Taxpayer Funded Sex Change in Idaho Prisons?

On December 13, 2018, Judge B. Lynn Winnmill ruled that the Idaho Department of Corrections (IDOC) must provide gender reassignment surgery within six months to a transgender person, Adree Edmo, who has been incarcerated in a men’s prison. He reasoned that withholding medically necessary surgery amounts to cruel and unusual punishment. Dr. David McClusky, the chairman of the Board of Correction and an experienced, licensed surgeon, disagrees. Dr. McClusky claims that “[D]isagreement among medical professionals, in this case, does not constitute cruel and unusual punishment.” Thus, IDOC will be appealing the ruling.

As humans, a feeling of incongruity with one’s body is relatively common. For example, as we age, our bodies no longer reflect how we feel inside. A transgender person identifies as a different gender than the one assigned at birth. The American Psychiatric Association describes gender dysphoria as the situation when gender incongruity impairs the ability to function in life. In 2015 and again in 2016, Edmo attempted to remove the offending anatomical parts with a disposable razor. Hospitalization was required after the second attempt nearly resulted in death. Not all transgender persons have gender dysphoria, but for those who do, the condition makes life incredibly challenging, both emotionally and physically.

As much as we sympathize with Edmo’s situation, we at the Madison Liberty Institute agree with Governor Little when he stated in a press release, “The hardworking [sic] 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. We cannot divert critical public dollars away from our focus on keeping the public safe and rehabilitating offenders.” The new IDOC director Josh Tewalt followed this line of thought, saying, “[P]rison is not where you go to get unwarranted surgery.” Edmo has had a number of years to undergo this surgery on his own. Until gender confirmation surgery is deemed medically necessary through consensus, IDOC bears no responsibility to pay for it.

At the Madison Liberty Institute, we will not trivialize the pain associated with gender dysphoria. Edmo has undergone a traumatic and difficult experience. However, there is no set precedent for the people of the state being forced to pay for this surgery; only one other inmate in the nation has undergone gender confirmation surgery. The right to something does not compel the state to pay for exercising that right. Changing one’s physical body to match one’s internal identity is neither against the law nor required by the law. Constitutionally, IDOC does need to ensure the safety of its inmates, but it has neither the funds nor responsibility to help Edmo feel congruous with his body.