Keri Renault

Follow-up on a Flawed System: Is HRT in Prison Life or Death?

Filed By Keri Renault | April 05, 2010 10:30 AM | comments

Filed in: Living, Politics, Transgender & Intersex
Tags: AMA, cisgender people, gender identity disorder, GID, incarceration, medical care, prison industrial complex, SRS, Standards of Care, transgender suicide, transition, US District Court, US Tax Court, Wisconsin, WPATH

Last week's court decision overturning Wisconsin law that precluded transsexual inmates from receiving transition-related care prison.jpgraised the age old question of equality.

Even fair-minded American tax-payers harbor conflicted feelings about subsidizing medical care for transgender inmates. I doubt I'm going out on a limb to speculate the majority do.

Likewise more than a few within the transgender community are at odds over the free lunch their incarcerated "cousins" receive on the tab of state taxpayers. Comparisons are made between the inequities of self-funded, transition-related medical care in the outside world and the assumed privilege of inmates receiving free transition care inside prison.

I'd argue there's a fundamental misunderstanding at play. It's based on a flawed system. That system has little to do with prison reform.

No Way Out

Transsexual individuals suffer a medical condition, defined by WPATH as "gender identity disorder" or "gender dysphoria". In the real world a transsexual's inability to afford hormone therapy can be excruciating. It delays and denies medically necessary treatment. The condition of gender incongruence, if unchecked, becomes an emotionally painful, psychologically debilitating and often life threatening reality.

Depression is a reality faced by many transsexuals lacking the ability to access medically necessary treatment. The vast majority of transitioning individuals, up to 88%--confront this profoundly disturbing economic fact-of-life and never surgically transition. Gender reassignment is the medical protocol recommended for treating Gender Identity Disorder by WPATH, the organization which governs transsexual Standards of Care.

In discussing Wisconsin's federal ruling, transgender and cisgender taxpayers alike may have an axe to grind, but it shouldn't be about prison "perks". The broader discussion should be about the inequities of fatally flawed health insurance coverage, a health care delivery system that leaves transsexuals no way out of GID by excluding transition care.

Not An Issue of Prison Protocol

This is a health care reform issue, not an issue of incarceration protocol. For many within the transgender community, the prison industrial complex offering free transition care is akin to pouring salt on a festering wound. "We can't afford it, why should you get it free, Ms. (or Mr.) Criminal?"

Similarly an uninitiated, uninformed mainstream--Mr. and Mrs. John Q. Taxpayer-- doesn't realize transition care is medically recommended protocol for transsexuals. They seethe at the notion of offering hormone therapy or gender reassignment surgery to transgender inmates. This segment of the population may view tax-funded medical services as an extravagance, akin to elective cosmetic surgery.

Suffice to say fundamentally far right taxpayers view transsexuality as a religious abomination. End of story. And since this group's sense of fair play is limited to "their own", I'm disqualifying their discriminatory viewpoint from an otherwise broad-minded discussion.

The Public Doesn't Grasp the Concept of Transsexual Medical Necessity

Gender Dysphoria, Gender Identity Disorder, Gender Incongruence--label it what you will--is a very real medical condition with troubling consequences for those who can't afford access to medical treatment. Let me reiterate: most Americans have yet to grasp the concept of transsexual "medical necessity". They do, however, grasp chronic conditions that affect them, their family and friends: Life threatening heart, liver and kidney disease, cancers of every kind; chronic conditions like asthma and arthritis to variant angina.

Some are acute conditions others less so. Each of them demands medical treatment. No one in their right mind would argue access--inside or outside of prison.

Most "conscientious objectors" argue that gender identity disorder isn't in the same life-threatening league as heart disease or the like. A heart (liver or lung) transplant is on a different plane of critical care than a sex change.

I maintain both medical conditions deserve treatment.

GID Kills

The former chronic condition may take a life sooner, but the latter has the proven capacity to claim a life, too. Depression caused by GID leads to medicating behaviors which do kill--like alcoholism, drug addiction and suicide. Transgender sources often cite a transsexual suicide rate of 31%, with 50% of all transsexuals attempting suicide by their 20th birthday.

