Sexual Reassignment for convicted murderer...

[ohiowan]

www.boston.com/news/local/massachusetts/articles/2012/09/05/mass_inmate_sex_change_ruling_praised_condemned/

what are your thoughts?

[ohiowan]

I have no problem with the surgery itself, but I'm on the fence about it being for a convicted murderer.

[Deleted]

I thought the same at first but Jake explained the cruel and unusual punishment side. I am still very ambivalent about it, but i will say i think not doing so when she really would otherwise need the surgery sets a dangerous precedent for how we treat prisoners. On a personal level I'm like "who cares about the fucker" - on a societal level i get it.

[ElizabethBennet]

I don't like it. I'm all for humane treatment of prisoners but this is taking it too far. This is not a medically necessary procedure.

[princesscal]

Sept 5, 2012 7:13:24 GMT -5 frkls said:

i can understand it as placement issue more than a healthcare issue. it must be absolute hell living as a woman in a men's prison facility, but they can't very well transfer him to a woman's facility and have to monitor the whereabouts of his penis at all times. if this makes it so he can be transferred to a women's facility while also keeping the women there safe, then i say do it.

I see you point, however, do you think the women in the women's facility will feel safe with someone who brutally killed their wife? I don't think so and don't think they should be subjected to it.

[Deleted]

Sept 5, 2012 7:42:59 GMT -5 princesscal said:

Sept 5, 2012 7:13:24 GMT -5 frkls said:

i can understand it as placement issue more than a healthcare issue. it must be absolute hell living as a woman in a men's prison facility, but they can't very well transfer him to a woman's facility and have to monitor the whereabouts of his penis at all times. if this makes it so he can be transferred to a women's facility while also keeping the women there safe, then i say do it.

I see you point, however, do you think the women in the women's facility will feel safe with someone who brutally killed their wife? I don't think so and don't think they should be subjected to it.

Well this doesn't make sense to me. I'd assume she'd go to a high level prison, meaning the women in there would have committed similar crimes. I don't think the gender of the person she killed would really matter.

But then again I'm not an expert in prison etiquette.

[rodeored]

Sept 5, 2012 7:42:59 GMT -5 princesscal said:

Sept 5, 2012 7:13:24 GMT -5 frkls said:

i can understand it as placement issue more than a healthcare issue. it must be absolute hell living as a woman in a men's prison facility, but they can't very well transfer him to a woman's facility and have to monitor the whereabouts of his penis at all times. if this makes it so he can be transferred to a women's facility while also keeping the women there safe, then i say do it.

I see you point, however, do you think the women in the women's facility will feel safe with someone who brutally killed their wife? I don't think so and don't think they should be subjected to it.

I wasn't aware that you got to choose your roomies in prison. Whats to say they aren't already living with a woman who brutally murdered their husband?

[Deleted]

Sept 5, 2012 7:42:59 GMT -5 princesscal said:

I see you point, however, do you think the women in the women's facility will feel safe with someone who brutally killed their wife? I don't think so and don't think they should be subjected to it.

Because there are no brutal killers in the women's prison or anything. They only go the jail for prostitution and stealing food their babies.

But to the OP, it's the only cure for his illness. I'm not sure how this is different than denying him surgery for cancer or medication for schizophrenia.

[Deleted]

I think there's something weird about seeing this as an "illness." It IS the only cure for her state of being, yes, and I really can't imagine the torture one must feel while going through something like this. But I don't think it's a disease or an illness. I don't know how transgendered people feel about it, either -- how they think of it.........

It's all complicated.

[Deleted]

I don't understand how it isn't an illness. She's been diagnosed as having the issue and she's been told what the cure is by more than one person. I'm not sure what else needs to be said before it's considered an illness.

[Deleted]

Hmm...I think I'm thinking of it like -- using "illness" is saying being transgendered is something "bad" and that needs to be cured. Though I see what you're saying, too. I don't know, this stuff is hard for me to wrap my head around, but I very much feel for her and others and fully support them.

[partiallysunny]

My question is: if this man was not a convict and has gender-identity disorder, would a doctor be able to say "she needs this surgery for her disorder"? Would it be covered by insurance as a necessity? Not as an elective surgery? (This is a serious question, I don't know how this works).

If it's not treated as such, why should it be for this super special inmate? If it is already treated as non elective surgery prescribed for gender-identity disorder, then she should get the surgery.

[Deleted]

Okay. I see.

[Deleted]

Sept 5, 2012 8:17:16 GMT -5 ninjabridemom said:

Hmm...I think I'm thinking of it like -- using "illness" is saying being transgendered is something "bad" and that needs to be cured. Though I see what you're saying, too. I don't know, this stuff is hard for me to wrap my head around, but I very much feel for her and others and fully support them.

I don't think it's always the case that it's something that needs to be cured. But in her case, doctors have determined that it does and that the cure is gender reassignment surgery.

But illness doesn't mean bad. It just needs treatment.

[psychmom]

This is probably a really stupid question but, don't some prisons pay the prisoners for the work they provide in prison? If they do, im sure its barely anything but maybe they could figure out a way where she could contribute something, even if it's $100, towards the surgery as a 'deductible' or whatever you want to call it.

Anyone outside of prison would have the same medical necessity as she does and would have to pay for it on their own. In this situation she obviously isnt able to do that, but if it were possible to at least contribute ... Does that make sense?

[Deleted]

And frkls is right. They wouldn't be treating the fact that she's transgendered. They are treating the gender identity disorder.

In the case of the prison system, not only is her condition take a toll on her mental health but it's also creating a difficult situation for her in terms of where to house her as a prisoner. To keep her in the men's prison when she is a woman is cruel. To put her in the women's prison while she is physically a male isn't quite right either.

