California sets path for inmates to get sex-reassignment surgery

Guidelines to decide whether transgender prison inmates in California can undergo sex reassignment surgery took effect Tuesday, making it the first U.S. state to offer a regular path to such treatment.

California last summer agreed to regularly provide and pay for treatments including hormones as well as surgery to alter the biological sex of its prisoners.

"California has set a model for the rest of the country and ensured transgender people in prison can access life-saving care when they need it," said Kris Hayashi, executive director of Transgender Law Center, which represents two inmates who sued the state after being denied the surgery.

Under the new rules, which follow a legal settlement reached in August with one of the inmates, prisoners seeking to change their biological sex would need to be evaluated by medical and mental health professionals, and present their cases to a six-member committee of doctors, psychologists and psychiatrists.

Committee members would vote on whether the surgery was warranted, and a committee chair who is a medical administrator in the prison system would hold a tie-breaking vote.

They would also have to live for a year in their preferred gender roles and undergo hormone therapy.

Under the terms of the settlement with Shiloh Quine, who was born male but identifies as a woman, the state agreed to provide her surgery and transfer her to a women's prison.

Officials also agreed to allow other male inmates who identify as female to be housed in women's prisons; female inmates who identify as male would also be allowed to live in men's prisons if they requested it.

The state also agreed to allow inmates who are transgender or have gender dysphoria access to clothing, toiletries and other items consistent with their gender identities.

The state had earlier been ordered by a court to pay for sex reassignment surgery for Michelle Norsworthy, another inmate who was born male but identified as female.

Norsworthy, who was released on parole and thus made ineligible for surgery funded by the prison system, also welcomed the new guidelines.

"I am beyond proud to have been part of the movement to make this policy happen," Norsworthy said. "I suffered for decades as my identity, my medical needs and my very humanity were denied by the people and the system responsible for my care."