The state of Idaho is arguing that gender confirmation surgery is not medically necessary. The Gem State is appealing a court order that it must provide surgery to a transgender inmate who is self-harming.
Governor Brad Little announced last week that the state will fight a U.S. District Court ruling that found it cruel and unusual to deny inmate Adree Edmo’s gender-affirming surgery.
“The hardworking taxpayers of Idaho should not be forced to pay for a prisoner’s gender reassignment surgery when individual insurance plans won’t even cover it,” Little said in the announcement. “We cannot divert critical public dollars away from our focus on keeping the public safe and rehabilitating offenders.”
Many insurers, however, do cover transition-related care, and Medicaid covers gender affirming care.
If anything Edmo’s case may test public opinion over whether gender-affirming healthcare is medically necessary. Courts across the nation have already largely found that prisons are required to provide transgender inmates healthcare, which includes hormones and gender-affirming surgery.
“When a person urgently needs medical care because they’re seriously in danger of health consequences and they don’t get it, then courts have made clear that that care must be provided,” said National Center for Lesbian Rights (NCLR) Attorney Amy Whelan, who is representing Edmo.
In Florida, a federal judge ruled that the state’s Department of Corrections must provide hormones to a transgender inmate and recognize her as female. The state is now appealing that ruling, a move that a dozen LGBTQ advocacy organizations are fighting.
In Edmo’s case, Chief U.S. District Judge B. Lynn Winmill said that the Iowa Department of Corrections (IDOC) had ignored medical standards in refusing Edmo treatment for gender dysphoria.
“This constitutes deliberate indifference to Ms. Edmo’s serious medical needs and violates her rights under the Eighth Amendment to the United States Constitution,” Winmill wrote. He gave the state six months to provide Edmo with surgery.
Edmo, who had been self-harming behind bars, said the ruling was a relief.
“Not having the care I need is like being in a prison within a prison,” she said in a statement. “Even though I am still living, it has felt like I have been dying inside.”
But many in Idaho have taken issue with the ruling, conflating Edmo’s past crimes with her being transgender. The governor’s office notes that Edmo is serving a 10-year sentence for sexual abuse of a minor.
An article on Edmo by ABC Local 8 News also parallels Edmo’s gender with allegations of sexual abuse. The article repeatedly deadnames and misgenders Edmo (this piece has not been linked as INTO does not condone either practice).
The article quotes Edmo’s ex, Brady Summers, who says he survived an abusive relationship with Edmo. But the station allows Summers to question if Edmo is even transgender.
“Never once indicated anything of gender dysphoria or sexual indifference,” Summers is quoted saying. “He was a predator. He, on several occasions, had his way with me. It was brutal.”
Asked to comment on the decisions to run the piece and its violations of the AP Stylebook and GLAAD Media Guide, News Director Curtis Jackson stood by the story.
“In our research the story is correct,” Jackson said in an email. “The reason we aired the story is because of the high interest in the prison case.”
Other articles note that Edmo would be only the second person in the nation to receive a bottom surgery behind bars. Advocates argue, however, that that hardly matters as many others have won the right to transition-related healthcare.
IDOC officials argue in Edmo’s case that gender-confirmation surgery is not medically necessary.
“If Ms. Edmo had a broken arm, we’d all agree it should be treated,” the state’s Chairman of the Board of Correction, Dr. David McClusky, said in a statement. “But disagreement among medical professionals in this case does not constitute cruel and unusual punishment.”
McClusky’s reasoning that gender affirming care is elective, however, flies in the face of consensus among major medical associations.
Richard Saenz, Criminal Justice and Police Misconduct Strategist at Lambda Legal, said the law is clear when it comes to providing medically necessary care for all behind bars.
“As a queer person who does this type of work, it’s difficult when we lose the idea of dignity and humanity of people who are incarcerated,” Saenz said. “I can understand, but I disagree with people who say they don’t deserve this healthcare. I believe that’s coming from a place of bias against transgender people in general, and it’s not where doctors are.”
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