California First State to Agree to Pay for Murderer’s Sex-Change Operation

Margaret Knapp | August 11, 2015 | 5:03pm EDT
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( --California has become the first state in the nation to agree to pay for a transgender inmate’s sex-reassignment surgery on the basis of “medical necessity,” according to state medical experts.

Rodney James Quine, 56, who since 1980 has been serving a life sentence without parole for murder, kidnapping and robbery, has been diagnosed with “severe gender dysphoria.” 

Last Friday, the California Department of Corrections and Rehabilitation (CDCR) conceded in court that sex-reassignment surgery was the only way to treat Quine’s condition.

Under the settlement agreement reached June 12 in U.S. District Court for the Northern District of California, Quine - who has been taking female hormones and goes by the name of “Shiloh Heavenly” - will be moved to a women's prison once the genital sex-reassignment surgery is completed, which his lawyers estimate will cost taxpayers between $15,000 and $25,000.

“Ms. Quine meets, and exceeds, the criteria for surgery: She has persistent, well-documented gender dysphoria,” Dr. Randy C. Ettner, who examined Quine, stated in an affidavit filed in the case. “Surgery is the therapeutic intervention that would significantly improve her emotional and physical health.”

The World Professional Association for Transgender Health (WPATH) states that the appropriate standards of care for gender dysphoria include changes in gender role, psychotherapy, hormone therapy, and surgery to change primary and/or secondary sex characteristics (e.g., breasts, chest, genitalia, body contouring).

However, Dr. Paul R. McHugh, the former psychiatrist-in-chief at Johns Hopkins Hospital and its current Distinguished Service Professor of Psychiatry, said that while transgenderism is a “mental disorder” that merits treatment, sex change is “biologically impossible.”

He added that people who promote sexual reassignment surgery are collaborating with and promoting a mental disorder.

Quine’s court victory was a corollary of a similar case involving another transgender inmate at Mule Creek State Prison in Ione, Calif.

Convicted murderer Jeffrey Bryan "Michelle-Lael" Norsworthy. (AP photo)

Jeffry Bryan Norsworthy - a convicted murderer who lives as a woman and goes by the name of “Michelle-Lael” - also asked prison officials for gender reassignment. A federal court order in April ordered CDCR to provide the sex-reassignment surgery.

But Norsworthy was granted parole after California Gov. Jerry Brown determined that he was no longer a danger to the community, making it highly unlikely that he will receive the surgery before he is released from prison.

Norsworthy began asking for the surgery in 2012 after learning that a Massachusetts judge had ordered that state to provide an inmate with the procedure. However, the 2012 Massachusetts decision was overturned on appeal in December and the U.S. Supreme Court declined to intervene.

San Francisco District Judge Jon Tigar then ruled in April that the State of California cannot deny Norsworthy a sex-change operation, which he called "a serious medical need".

The 9th Circuit Court of Appeals agreed to hear California's appeal of Tigar’s ruling, noting that the case raises serious legal questions about whether denying the surgery violates inmates' constitutional rights against cruel and unusual punishment.

"This is clearly where the law is going and where the entire health industry is going," said Ilona Turner, legal director at the Transgender Law Center in Oakland, which handled both cases. "These exclusions in health management plans are illegal."

But other lawyers pointed out that classifying sex-reassignment surgery as a constitutional right is a legal stretch.

"The idea that the 8th Amendment requires something for prisoners not available to the law-abiding public is something a lot of people find offensive," said Kent Scheidegger, legal director for the Criminal Justice Legal Foundation, a conservative organization based in Sacramento that weighs in on criminal justice litigation across the nation.

"A settlement is not a precedent, but I suppose it gives a little ammunition to the next guy, to say you did this for him, why not me?" Scheidegger added.

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