[partiallysunny]

Sept 5, 2012 8:28:01 GMT -5 @habbsies said:

In the case of the prison system, not only is her condition take a toll on her mental health but it's also creating a difficult situation for her in terms of where to house her as a prisoner. To keep her in the men's prison when she is a woman is cruel. To put her in the women's prison while she is physically a male isn't quite right either.

Hmmm, that is a point.

I still don't think it's "right" that she would get her surgery for free while others with the disorder are saving their pennies for surgery. But I think your point trumps the unfairness of the situation.

[jaylea]

This is where I give pause:

"Kosilek's lawsuit has become fodder for radio talk shows and Massachusetts lawmakers who say the state should not be forced to pay for a convicted murderer's sex-change operation -- which can cost up to $20,000 -- especially since many insurance companies reject the surgery as elective."

So someone on the outside, who has private insurance, wouldn't have this covered as medically necessary. How are taxpayers then held responsible (in terms of payment) for providing it for an inmate?

I am not disputing gender dysmorphia is a real diagnosis and condition. I am questioning whether it is justifiable to pay for something that is not medically necessary for other citizens - the taxpayers who pay for their own medical care.

I don't know where I fall on this, honestly - because it's also not safe to have her living in a men's prison.

[Deleted]

I don't think it's right for the insurance companies to consider it elective though. I guess that's my point. After all, it seems some insurance companies do cover it.

And $20K actually isn't that expensive in terms of inmate healthcare especially considering some of the inmate population is aging or have chronic conditions. I imagine cancer treatment is much more expensive with far less of a guaranteed outcome.

[Deleted]

Yeah, it's really complicated. But maybe/hopefully this will help insurance companies see it as medically necessary? It sets that precedent at least.

[Deleted]

I think people get the impression that people who suffer from this disorder just wake up one more and think to themselves, self, you know being a woman would be fun. And the reality is far from it. It takes years of treatment and therapy before most doctors will even suggest the surgery, much less recommend you as a candidate. There's also an entire process for prepping to undergo it. It's not like deciding to get a boob job.

[psychmom]

Sept 5, 2012 8:17:16 GMT -5 ninjabridemom said:

Hmm...I think I'm thinking of it like -- using "illness" is saying being transgendered is something "bad" and that needs to be cured. Though I see what you're saying, too. I don't know, this stuff is hard for me to wrap my head around, but I very much feel for her and others and fully support them.

Being transgendered isn't the illness they're referring to. The mental anxiety she experiences bc her physical body is different from how she emotionally and mentally feels it should be is the illness.

[Deleted]

No i get it now. It makes sense to me. Thanks!

[psychmom]

Sept 5, 2012 8:33:13 GMT -5 partiallysunny said:

Sept 5, 2012 8:28:01 GMT -5 @habbsies said:

In the case of the prison system, not only is her condition take a toll on her mental health but it's also creating a difficult situation for her in terms of where to house her as a prisoner. To keep her in the men's prison when she is a woman is cruel. To put her in the women's prison while she is physically a male isn't quite right either.

Hmmm, that is a point.

I still don't think it's "right" that she would get her surgery for free while others with the disorder are saving their pennies for surgery. But I think your point trumps the unfairness of the situation.

this sums up my thoughts as well.

[jaylea]

Sept 5, 2012 8:41:46 GMT -5 @habbsies said:

I think people get the impression that people who suffer from this disorder just wake up one more and think to themselves, self, you know being a woman would be fun. And the reality is far from it. It takes years of treatment and therapy before most doctors will even suggest the surgery, much less recommend you as a candidate. There's also an entire process for prepping to undergo it. It's not like deciding to get a boob job.

I don't think that at all. My background is in psych, and I am familiar with the diagnosis.

What I am considering is more in terms of access to care - and whether prisoners (who murdered people) should have access to treatments above and beyond what the general public is entitled to.

Again, I don't know where I fall on this issue, but this is the question I am pondering.

If we had a single-payer system, we'd all be on the same page, wouldn't we?

[Deleted]

Well, there are people who can't afford a variety of treatments and medications that the prison system provides. So I can't see why that point is relevant.

The fact of the matter is that the prison system assumes care of the inmates once they are processed. That care shouldn't be dependent upon what someone on the street can or cannot afford.

[fuckstick]

A lot of psychologists and doctors are no longer requiring the patient to "live (x amount of time) full time as (new gender)" there are still a lot of hoops to jump through if you go the legal route. A lot of people who can't afford the hormones or can't get a therapist to sign off on something will often go the black market route to obtain the hormones.

All that being said, this is absolute bullshit. S/he is a murderer. I don't think this is the time to try and set a precedent for what insurance should/should not consider elective surgery when it comes to GRS.

But maybe I'm wrong. Because its so controversial its obviously getting a decent amount of attention. I just think that since s/he decided to disregard the law by committing murder and waive freedoms as a consequence, why should taxpayers foot the bill for the surgery regardless of how relatively small the cost in the grand scheme of things?

[jaylea]

Does Medicaid cover this surgery as medically necessary? Because the state prison system is essentially providing Medicaid, yes?

I do think it has a bearing on these types of decisions. Does that mean it can't be appealed? Of course not, as evidenced by this case. But I think the standard of care should match for those receiving state insurance coverage both inside and outside the prison system.

[Deleted]

Right but the state has custody of these inmates. That's what makes them different than the average person on the street, imo. It's not as if the inmate has the chance to "save their pennies", switch carriers, find black market hormones, etc.

[bleubook]

So if I "identified" as a superhero, would surgery to give me say...steal claws or bionic man shit be 'medically necessary" because it was the only "cure" to my condition?

This is a freaking waste.
and yes, I think sexual reassignment surgery is always wrong.