Transsexuals aren't taking their lives because of depression over having sex-reassignment surgery. Only 1-2% of post-ops polled have transition regret. It's a lack of economic means that sends most "pre-reassignment" transitioners over the edge. The dire consequences of being unable to reconcile mind, body and spirit through a combination of cost-prohibitive HRT and gender reassignment procedures cannot be overstated.

Heart disease is a physiological condition. GID is both a psychological and physiological condition. Neither chronic disorder discriminates. Both kill if untreated.

Even the Tax Court Agrees

Recently, medical treatment equality for transsexuals was upheld in another court of law.

On February 2nd, the US Tax Court ruled in favor of transsexual woman Rhiannon O'Donnabhain in her case against the IRS. The court denied the IRS claim that hormone therapy and gender reassignment procedures were "cosmetic". The court's majority opinion declared GID to be a medical condition requiring medical treatment.

The O'Donnabhain verdict established precedent for deducting gender reassignment protocols, including HRT and SRS on tax returns.

The issue that underlies the conflict of gatekeeping health care benefits is health insurance--both behind bars and in the real world.

Health Insurance Disregards the AMA

The health insurance industry has yet to adopt the 2008 position of the American Medical Association to include treatment of GID. Had the insurance industry relocated medically necessary protocols like hormone therapy and gender reassignment from standard exclusions to policy inclusions the debate over the Wisconsin verdict would be moot.

Health insurance reform would enforce equality. It adds the health industry "seal of approval" to transition care. Tax payers and the transgender community alike would be served notice: life threatening conditions such as GID are to be treated like every other chronic condition.

Inclusion of GID in the standard package of health insurance benefits would signal an end to the onerous financial burden that drains the very life out of many transitioners. It would quell the uproar over tax payer funded "cosmetic procedures" and stop political spin that depicts a "travesty of justice" in the Wisconsin prison system and beyond.

A Final Note on Transgender Crime

As in the mainstream, transgender individuals are both victim and victimized. They are proportionately law abiding citizens and hardened criminals. A few commit violent crime, but more often transgender offense is non-violent.

Transgender inmates find themselves inside detention centers and prisons, not typically for committing hate crime or sociopathic violence, or white collar larceny, but as the result of crimes of desperation and destitution.

Prostitution, drug trafficking, transgender unemployment, transgender underemployment, transgender homeless youth, transgender hate crime, these are the major contributors to incarceration. This is the plight of the typical transsexual as the world turns today.

Until protections for gender identity & expression are federally mandated and enforced, until the health insurance industry is reformed to include transition care, the transgender community will continue to find itself desperate, misunderstood and often without hope--either in front of society or behind bars.

More trans will commit survival crime. Many more will take their own lives, unable to cope with a short list of unacceptable, unforgivable options.


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If a doctor prescribes the treatment, the prisoner should get it. Period. I don't think jailers are a better judge of an inmate's health than their doctor is.

I agree with you Bil, but on top of that, there's the issue of many trans people who end up in prison might be taking black market or self-prescribed HRT due to the complexities of getting trans-positive health care in low income areas. So it kind of has to go beyond prescriptions

I saw an interesting comment on another site relative to this ruling. (The site, Broadsheet, is part of a larger liberal site, Salon). I paraphrase:

"Transgendered ppl are so amazing! They can actually get liberals to find something they agree with conservative on!"

Which was in response to several angry and disgusted reaction by other commenters, many of whom described themselves as 'liberals, but..." I have seen the same thing play out on Femininsting.

We seem to be the thrid rail of everything in almost all contexts...

Carol ~

Very condescending and unpersuasive follow up to a condescending and unpersuasive original post.

First, legislatures can make determinations on the availability of medical care in prisons. They have to show that they considered a record supporting their conclusions, but it is simply not true that lawmakers can't set the parameters of medical care. That is why ultimately, the WI legislature will prevail, even if it has to go back and establish a fuller record and even if it has to tweak the language of the statute slightly.

Second, you offer a false dichotomy. Either a medical procedure is necessary to preserve health and life or it is like cosmetic surgery. No one should be fooled by this rhetorical trick favored by trans activists. There are many medical conditions for which one or more remedies might be desirable or recommended, but which are not necessary to preserve life or to avoid serious compromise of health.

