence, she was diagnosed with gender dysphoria, a condition where a person experiences discomfort or distress because of the mismatch between their biological sex and gender identity. She started hormone therapy, which includes taking estrogen to develop more feminine physical characteristics. But after five years of severe gender dysphoria, two attempted self-castrations and continued denial of gender confirmation surgery by prison authorities, Edmo filed her lawsuit.

The seriousness of gender dysphoria is well known throughout the medical world, said Erica Anderson, a clinical psychologist who works with transgender patients at a University of California, San Francisco clinic. And Edmo’s self-harm “is not at all unusual,” said Anderson. “I have had children who have taken out shears to try to cut off their penis,” she said. “This is how horrible gender dysphoria is for some.”

Luna Anna Archey/High Country News

Not all transgender individuals require surgery; for some, the physical changes less invasive treatments bring are sufficient to help them feel at home in their body. For others, though, the surgery is essential. The ruling in Edmo’s case doesn’t mean that prisons will have to provide all transgender inmates with surgery. However, it does set a precedent that the procedure is medically necessary for prisoners suffering from severe gender dysphoria.

For lawyers across the country, the 9th Circuit’s decision was a long time coming. For nearly two decades, courts have been battling over the medical needs of transgender prisoners, specifically gender reassignment surgery and hormone replacement therapy. Typically, prison facilities either deny such inmates care altogether or are too poorly equipped to provide it, said Gillian Branstetter, the spokesperson for the National Center for Transgender Equality. The 9th Circuit’s ruling will further help a vulnerable population receive adequate treatment while behind bars.

However, Little’s plan to appeal to the Supreme Court could change that. In similar cases from the 5th and 1st circuit courts, judges ruled against providing inmates with gender confirmation surgery, creating a split among the circuit courts and increasing the likelihood that the Supreme Court will agree to hear Edmo’s case. That would greatly increase the stakes: If the Supreme Court rules in Edmo’s favor, the decision could extend past the 9th Circuit to the entire nation, but if the ruling is overturned, transgender inmates will lose the precedent it set. The state has until Nov. 21 to submit an appeal.

In the meantime, prisoners across the nation can use the 9th Circuit’s decision to bolster their own cases. This is a “groundbreaking decision in this country,” said Molly Kafka, the interim legal director at the ACLU of Idaho. “It provides a road map as to how other trans prisoners can use this decision to advocate for themselves if they are not receiving medical treatments.” In fact, Kafka said, she has already seen some colleagues analyze pending lawsuits with Edmo’s case in mind. Additionally, inmates with other ailments can use the ruling to support their own medical rights.

And, according to Kafka, lawsuits like these are bound to influence social views on transgender individuals. “Prisons are part of our society and communities,” she said. “When courts uphold the rights and dignity of transgender prisoners, it will have an effect on the public.”

Helen Santoro is an editorial intern at High Country News. Email her at [email protected] or submit a letter to the editor.

High Country News Classifieds
  • EXECUTIVE ADMINISTRATIVE ASSISTANT
    Job Announcement: Executive Administrative Assistant (Part-Time) Announcement date: October 27, 2021 Applications will be reviewed on an ongoing basis and first review will begin: November...
  • EXECUTIVE DIRECTOR
    Job purpose The Executive Director is a proven leader with demonstrated and sustained experience managing people, budgets, fundraising, and contract compliance who guides a well-established...
  • COMMUNICATIONS ASSOCIATE
    The Greater Yellowstone Coalition seeks a Communications Associate to support the advancement of GYC's mission by working closely with the Communications Coordinator and program staff...
  • MONTANA DIRECTOR OF DEVELOPMENT
    YOUR POSITION WITH TNC The Director of Development (DoD) is responsible for directing all aspects of one or more development functions, which will secure significant...
  • DEVELOPMENT AND OPERATIONS COORDINATOR
    Development & Operations Coordinator Terms: 1.0 FTE (full-time), Salary DOE ($45,000 - $55,000) Benefits: Paid Time Off (12-24 days/year depending on tenure), Paid Holidays (10/year),...
  • GUIDE TO WESTERN NATIONAL MONUMENTS
    NEW BOOK showcases 70 national monuments across the western United States. Use "Guide10" for 10% off at cmcpress.org
  • CARBON RANCH PLANNER
    The Quivira Coalition (www.quiviracoaltion.org) is a Santa Fe-based nonprofit that builds resilience on arid working lands. We foster ecological, economic, and social health through education,...
  • EDUCATION AND OUTREACH DIRECTOR
    Education and Outreach Program Director The Quivira Coalition (www.quiviracoaltion.org) is a Santa Fe-based nonprofit that builds resilience on arid working lands. We foster ecological, economic,...
  • WESTERN DIVISION DIRECTOR OF FIELD PROGRAMS
    DEADLINE TO APPLY: October 29, 2021 LOCATION FLEXIBLE (WESTERN HUB CITY PREFERRED) Overview The Land Trust Alliance is the voice of the land trust community....
  • COMMUNICATIONS AND OUTREACH ASSOCIATE
    Communications and Outreach Associate Position Opening: www.westernlaw.org/communications-outreach-associate ************************************************* Location: Western U.S., ideally in one of WELC's existing office locations (Santa Fe or Taos, NM, Helena,...
  • FREELANCE GRAPHIC DESIGNER & PROJECT COORDINATOR (REMOTE)
    High Country News (HCN) is seeking a contract Graphic Designer & Project Coordinator to design promotional, marketing and fund-raising assets and campaigns, and project-manage them...
  • FILM AND DIGITAL MEDIA: ASSISTANT PROFESSOR OF INDIGENOUS MEDIA, CULTURAL SOVEREIGNTY AND DECOLONIZATION (INITIAL REVIEW 12.1.21)
    Film and Digital Media: Assistant Professor of Indigenous Media, Cultural Sovereignty and Decolonization (Initial Review 12.1.21) Position overview Position title: Assistant Professor - tenure-track Salary...
  • REAL ESTATE SPECIALIST
    To learn more about this position and to apply please go to the following URL.
  • ENVIRONMENTAL GEOPHYSICS
    "More Data, Less Digging" Find groundwater and reduce excavation costs!
  • RARE CHIRICAHUA RIPARIAN LAND FOR SALE
    40 acres: 110 miles from Tucson: native trees, grasses: birder's heaven::dark sky/ borders state lease & National forest/5100 ft/13-16 per annum rain
  • CENTRAL PARK CULTURAL RESOURCE SPECIALIST
    Agency: Oregon Parks and Recreation Department Salary Range: $5,203 - $7,996 Position Title: Central Park Cultural Resource Specialist Do you have a background in Archaeology...
  • STAFF ATTORNEY
    Come live and work in one of the most beautiful places in the world! As our Staff Attorney you will play a key role in...
  • ARIZONA GRAZING CLEARINGHOUSE
    Dedicated to preventing the ecological degradation caused by livestock grazing on Arizona's public lands, and exposing the government subsidies that support it.
  • OPERATIONS MANAGER
    Position Summary: Friends of the Inyo (friendsoftheinyo.org) is seeking a new Operations Manager. The Operations Manager position is a full-time permanent position that reports directly...
  • WATER RIGHTS BUREAU CHIEF
    Water Rights Bureau Chief, State of Montana, DNRC, Water Resources Division, Helena, MT Working to support and implement the Department's mission to help ensure that...