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Judge orders state to give inmate gender reassignment surgery


BOISE — A federal judge has ordered the Idaho Department of Correction and its medical contractor to provide gender reassignment surgery to a transgender inmate.

Adree Edmo, who was first incarcerated in 2012, will be the first Idaho inmate to receive gender reassignment surgery. The decision was handed down by the United States District Court for the District of Idaho on Thursday.

“Inmates have no choice but to rely on prison authorities to treat their medical needs,” U.S. District Court Judge B. Lynn Winmill said in his decision. “This constitutional duty also applies to far less routine, and even controversial, procedures — if necessary to address a serious medical need.”

The 31-year-old transgender woman is in prison for sexually abusing a child under 16 in Bannock County. She has been housed in the men’s prison since 2012 and is due to finish her sentence in 2021. Prior to her incarceration, court documents say she lived and dressed as a woman.

According to court documents, Edmo was diagnosed with gender dysphoria by an IDOC psychiatrist shortly after her incarceration. That diagnosis was confirmed by an IDOC psychologist.

Two conditions are required before a gender dysphoria diagnosis can be given, according to the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders.

The first is an incongruence between the person’s expressed gender and their “assigned gender.” The second is the person must experience significant distress or impairment in social occupational or other areas of their life due to their condition.

Once diagnosed the World Professional Association of Transgender Health recommends various treatments. Surgery is the last treatment recommended.

Edmo’s gender dysphoria was treated by undergoing hormone therapy. Despite achieving the maximum physical changes possible through hormone treatment, Edmo continued to experience “extreme gender dysphoria.”

Edmo attempted self-castration twice. The second time she had to seek medical assistance after losing too much blood.

Winmill explained in his ruling, “deliberate indifference” to a prisoner’s need violates the Eighth Amendment of the U.S. Constitution. To constitute deliberate indifference Edmo needed to show she has a serious medical need and show prison officials were aware of the need yet failed to treat it.

“She has presented extensive evidence that, despite years of hormone therapy, she continues to experience gender dysphoria so significant that she cuts herself to relieve emotional pain,” Winmill wrote. “With full awareness of Ms. Edmo’s circumstances, IDOC and its medical provider Corizon refuse to provide Ms. Edmo with gender confirmation surgery.”

Winmill explained his decision was based on the unique aspects of Edmo’s case against IDOC and Corizon.

“This decision is not intended, and should not be construed, as a general finding that all inmates suffering from gender dysphoria are entitled to gender confirmation surgery,” Winmill said.

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