Prisoners do not have access to organic foods, or to special low-cal versions of favored foods, not even when they are obese and not even when the lack of access to these foods causes depression.
Prisoners have no right to see a chiropractor even though their back pain might be very real, and they have no right to get special footwear if they are suffering from bunions and even if the footwear is recommended. If depressed, they might have the right to anti-depressants, but not the latest and most expensive kind and certainly not the extremely expensive electro-shock therapy that a non-criminal could get by paying thousands of dollars. Prisoners with phobias or with OCD don't have the right to contraband or to get their cells re-designed or furnished in manner that would alleviate negative feelings stemming from the phobia or OCD.

I could go on and on, but the gist is that taxpayers don't have any obligation to make prisoners' as comfortable and happy as possible. If there is a medical condition that can be treated post-incarceration at the convict's expense, or treated in a less expensive manner in prison, taxpayers should spend the least amount of money constitutionally required. The rules shouldn't change for trans criminals.

It is appalling that Lambda would waste gay money (and it is gay money, since I doubt trans people donate more than 1% of Lambda's coffers) on this nonsense. I gave Lambda $150 last year. Maybe this year, I'll give them a piece of my mind.

Mela,

I was most pleased to see that you acknowledged that your response was unpersuasive and condescending.

What you left out, however, was that your points were wrong.

1 - While legislatures do have the ability to make laws regarding health care, they must do so in accordance witht he provisions of law within the national scope -- which the court case involved here noted. Not treating someone's medical needs is, indeed, a violation of their constitutional rights, and they do not lose them willy nilly when they are placed in prison.

THis is why they will not previal, so long as they pointedly exclude something that is medically necessary in the eyes of the court.

2 - Actually, you offer a false dichotomy. The issue is not atually that it be life saving or even life threatening. The issue is that it is medically necessary -- depriving someone of medically necessary care is cruel and unusual punishment. Even serial axe murdering pedophiles on death row get medically necessary care.

3 - Prisoners who have shown a medically necessary need for organic foods do indeed get organic foods. The same with gluten intolerance, low calorie versions of foods, and so forth. Especially when lack of these foods causes particular health conditions such as depression which places their health at risk.

4 - Prisoners with OCD do indeed get their livng arrangements taken care of in a manner that handles the OCD best.

5 - You are correct that the taxpayng American public doesn't have an obligation to make their lives comfortable and happy as possible -- but they do have an obligation to see to their medical needs. Because Prisoners are wards of the state with rights like every other human has, and, as a result, are subject to the same basic provisions as any other citizen is (hence things like food stamps and Medicaid and Medicare).

6 - The rules do indeed change for trans people -- they change in order to remove what would otherwise be a perfectly normal situation (were you aware that prison's provide hormonal treatement for post and peri-meopausal women because of medical necessity?) from them, specifically, and in your case what you are doing is advocating the the rules be changed for trans people from the way that everyone else is treted.

While Trans people may not contribute money to Lamda's coffers, they do indeed contribute bodies and lives to Lambda's work. Or had you forgetten that the Lambda counsel who won the court case for Marriage in California prior to Prop 8 was a trans person?

If I am not incorrect, you are the Bilerico writer who has said on several occasions that she engages in dialogue with commenters to play with them or to draw them out. It's a shame you are close-minded. Anyway, I am willing to take the time to dialogue, but not to feed the pathologies of others. So I won't bother responding to all of your false points above.

However, I will respond to one issue: Please do point me to any source that indicates that a prisoner with OCD has required a prison to re-design or re-furnish his cell. Or where any prisoner in any state or federal prison has ever won the right to organic food or low cal food for weight loss. They don't get this because prisons do not have to supply all medically recommended services, only basic services. HRT is not a basic service, no matter how much trans activists insist that it is. Anyway, I look forward to a link or citation.

