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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?
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.
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:
The law doesn't prohibit hormone therapy (which the prisoner got) or social transitioning:
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 personally find the very notion rather crass. We are going to spend millions in taxpayers’ money to transition convicted felons while the people who will be paying for it can end up owing thousands of dollars because their insurance doesn’t cover 100% of their frivolous cancer treatments and heart surgeries and so on. The state doesn’t have infinite money to do everything it wants to do, and it seems that doing essentially cosmetic procedures on prisoners while other much more pressing issues cannot be dealt with due to lack of funds? If hormones plus surgery cost (totally made up number) 75,000 dollars a person, what are we no longer going to provide to pay for this?
I do personally find it a bit odd that he didn't seem to be suffering from much dysphoria before he decided to murder someone, and in fact for the first 16-18 years, he wasn’t really saying or doing much that indicates dysphoria. I’m not sure that he isn’t faking to some degree either as a “fuck the system” thing or as a way to get better treatment that he imagines he’d get as a female prisoner. In short I suspect he is playing a game here, and he’s trying to be manipulative.
Being fair to him, I don’t think he’s the danger here. Female gang members and murderers are tough and they aren’t going to take this lying down. These aren’t nice polite PTA wine moms he’s going to be housed with. They are highly likely to try to hurt him before he could try anything stupid.
On the first point, prison is already quite expensive. Even if a substantial number of prisoners would take advantage of this, it would probably make up less than 1% of the price of prison. And offering violent prisoners better conditions in exchange for castration actually seems like a good deal for everyone involved.
On the second, remember, crime doesn't pay, especially not random murder, so the average murderer is stupid, insane or emotionally disturbed (probably a combination, in fact). So he might be trying to game the system in a stupid way, or he might just be fucked up enough to believe it.
I notice that this reasoning could be used to justify almost any frivolous expense. "Let's give every inmate a PS5 when they're successfully paroled." "Why?" "Who cares? It'll make up less than 1% of the price of prison."
The difference between gender-affirming care and other prison expenses is that the taxpayer actually gets something back from most of the other costs associated with prisons. Most prison funding goes towards line items which will prevent convicts from escaping (walls, bars, COs), thereby protecting the taxpayer in the short-term; or which are designed to rehabilitate convicts, protecting the taxpayer in the long-term (education, shop classes, anger management training). Of course you can interrogate whether any given line item actually accomplishes its stated goal or passes a cost-benefit analysis (maybe if you're serving a life sentence without possibility of parole, any attempt at rehabilitation is a waste of time and resources, except to protect the COs and fellow inmates from you; maybe art classes to teach inmates how to get in touch with their inner child and express themselves visually actually increase recidivism rates, who knows?), but that's generally how they're justified.
Gender-affirming care for inmates meets neither criterion: it only "benefits" the inmate. At a push there's an ancillary benefit in that an inmate who undergoes a vaginoplasty can no longer rape taxpayers with the penis he no longer has, but not every inmate who requests gender-affirming care has a history of sexual violence: if Bob already was at zero risk of committing a sex crime after release and requests a vaginoplasty, we've just spent $75k of the taxpayer's money and gotten nothing back to show for it.
Perhaps a doctor will argue that the entire reason for the inmates' history of criminality or violent behaviour was unresolved distress due to their gender dysphoria, so providing them with gender-affirming care will actually have a rehabilitative effect in the long run. I haven't yet seen anyone try to justify the policy on those grounds, however.
I don't think we disagree as much as you think; I also care very little about making prisoner's life nicer. I'm not really in favor of this policy so much as thinking that among the crazy stupid stuff we're doing, this one is pretty low on my list of priorities, and might even have some unintended benefits.
This is what we disagree on, I guess. Testosterone is the primary driver of violence in general, not just of sexual nature. And castration is by far the most reliable way of reducing T-levels. Even historically it was regularly noted how tepid and submissive eunuchs tended to be; But you don't need to take their word for it, modern studies on this topic consistently find a very strong relationship between violence and T-levels as well. It's not super advertised since it leads to some conclusions that most people don't like thinking about, but in a field were many things don't replicate, this one does reliably.
On the other hand, consider this report (I've been linking to it a lot lately) which found no statistically significant differences in the rates of violent offending between males who had undergone gender reassignment surgery and the general male population.
This is quite interesting. I find no obvious problems with the design except the unavoidable (large CI, now randomisation, etc.), so it does move the needle quite a bit for me. The only possible issues I can see is that I'm not entirely convinced that criteria i) strictly requires an actual surgery to take place, that the large CI can still hold some surprises (0..3-2.1 ranges from "almost female-pattern criminality" to "holy shit even higher than male-pattern criminality") and the usual troubles with selection effects.
It's very weird that somehow FtMs have male-pattern criminality, while MtFs ... also have male-pattern criminality.
Is that true? I wasn't aware.
According to the paper the report is based on, yes. See there under "Results:Gender Differences".
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I didn't look at those numbers, but someone compiled some stats showing it's actually higher:
https://x.com/eyeslasho/status/1831735103082410239#m
Our own @ymeskhout wrote an article arguing that the stats on which this graph is based are being misinterpreted: https://www.ymeskhout.com/p/contra-dolly-on-trans-criminality
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