California Agrees To Surgery For Transgender Inmates, But It May Be Too Late For One


A transgender inmate in California has secured a settlement that will ensure she is safe and receives the medical care she deserves. Another trans inmate who has been guaranteed such care by a federal court will be released before she can receive it.

Shiloh Quine is a transgender women who has been housed in a men’s prison and denied not only gender-affirming surgery, but also the opportunity to dress and present as a woman. Under a new settlement with the California Department of Corrections and Rehabilitation (CDRC), all of that will change. She will be moved to a women’s facility and provided medical care including the surgery her doctors have determined is medically necessary.

It is not her victory alone; the department is revising its policies regarding transgender inmates’ access to such treatment. Additionally, the department has agreed to change its policies to allow transgender prisoners to access clothing and commissary items consistent with their gender identity.

The Transgender Law Center, which represented Quine, hailed the settlement as a significant victory. Executive Director Kris Hayashi pointed out that it benefits not only inmates, but “all transgender people who have ever been denied medical care or basic recognition of our humanity just because of who we are,” because “transgender people nationwide will hear a state government affirm that our identities and medical needs are as valid as anyone else’s.”


The change does not come soon enough for Michelle-Lael Norsworthy. In April, a federal court ordered that CDRC must provide for her the sex-reassignment surgery that her doctors said was medically necessary for her. Denying such treatment, the judge ruled, was a violation of the Eighth Amendment’s protections against cruel and unusual punishment. Last week, however, Gov. Jerry Brown (D) allowed for her parole, which means she might be released within a week. If she is no longer a ward of the state, the state is no longer obligated to provide her medical care, though she may still be able to find the support she needs for her surgery through Medi-Cal or other health care coverage.

Norsworthy’s case might actually still proceed, though. California appealed the April ruling and the Ninth Circuit has scheduled a hearing for this Thursday. The stay it granted is why she has not already received the surgery. It remains unclear if her release or the changes being made as a result of the settlement in Quine’s case could make the proceedings moot.

The Court could decide that it’s not unlikely that a future transgender inmate will similarly require surgery and so it’s a question worth answering even if it would no longer apply to Norsworthy. This could have significant implications, because the First Circuit ruled against Massachusetts inmate Michelle Kosilek in a similar case last year. Thus, if the Ninth Circuit ruled that prisons are required to provide medically necessary surgery to transgender inmates, the Supreme Court may have to then consider the case to address the conflicting opinions between the First and Ninth Circuits.

If, however, the case is declared moot, none of the rest unfolds and there would be no precedent sent by Norsworthy’s case. The CDRC’s changes agreed to in the new settlement may alleviate the need for any such litigation in the future. The question of what treatment transgender inmates in other states deserve will go unanswered until new complaints are filed.

It’s unclear how a proposed ballot initiative that would prohibit transgender people from using the facilities that match their identity would impact CDRC’s changes if it should come to pass.