As far as the WI case goes, as I said b4 I very much doubt that the decision will survive appeal. But even if it does, WI can easily rectify the problem by tweaking the language to allow for HRT under the most narrow circumstances allowable and with the barest degree of discretion afforded doctors - in effect satisfying any purported constitutional obligation but effectively making HRT unavailable. Hopefully WI will just win outright on appeal so the legislature doesn't have to waste any more time on this foolishness.

I do indeed play with commenters.

That does not, however, mean I am close minded. What I am is incisive and the reason I play witht hem is that they are often the ones who are closed minded and subject to various prejudices that I use thier own efforts to reveal.

One note: It's not about me, personally, It's about the Original post and the comments you made. If you'd like to engage in efforts to make it all about me, you will lose. And badly.

I did err in one point above -- I was thinking of Cole and cited Shannon instead, which is an error for which I apologize.

However, the points regarding prisons are all based on Arizona Prisons (both State and Federal), inclusive of the OCD person having a situation where their confinement was adjusted to account for their OCD.

Organic foods are actually served in several prisons -- since the prisons grow a large amount of it for the inmates to consume. OFten via chain gang labor and as a cost cutting measure (growing small scale organically is cheaper when you remove the cost of labor since you don't have the cost of chemicals). That's not just Arizona, but several prisons across the US (and notably in the south).

Low calorie diets are occasionally ordered by prisons because of health reasons (and the typical kitchen has persons who specially are assigned to make specialty meals for various prisoners).

The key in all cases is still medical necessity.

You want a link, however, you will have to go dig it up yourself. One good place is any of the prisoner's organizations, or you could look up any of the Trans people who have been incarcerated. I would be more than happy to provide you with several links (right now I have 18 open and available to me). The fee for such will be 150 dollars. Please contact me via email for the means by which you can pay. If you balk at the fee, that's your problem: I don't work for free anymore.

If someone else does want the information, just contact me and pay me for the effort and I'll send it to them. I say that because I doubt that Mela will do so.

Your hope, again, is unfounded. The Federal district in several location has already ruled that it's applicable. The law is actually in the favor of trans people here.

Lastly, the narrowest circumstances available would be the official standards of care, which are supported by the NIH in such situations and are already held up in court as the minimum such circumstances allowable.

Those standards of care are available online should you choose to peruse them at some point.

If you "play" with commenters - even ones you deem to be prejudiced (like yourself) - rather than listen to their views with respect, that makes you close-minded, not incisive.

Your points about organic food and low cal food completely miss the point. Obviously, prisons can for their own reasons, allow prisoners to grow their own food or to have low cal food. Just as the prison can allow movies and cable. That doesn't make it a right. And nothing you said says otherwise.

On the OCD, you don't cite a source - not a newspaper or magazine article or a website dealing with prison or OCD issues - nada - and say that it is my responsibility to go find the sources for your post. Sorry, you may not work for free, but if you shoot your mouth off with no authority to back it up, no one need take you seriously.

On the appeal, you say: "Your hope, again, is unfounded. The Federal district in several location has already ruled that it's applicable."

This is incoherent. Please try centering yourself before posting.

You make an interesting assumption there.

Primarily, you assume that "playing" means I don't pay close attention. THis is in error. Grave error. Indeed, I pay very close attenti0n to what they say, precisely because I am playing with them.

My examples (not points) regarding the organic and low cal food do not miss the point. THey deal directly in what you discussed and are specific examples of things you noted didn't exist and yet, they do.

I told you that I would cite a source -- all you have to do is pay me for the effort. You say I shoot my m9uth off with no authority, and that's an appeal to authority -- a logical fallacy one would expect you to be above.

I don't need the authority to have the points, and I did point out that I have first and second hand experience with such, which, technically, gives me authority enough (especially considering I wrote about it not too long ago here).

So what you have, then is first or second had direct evidence that is oppositional your statements and your use of a logical fallacy to dismiss such.

Might be possible in a situation where one is dealing with hearsay, but then, again, I could probably get the seocnd hand person to come here and provide the acocunt and assorted information if such becomes necessary (and Ms. Barden, incidentally, secured the same medical treatment for trans folk in state prisons here).

None of which would have been notable if I were not, in fact, paying close attention to what you said.

