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PaperclipPerfector  9mo ago (text post)   33130 thread views

Culture War Roundup for the week of September 16, 2024

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Is plastic surgery an essential medical procedure that a Department of Corrections must pay for, if a prisoner is sufficiently distressed about it? And if a M-to-F transwoman undergoes full reassignment surgery, will that prisoner be transferred to women's prison in due course?

A federal judge ruled the Indiana Department of Correction's ban on gender-affirming care is likely unconstitutional, and an inmate from Evansville is at the center of the lawsuit.

Source, archived version.

The prisoner (neé Jonathan Richardson, now Autumn Cordellioné) is serving a 55-year sentence for almost two decades for killing one's baby stepdaughter. The prisoner was diagnosed with gender dysphoria four years ago and put on testosterone blocker and female hormone.

While the medicine has helped, the lawsuit states Cordellioné continues to experience symptoms of gender dysphoria including depression and anxiety. [...] Cordellioné was on a wait list for evaluation for the surgery, but a new Indiana statute does not allow the DOC to provide or facilitate "sexual reassignment surgery." The ACLU [representing Cordellioné] argues in its suit that for some, the surgery is a medical necessity. In this case, Cordellioné is seeking a orchiectomy, which removes the testicles, and vaginoplasty, which is the construction of the vagina.

"By prohibiting the surgery, regardless of medical need, the statute mandates deliberate indifference to a serious medical need and therefore violates the Eighth Amendment," the suit states. "Additionally, the statute discriminates against Plaintiff and other transgender prisoners in violation of the Equal Protection Clause of the Fourteenth Amendment to the United States Constitution."

The judge agreed, issued a preliminary injunction against the Indiana statute in question.

Here's a summary of the statute (HEA 1569, passed in 2023) that perplexity.ai provided:

It prohibits the Indiana Department of Corrections from performing certain surgical procedures for the purpose of altering the appearance or affirming an inmate's gender identity if it's inconsistent with their sex assigned at birth. Specifically, the law bans the following procedures [gives a list including castration and vaginoplasty, and in general removing healthy tissue or non-diseased body part].: The law does not define "gender" or "sex" but appears to use "sex" to refer to an individual's sex assigned at birth.

The law doesn't prohibit hormone therapy (which the prisoner got) or social transitioning:

The lawsuit states Cordellioné has lived as a woman to the "extent possible" while in a prison housing only men. She has been permitted gender-affirming items such as makeup and "form fitting clothing."

I will put aside for now how utterly annoying I find the assumption that, to be a woman, one wears makeup and form-fitting clothes. By all means fellas, go all 17th-century Versailles. My main question is this: if the Indiana Department of Corrections is required accommodate "gender-affirming" transitions, including the extreme surgeries of removing testicles and shaping the penis to look like a vagina, wouldn't the reasonable next step be to affirm the prisoner's womanhood by placing the prisoner in women's correctional facilities?

(My husband said that if he ever had to go to prison and there was an option to go to women's prison rather than men's, his only question is: what needs to be chopped off and how soon?)

Let me end on a controversial (for The Motte) note: maybe I simply shouldn't care. Cordellioné has been in prison since early 2000, which makes the person at least 40. So even if I don't see this person as a woman, this is a middle-aged male on testosterone blockers with some serious surgeries between his legs. How dangerous would he really be to the female prisoners, compared to other female prisoners already serving there?

I should probably do an effort post on this at some point but the distribution of trans patients in general medical care (which aligns closeish with real life), primary psychiatric settings, and correctional/forensic settings are all wildly different.

This causes a number of headaches, since political leadership inside the prison system often has minimal experience with prison (to say nothing of more general political leadership). You might be a well meaning left leaning person, primarily interact with well meaning and convincing trans people, and assume that the prisoners are the same. They are not.

"Real" trans people exist. In say, a locked psychiatric inpatient unit (where everyone is by definition mentally ill) most of the trans people are psychotic patients or those with borderline personality disorder or some other process causing identity instability. Correctional settings has those, and also people malingering. And yes you have people malingering so hard they'll cut their dick off if given the option.

For the usual reasons of wokeism activists can't really admit these other types of trans people exist and causes all kinds of problems, although it can be darkly funny when physicians are involved.

Wokeism does not typically survive very long with day to day contact with the prison population, so you'll find staff (even doctors and social workers) are much more clear eyed about all this but they don't make the decisions. People with strong ego defenses can stay woke but they almost uniformly end up on therapy to do it, which is...worrying.

In my state (redacted) the "worst" prison doesn't have functional climate control in the high security unit because too much of the budget has been redirected towards gender affirming care.

And yes you have people malingering so hard they'll cut their dick off if given the option.

Maybe that's a win, in a sense. If a male with sufficient propensity for violence or anti-social behavior chooses to castrate himself, I'd be happy if that procedure was paid for with taxes. I would be OK with the additional tax burden there.

Hard to research but - not necessarily a good outcome, once the identity instability clears or the secondary gain abates the patient may have increased rage at the system, violent urges, etc.

People in prison almost never have the ability to accurately assign blame "I can't believe specific person/the system let me do that, I need revenge on them specifically or people in general."

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