Should Taxpayers be Funding Sex Reassignment Surgery for Transgender People in Prison?

Twenty-two years ago, Michelle Kosilek, then Robert, murdered her wife. Now in prison, she wants to surgically transition to female, and the state of Massachusetts might be paying for it. I'm actually totally OK with this.
Publish date:
September 11, 2012
transgender, prisoners' rights, michelle kosilek

Local news in my adopted state of Massachusetts is all abuzz lately with controversy over prisoner Michelle Kosilek, currently incarcerated for the 1990 murder of her spouse, and who has, after years of legal struggles, been awarded a court order mandating that she receive the surgery she so desperately needs, on the taxpayers’ dime.

The catch -- and of course there’s a catch -- is that Michelle Kosilek is transgender, and the court-ordered surgery is sex reassignment surgery. She was convicted of murdering her wife by strangling her with a wire (and, apparently, nearly decapitating her in the process), when her name was Robert Kosilek, and is now serving a life sentence for that crime. Kosilek began transitioning the same year as the murder, and has brought numerous lawsuits fighting for her right to trans-specific medical care, from hormone therapy to electrolysis treatments.

The order for the state to supply Kosilek’s surgery is a decision still extremely controversial, and even today Massachusetts Governor Deval Patrick has said it will be “reviewed” by his administration prior to implementation. The decision was delivered by US District Court Judge Mark Wolf, who cited Kosilek’s “serious medical need,” illustrated by at least two attempts at suicide, as well as self-castration.

Kosilek’s case is critical given the growing awareness of ever-present difficulties in providing the transgender prison population with reasonable accommodation; this issue was raised just a few months ago in the manslaughter case against CeCe McDonald, the trans woman who is currently in prison in Minnesota for fighting back against a man who had shouted threats and slurs at her and her friends. McDonald, like Kosilek, is serving her term with an all-male prison population.

Most of the controversy around the Kosilek ruling seems to stem from the idea that this surgery is somehow rewarding Kosilek for being imprisoned. Sex reassignment surgery is rarely covered by health insurance, although some large companies -- among them Apple and American Express -- do cover the procedure for their employees. Odds are good that if Kosilek were not in prison, affording the surgery, which can run up to $50,000 depending on a host of factors, would be challenging at best.

Of course, much of the outrage can be traced to a misunderstanding -- if not straight-up loathing -- of the very real needs of trans individuals. Unfortunately, lots of people still assume that sex reassignment surgery is purely cosmetic and elective, and not a matter of survival for some trans folk (it’s also worth noting here that not all trans people want surgery, and that the need for it cannot be a blanket assessment but must always be taken on a case-by-case basis). Many of the opponents resent the idea not only that Kosilek should be "indulged" in this way, but, adding insult to injury, that taxpayer funds should be used to pay for it.

U.S. Sen. Scott Brown of Massachusetts, who as a state senator filed unsuccessful legislation in the late 2000s to ban the use of tax money to pay for the surgery for prison inmates, said surgery for the inmate at the center of Tuesday’s ruling would be "an outrageous abuse of taxpayer dollars."

"We have many big challenges facing us as a nation, but nowhere among those issues would I include providing sex change surgery to convicted murderers," he said in a written statement. "I look forward to common sense prevailing and the ruling being overturned."

Scott Brown’s individual dickishness aside, this line of thinking is a common one amongst those who think this ruling is unreasonable. But if we can accept the logic of providing other, non-gender-related surgeries to ill prisoners should they need them, as required under laws providing the incarcerated with certain basic human rights, then we must accept that these rights will hold true for all prisoners. In Kosilek’s case, the court has decided that this surgery is no more elective for Kosilek than an appendectomy would be for a person with an appendix in danger of bursting.

But that’s not what people want to hear.

It only exacerbates the problem when much -- though not all, thank you, Boston Globe, for having a clearly-stated policy of identifying trans individuals by their preferred gender identity -- of the local news coverage persistently refers to Michelle Kosilek as Robert, and using male pronouns, despite her having legally changed her name to Michelle. The refusal to acknowledge her legally correct name is especially galling given that were she not trans it is unlikely media would insist on using a name that has ceased to be relevant.

It’s a tough thing, to advocate for the rights of a killer, to affirm her entitlement to life-saving medical treatment when she has so disrespected and disdained the life of another person so as to commit murder. The vocal and desperate rage of victim Cheryl Kosilek’s surviving family is understandable.

But what makes us better than murderers is that we value human life, even the lives of those who don’t value life themselves, their own included. For that reason, I support this ruling, and I sincerely hope that Kosilek can get the sympathy and kindness she could not give to her victim. This ruling is inarguably a win for trans rights activists in general, reluctant though many may be to associate with a person like Kosilek. Thoughtfully providing compassionate treatment to a convicted murderer -- who by her crime ostensibly represents one of the least sympathetic levels of human society -- can only bode well for the broader social acceptance and rights of all trans people everywhere.