I can't argue with the somehwat incoherent aspect, since it's obvious that you've only partially given my statements the same courtesy (you skipped the whole offer thing there, and elsewhere falsely accuse me of refusing to answer).

Therefore, let me make it more clear for you:

Your hope is a shallow one. The basis of the judgment relies on the question of medical necessity. Treatment which is medically necessary is already required under the "cruel and unusual punishment" clause per SCOTUS.

So to do achieve the success that you are describing, the State would have to prove, using medical testimony from medical experts in the field, that it is not medically necessary, while the AMA (from whence most of the experts would come) and the WPATH (where other experts would come from) both hold that the treatment is, in fact, medically necessary.

And have for at least two years (AMA) or 9 years (WPATH).

Unless you'd like for them to introduce testimony from such organizations as NARTH, the hope is pretty shallow.

You seem to consistently confuse medical necessity with the examples being given. Medical necessity does not mean that one is in immiment danger, merely that one has a medical need that should be addressed.

While you can say that in your opinion there's no medical necessity involved, you would be doing so from an uninformed position, which is pretty shaky ground to be on.

Next I suppose youll be telling me the don't serve Kosher meals in prison, as well.

Also, are you aware that Prisons are different than Jails?

From the Milwaukee Journal-Sentinel

Earlier, Kevin Kallas, a psychiatrist and mental health director for Wisconsin's prisons, testified he opposed the law banning hormones.

Besides in federal prisons, hormones are given in all of the Midwestern states surveyed by the Department of Corrections, he said. Kallas called hormones a "medically necessary" treatment in some, though not all, cases.

Kallas said patients who are taken off hormones typically need counseling, drugs and hospital stays instead, suicide treatments that are more expensive than the hormones, which cost $675 to $1,600 a year. Kallas said he did not know of any other medical treatment that the state Legislature has banned in prisons.
The question is, since the cost of giving Hormone Replacement Therapy is far, far less than the costs of dealing with the consequent health problems ... how much extra is the Wisconsin Taxpayer willing to pay just so Trans inmates suffer and die?

How much do you want them to, Mela?

It is up to the legislature, considering all of the testimony and evidence, to chart a financially prudent course for WI prisons. If it is true that hormones are cheaper, then that is a factor that supports their use. Of course, you are cherry picking the testimony of one doctor who supports your view, and are not presenting the full record. For example, the legislature could conclude that hormones pose hidden costs such as potential liability or the need to hire physicians with specialized knowledge of HRT. It isn't just the raw cost of the chemical that needs to be considered. I don't know the full record that WI considered and it is entirely possible that they got it wrong as a fiscal matter. But that doesn't make HRT a constitutional right.

Once again: no one dies from not getting HRT, no matter how many times you say it. They may suffer and feel frustrated and sad. But such is prison. Why do trans activists think that everyone is so gullible that they will fall for blatant lies?

Toni, a correction. You said that "the Lambda counsel who won the court case for Marriage in California prior to Prop 8 was a trans person?" I believe you are referring to Shannon Minter, the trans man who was lead counsel during the oral arguments before the California Supreme Court in the California Marriage Cases. Shannon was, and still is, an attorney employed by NCLR, not Lambda Legal. Also, although Shannon played a significant role in that case, to say that he "won" it is obviously an exaggeration, given the number of other attorneys and organizations involved on the plaintiffs' side.

At the risk of being redundant, although that would assume my blog was fully read, the Wisconsin court case is an issue of equality. That’s not opinion. It is fact. Wisconsin violated the 8th and 14th amendments. Since 2005, the WI state legislative code enforced by prisons was ruled “cruel and unusual”.

ALL prisoners must receive medically necessary treatment. It’s not trans issue, it’s an equality issue and an issue of health care reform.

No one other than a physician—not a warden or a guard, politician or taxpayer, blogger or blog commenter--- is qualified to make that call of what’s medically necessary. Medical treatment is the sole province of physician and patient. I linked to the court decision in this blog, but let me post the salient points here:

“After careful consideration, the court concludes that the defendants’
application of Wis. Stat. § 302.386(5m) to these plaintiffs constitutes deliberate indifference to the plaintiff’s serious medical needs in violation of the Eighth Amendment inasmuch as enforcement of the statute results in the denial of hormone therapy without regard for the individual medical needs of inmates and the medical judgment of their health care providers.

