A trans woman serving 50 years to life in a California male prison is suing and asking the 1st District Court of Appeal in San Francisco to require the state to pay for gender reassignment surgery so that she can be moved to a women’s prison. California currently determines gender by the sex organs of the inmate.
The woman in question, Lyralisa Stevens, is in prison for killing a woman with a shotgun. She has been diagnosed with Gender Identity Disorder and presents as female complete with breast implants and feminized hips, procedures she underwent before entering prison. She alleges that she has been raped a number of times since her incarceration in 2003 and continues to be put at risk.
The state provides Stevens with hormone replacement drugs, but says that gender reassignment goes beyond the level of care they are required to provide. Lawyers acting on behalf of Stevens disagree, saying that it is necessary because if California will not house her in a women’s prison without the reassignment surgery, the surgery must be provided so as to prevent further risk of physical and sexual assault related to her gender expression.
From The Los Angeles Times:
As prison officials have struggled to address chronic overcrowding, the constant threat of gang violence and a health system that federal judges have equated with “cruel and unusual” punishment, they have also gone to court multiple times to answer allegations that they failed to properly treat and protect transgender inmates.
A ruling in Stevens’ favor would make California the first place in the country required to provide reassignment surgery for an inmate, according to lawyers for the receiver appointed to oversee California’s troubled prison health system. They argue that the state should be required to provide only “minimally adequate care,” not sex-change operations that cost $15,000 to $50,000.
Stevens, who has a slight build — 5-foot-6 and about 115 pounds — and entered prison with silicon injections in her breasts and hips to feminize her physique, said in a court filing that she feels like she’s under threat of sexual assault in the men’s facility and wants the surgery, in part, so she’ll be sent to a women’s institution.
“The male inmate is not expecting to see breasts … in the shower next to him,” Stevens wrote. The situation can lead to violent disputes among the men and sparks attacks against transgender inmates, who may have less upper body strength because of the hormone therapy, Stevens said.
In a court filing supporting Stevens’ petition, psychotherapist Lin Fraser said she has “grave concerns” for Stevens’ safety because she “had been put alone in cells all night long with men who threatened and abused her.”
Stevens is arguing that by denying her this surgery and housing her in such a hostile environment, the state is increasing her emotional suffering and the likelihood that she may self-harm. Trans people are also thought to be 3 times more likely to suffer sexual assault than other inmates.
Lawyers for the prison say that they are not required to meet the same medical needs as prisoners would be able to access in the wider world and certainly not what they term “affluent” medical care.
However, the state lost in a 1999 court battle when a judge ruled that the state must provide hormone replacement drugs to transgender inmates who were using hormone treatments before entering the facility, saying that to deny them such provisions amounted to cruel and unusual punishment.
Stevens’ lawyers are arguing the denial of surgery amounts to the same thing because the state will not allow her to transfer without the surgery and while she is in the male prison she continues to be at risk.
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