Ophelia De’Lonta had had enough. Tired of prison guards referring to her as a man, despite her repeated insistence on identifying as a woman, De’Lonta took matters into her own hands. For three hours she sawed away at her genitalia with a disposable razor in an attempt to castrate herself and become the woman she felt she was. She was discovered by guards before she could complete her brutal task. The wound required 17 stitches to heal.
It was not her first such attempt.
A pre-operation transgender inmate on hormone therapy inside a Virginia men’s prison, De’Lonta is now suing for the state to provide her with gender reassignment surgery—citing the medical necessity of the procedure. She is one of several transgender individuals incarcerated across America who are seeking similar treatment.
The surgery, however, is expensive—it can cost upwards of $20,000. Though many detention facilities pay for hormonal treatment for transgender inmates, they are drawing the line at reassignment surgery.
“A prison is not required by law to give a prisoner medical care that is as good as he would receive if he were a free person, let alone an affluent free person,” California state attorney Steven J. Bechtold wrote in a legal response to a reassignment request by an inmate serving life in prison on a third-strike burglary charge.
Many advocates for the transgender community are insistent that sexual reassignment surgery is a medical necessity for those who have received the approval of a doctor.
“We continue to validate that system of unworthiness through our health care and prisons,” says Mock. “Imagine you’re a 22-year-old girl who worked for four years to get hormone treatment. How do you pay for that all over again? How do you get a job now?”
“All people who are incarcerated have a right to access health care that they need,” Kristina Wertz, director of program and policy for the Transgender Law Center, tells TakePart. “Too many of our transgender sisters who are on the inside are denied the basic care they need to be healthy and safe.”
Journalist Janet Mock, who opened up about her sexual reassignment surgery in 2011 and has become a leading advocate for the trans rights movement, agrees.
“This is not about rewarding prisoners,” she tells TakePart. “These surgeries and care are necessary. It’s about a person and their doctor. Do you just deal with it each time they cut themselves? We need to take society’s popular conception of morality out of this.”
Mock notes that many transgender women find themselves in the prison system in the first place because of discrimination in the workforce and the tremendous expense of hormonal treatment and reassignment surgery.
“Most of these women are not in jail for violent crimes; it’s for survival work.”
Meaning prostitution. Because of the aforementioned job discrimination, as well as the fact that even for those who do have jobs, insurance rarely covers hormonal treatment and certainly doesn’t cover reassignment surgery, working the streets is an all-too-common revenue source for trans women in the early stages of their transition.
Advocates believe that pre-operation transgender prostitutes are particularly targeted by police and arrested. While these women are incarcerated, they are treated as men and lose all progress they’ve made in their transitions. The result is a vicious cycle of incarceration, treatment started, and treatment lost.
“We continue to validate that system of unworthiness through out health care and prisons,” says Mock. “The one thing they know about is stripped away from them. Imagine you’re a 22-year-old girl who worked for four years to get hormone treatment. How do you pay for that all over again? How do you get a job now?”
Though the social inequalities that put transgender individuals at greater risk of being incarcerated show no signs of abating, some law enforcement departments are starting to exercise more care in dealing with transgender inmates. This past April, the Los Angeles Police Department instituted a series of reforms for dealing with incarcerated transgender individuals.
Officers are now expected to refer to trans inmates by their chosen name, even if it differs from their identification. The LAPD also no longer permits pat-downs of transgender inmates to determine their anatomic sex. A separate holding facility has been created for inmates awaiting arraignment.
These concessions to the fair treatment of transgender inmates, however, are the exception and not the norm. Trans women in men’s facilities are 10 times more likely to face sexual assault than are other inmates. Sexual assault rates for prison and jail populations are already astoundingly high. In these cases, sexual reassignment surgery would allow these women to transfer to an all-female facility—greatly enhancing their security.
In September 2012, a federal judge in Boston unleashed a firestorm of controversy when he ruled that Massachusetts authorities were obligated to provide taxpayer-funded gender reassignment surgery to Michelle Kosilek, a transgender inmate at an all-male prison in Norfolk, Mass.
At a time when budget cuts are threatening the American social safety net on all fronts, convincing states to pay for gender reassignment surgery is a difficult proposition. What shouldn’t be difficult is this: a society that respects transgender individuals and their health care needs. Ending the punitive cycle of incarceration for trans women is arguably the most effective way of heading off escalating costs to the state.
As Mock puts it: “If you’re going to run a huge prison industrial complex, the state should have to take on the costs associated with that.”
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