The court further finds that Wis. Stat. § 302.386(5m) is unconstitutional on
its face under the Eighth Amendment because it bans the use of any Wisconsin State
resources or federal funds passing through the government to provide hormone therapy
and, thereby, requires the withdrawal of any such ongoing hormone therapy for inmates
in DOC facilities without regard for the medical need for that treatment.

The court further finds that Wis. Stat. § 302.386(5m) prevents DOC medical
personnel from evaluating inmates for treatment because such evaluation would be futile
in light of the statute’s ban on such hormone therapy. Furthermore, the application of Wis.Stat. § 302.386(5m) to the plaintiffs violates the plaintiffs’ constitutional right to equal protection because there is no rational basis for treating the plaintiffs differently than similarly situated inmates.

The court further finds there is no rational basis for Wis. Stat. § 302.386(5m)
and that the statute is invalid on its face, as it violates the Equal Protection Clause of the Fourteenth Amendment. A memorandum decision shall be issued forthwith. Now,
therefore,

IT IS ORDERED that enforcement of Wis. Stat. § 302.386(5m) violates the
plaintiffs’ Eighth Amendment right to be free from cruel and unusual punishment and
Fourteenth Amendment right to equal protection.

IT IS FURTHER ORDERED that Wis. Stat. § 302.386(5m) is unconstitutional.

IT IS FURTHER ORDERED that the defendants are permanently enjoined
from the enforcement of Wis. Stat. § 302.386(5m).
Dated at Milwaukee, Wisconsin, this 31st day of March, 2010.

PS: Don’t worry about Lambda Legal blowing their entire slush fund on this case. The ACLU went halfsies with them as part of the defense team.

CatherineCC | April 5, 2010 5:08 PM

Mela, thanks for reminding us that gays and lesbians aren't always our allies. You know, sometimes we start seeing the world through rose colored glasses, get optimistic and and forget that pretty large (but usually silent) parts of the gay and lesbian community is completely willing to toss us under a bus again.

Thanks also for reminding us that transpeople are poor (stereotypes are fun, aren't they?)

But I totally see your point - Prisons should TOTALLY only give AIDS drugs from the '80s to those gays, who probably deserved it and infected themselves with all their gayishness. I mean, like why not? /sarcasm.

You seem to be under the impression that transpeople are going to pop into prison to get free care. Over 60% of transwomen report being raped in prison, physical assault rates are also incredibly high and the rape rate likely doesn't include transwomen who have found "a husband" for protection. We're not stupid, we know it's not a good place for us.

Just because the medical system in the USA is completely dysfunctional and screwed beyond belief, does not mean prisons have to aspire to ever lower standards of care for prisoners.

And don't forget these same rules apply to people held in pre-trial confinement because they weren't able to afford to put up bail.

"thanks for reminding us that gays and lesbians aren't always our allies."

You are most welcome. We are allies on some things and not on others. But whether we are or are not - it is a decision gay people make for themselves. We don't take orders.

" parts of the gay and lesbian community is completely willing to toss us under a bus again."

If not doing exactly as you demand and not subordinating gay rights to your priorities is throwing Ts under the bus, then we should be doing a lot more throwing.

"Thanks also for reminding us that transpeople are poor (stereotypes are fun, aren't they?)"

I didn't say that. I simply said that a tiny fraction of Lambda's money comes from trans people. Whether that is the result of poverty, stinginess, or whether it is b/c trans people rationally conclude that they can free-ride off of gay money while sending their own funds to trans groups, I don't know. I'd love to see a Bilerico piece on that. (Like that would ever happen.)

"But I totally see your point - Prisons should TOTALLY only give AIDS drugs from the '80s to those gays, who probably deserved it and infected themselves with all their gayishness."

- You obviously missed it. The whole point is that lack of access to HRT is not life threatening in contrast to cancer drugs - or AIDS drugs. Since it is not necessary, taxpayers shouldn't pay for it.

CatherineCC | April 5, 2010 9:53 PM

Wow... that post pretty much sums up everything doesn't it...

