Second Calif. Trans Prisoner May Receive Option of Gender-Affirming Surgery

California has taken a definitive lead in transgender prisoners' surgical rights following a Friday appeals court ruling that trans inmate Mia Rosati's rights may have been violated when she was denied access to gender-affirming surgery in prison, reports the Associated Press.

The news comes after Michelle-Lael Norsworthy, a 51-year-old Ione, Calif., inmate, became the only prisoner nationwide granted access to gender-affirming surgery following an April order from a federal judge to California's Department of Corrections. Norsworthy's surgery, however, has been postponed since late May after she was granted the possibility of parole.

Though the decision the ruling in Rosati's case does not guarantee the 58-year-old trans woman access to surgery, the Ninth Circuit Court of Appeals found that her allegations of cruel and unusual punishment and denial of equal protection were "plausible and sufficient" to warrant further review by a court, according ot the AP. A lower court had previously thrown out Rosati's case.

Rosati is serving 83 years to life in a San Diego men's prison after being convicted of murder. She has been diagnosed by prison medical staff with "gender dysphoria" -- the clinical term for experiencing severe distress from a mismatch between one's internal gender identity and external anatomy.

Rosati's case argued that by ignoring her repeated attempts to castrate herself, as well as other "severe" symptoms of gender dysphoria, the prison staff has "recklessly disregarded an excessive risk to her health by denying [sex-reassignment surgery]," according to court documents.

That state is currently reviewing the appeals court's decision in Rosati's case, notes the AP.

The first victory of this kind in the U.S. occurred in 2012 when Massachusetts trans inmate Michelle Kosilek was granted access to gender-affirming surgery -- but that decision was overturned last December. Both Kosilek and Norsworthy's cases have received much public and legal pushback over state institutions funding surgical care for transgender prisoners, with debates colored by the brutality of the women's crimes. Many detractors have argued that taxpayer dollars should not be used to provide trans prisoners with transition-related surgery, claiming, contradictory to medical standards, that such procedures are unnecessary or simply cosmetic.

Meanwhile, trans advocates have bristled at those implications, arguing with increasing success that incarceration should not preclude a person from reciving medical care recommended by their doctor.