Not often that people make their true feelings known.

Just do us all a favor and say what you really mean from the very beginning. Show some guts, ok?

And you missed the point: life threatening is not the standard by which medical necessity is measured.

If not doing exactly as you demand and not subordinating gay rights to your priorities is throwing Ts under the bus, then we should be doing a lot more throwing.

Given that this usually means that you expect trans people to subordinate our rights to your priorities, yes, it is throwing trans people under the bus.

Trans prisoners receiving HRT does not in any way harm or interfere with cis LGB rights, and yet you seem to be opposed to medical care that is, frankly, vital for a large number of trans people. Why is that? Why do you seem to want to dictate what trans people should need or want or have in any circumstance? Why aren't T needs as important as cis LGB needs?

"Given that this usually means that you expect trans people to subordinate our rights to your priorities, yes, it is throwing trans people under the bus."

I don't expect trans people to subordinate their rights. In fact, I think it is ridiculous that these 2 different groups have been forced together into one fictitious "community". Trans people should make their rights their top priority and gay people should make their rights their top priority. When we can work together to our mutual benefit, we should do so. When we can't, then we shouldn't.

"Trans prisoners receiving HRT does not in any way harm or interfere with cis LGB rights, and yet you seem to be opposed to medical care that is, frankly, vital for a large number of trans people. Why is that? Why do you seem to want to dictate what trans people should need or want or have in any circumstance? Why aren't T needs as important as cis LGB needs?"

- Well this HRT issue imposes on the rights of all taxpayers, including LGB taxpayers and, for that matter, trans taxpayers. But more directly, the issue is simply irrelevant to gay people. So it is a waste of Lambda's resources - gay money - to pursue a case like this. When Lambda takes a case like this, it is basically tithing to the church of LGBT. LGBT is a kind of religion and its adherents have to prove their continued faith in it against all common sense.

I don't want to dictate to trans people. If a law abiding trans person wants to get HRT at her own expense, go for it. But when you ask me to pay for it, I get a say.

CatherineCC | April 6, 2010 4:49 PM

-I don't want to dictate to trans people.

Uhh yeah, you do. Let's call a spade a spade.
Good job forgetting trans males too.
Or do you just spit on the mtf trannies?

"Let's call a spade a spade."

Racist much?

battybattybats battybattybats | April 7, 2010 12:15 AM

* We both got decimated by AIDS.

* The law used to raid Stonewall was an ANTI-CROSSDRESSING LAW

* We rioted side-by-side

* Homophobia and Transphobia are regularly connected, most anti GLB laws are also anti-TI laws and vice versa

* Science has found cross-sex neurology and neural activity in BOTH G, L and T. Suggesting we are actually biologically connected, subsets perhaps of lesser Intersex

* Many cultural and historical connections including some surviving Indiginous cultural traditions connect us together.

* we have the shared experiences of the closet, of rejection, oppression and prejudice

Therefore there is cultural, historical, scientific biological, sociological, shared-experience and shared human-rights issues that connect us together.

Oh and a few more things:

* common problem of accepting hypocritically other biases so long as they don't directly apply to us

* attempting to ditch others human rights to make ours seem more palatable

* scapegoating other marginalised connected groups as being to blame for our problems with mainstream society rather than laying the blame where it belongs on mainstream societies shoulders.

battybattybats battybattybats | April 5, 2010 11:04 PM

DUTY OF CARE.

Thats what the state owes all wards of the state.

That includes prisoners.

They are there to be rehabilitated to ensure they can be returned to the community and not commit further crime.

During which time the state owes them the same as it owes anyone else deemed unable to care for themselves. The same as it owes children not legally able to work or live independantly that become wards of the state. Same as with the elderly no longer able to care for themselves. Not an iota less.

Now that will upset everyone who has an irrational 'prison as vengeance' notion or a somewhat groundless 'prison as deterrant' notion both of which they feel justify prison existing totorture prisoners and terrify the rest of the populace. But tough for them the state has a DUTY OF CARE.

The issue of trans-care access outside of prisons is a seperate issue. If people think its unfair prisoners may get access to care others don't then it is the access of everyone out of prison to healthcare that is a problem not the other way round.

Regan DuCasse | April 6, 2010 7:17 AM

Had a long talk last night with our friend Tobi Hill-Meyer over this issue. If I can swing it, I usually try to be more informed before I shoot of my big mouth.
So she schooled me, as did a few of the other posters on the condition of GID and the varying qualities of hormones utilized for that condition.

Always good to have knowledgeable friends around.
I can agree that individuals belonging to a group can't and shouldn't be set aside for deprivation because of what they are physically and so on, the problems with incarceration or running the risk of being a ward of the state is that in our tough economic times, or any time, lack of control of one's situation is a given.

And being able to access or have your medical needs met isn't as likely, whatever your medical status.

I might not have initially understood the gravity of HRT for GID, but prison is a situation precisely because of it's very nature, why it's hard for the general public to care about the comforts and extraordinary needs of the criminal population.

Thanks for sharing.

I am again completely offended by the references made to prisons that have been made with little/ no backing. The previous entry regarding the ruling in Wisconsin began with a statement implying that inmates are readily given medication for diabetes, etc. THIS is not the case.

I've spent HOURS of my time making phone calls, writing letters, being transferred and put off while attempting to get something akin to medical care for inmates. Inmates must fight every step of the way to get treatment. They have a process through which to go prior to even seeing a nurse---much less a live doctor (that usually happens via Telemed Conference which is like a low-tech web cam situation).

Each trip to "medical" even when the treatment is not accurately done/ not what the problem at hand requires and instead what another condition might/ not done by licensed professionals requires a co-pay as does the ointment, pills, etc that are prescribed. If you refuse a treatment because, say you've had your tonsils out and know you can't have tonsillitis---well, then you can't go on to the next level of treatment. You've got to be treated for tonsillitis, have that treatment fail and then go back and request that you be able to see the next higher person who may be a trained medical technician or POSSIBLY a nurse's aid. So as an inmate you pay your way up the chain of command with co-pays and for medications you don't need.

Inmates who need to get treatment for anything go through some form of this. For an inmate who suffers from GID to get HRT there will also be some kind of hurdles. The inmate (unless in a state that is really awesome) will be paying for this treatment, too. If the inmate doesn't have family on the outside or friends who support them they will owe the state upon release for medical treatment received, any mail supplies used and any damages done to state property. If the inmate does have family on the outside who can send funds the inmate will still have a fee for maintaining funds each month. And the person on the outside will either have to pay a per deposit fee or at the least for a money order----depending on the state and what the process is.

Inmate labor is used for farming in some places in the south (I'm most familiar with GA) but anything that is organically grown is not done with enough frequency or in enough situations to warrant mention. It's been done in Washington, in California and on occasion here and there. It is much like the other programs touted by prisons that usually are the first to get cut. The number of organic items served to inmates is at most, tiny.

A large part of society doesn't like or care about Trans people and the incarcerated on their own, never mind incarcerated Trans people! I think that alone makes this a HUGE ruling. As I before mentioned this is an opportunity for those who have not been active in fighting the PIC to become involved. For those who aren't by nature activists it sometimes takes something closer to home to get them involved and I say we in the queer community have now something closer to home in this ruling to motivate ALL of us to become somehow involved. At the least we ought all become more aware of the life of those members of our community who are incarcerated.

battybattybats battybattybats | April 6, 2010 10:40 PM

Australias prison system and healthcare system is far from perfect and needs much reform but what your describing?

Barbaric, inhuman, sick, depraved.. these words are insufficient.

And something like 1% of your country is incarcerated?

And the 'success' of the American system is used to justify increased corporatisation of our prisons and detention centres and the reduction of our public health and education system? *shudder*

I just realized you replied to this comment- months later! In case it inspires you or anyone else to take action I'll make note of something I rather recently learned: the FDA does not regulate foods served in the prisons. This both explains how on earth those for whom I advocate are served the meals they've described as well as displays in yet another way how very inhumanely we treat those who are incarcerated. The foods we feed animals require at least a base level of inspection for quality. Apparently animals are more highly regarded than inmates.