A trial that
opened more than a year ago has become bogged down in Boston
federal court. There have been hundreds of hours of
testimony from witnesses, including 10 medical
specialists paid tens of thousands of dollars. The
judge himself even hired an expert to help him make sense of
it all.
The question at
the center of the case: Should a murderer serving life in
prison get a sex-change operation at taxpayer expense?
The case of
Michelle--formerly Robert--Kosilek is being closely watched
across the country by advocates for other inmates who want
to undergo a sex change. Transgender inmates in other
states have sued prison officials, and not one has
succeeded in persuading a judge to order a sex-change
operation.
The Massachusetts
Correction Department is vigorously fighting Kosilek's
request for surgery, saying it would create a security
nightmare and make Kosilek a target for sexual
assault.
An Associated
Press review of the case, including figures obtained
through Freedom of Information Act requests and interviews,
found that the correction department and its outside
health care provider have spent more than $52,000 on
experts to testify about an operation that would cost
about $20,000.
The duration and
expense of the case have outraged some lawmakers who
insist that taxpayers should not have to pay for inmates to
have surgery that most private insurers reject as
elective.
''They are
prisoners. They are there because they've broken the law,''
said Republican state senator Scott Brown, who introduced a
bill to ban sex-change surgery for inmates, which
ultimately did not pass. ''Other folks, people who
want to get these types of surgeries, they have to go
through their insurance carrier or save up for it and do it
independently. Yet if you are in prison, you can do it for
nothing? That doesn't make a lot of sense.''
But advocates say
in some cases, such as that of Kosilek, who has twice
attempted suicide, sex-change surgery is as much a medical
necessity as treatment for diabetes or high blood
pressure.
''The duty
belongs to the prison to figure out how to fulfill its
constitutional obligations to both provide adequate medical
care and provide a fundamental security for all
inmates,'' said Cole Thaler, an attorney with Lambda
Legal, a gay and transgender rights group.
Kosilek, 58, was
convicted of strangling his wife in 1990. He claimed he
killed her in self-defense after she spilled boiling tea on
his genitals.
Robert Kosilek
legally changed his name to Michelle in 1993 and has sued
the correction department twice, arguing that its refusal to
allow a sex-change operation violates the Eighth
Amendment protection against cruel and unusual
punishment.
In 2002, U.S.
district judge Mark Wolf ruled that Kosilek was entitled to
medical treatment for gender identity disorder but stopped
short of ordering the surgery. Kosilek sued again in
2005, arguing that the hormone treatments, laser hair
removal, and psychotherapy she has received since
Wolf's ruling have not relieved her anxiety and
depression.
''I would not
want to continue existing like this,'' Kosilek testified.
Kosilek's second
trial, which began in May 2006, has featured expert
testimony from 10 doctors, psychiatrists, and
psychotherapists. Wolf has not indicated when he will
rule.
The correction
department has spent about $33,000 on two experts it
retained to evaluate Kosilek. Both Cynthia Osborne, a
Baltimore psychotherapist, and Chester Schmidt, a
psychiatry professor at Johns Hopkins University, said
Kosilek does not need the surgery. Schmidt's fee alone
was $350 per hour.
Two other doctors
retained and paid for by the department's outside
health provider, the University of Massachusetts
Correctional Health Program, at a cost of just under
$19,000 said they believe the surgery is medically
necessary for Kosilek. Two other doctors who work for the
health provider agreed with that.
In addition, two
psychiatrists who testified for Kosilek recommended the
surgery. A Boston law firm representing Kosilek for free
paid for those experts but would not disclose the
cost.
In Wisconsin five
inmates sued after that state's legislature passed
a law that bans correction department funding for hormone
treatments or sex-change surgery. The case is expected
to go to trial in October.
Those who argue
against allowing the surgery say it could open the
floodgates to other inmates who want sex-change operations
or other treatments considered elective.
In Massachusetts,
10 inmates have been diagnosed with gender identity
disorder and are receiving hormone treatments. Two other
inmates besides Kosilek have asked for sex-change
surgery.
Corrections
officials say their decision to deny the surgery has nothing
to do with costs or the politics of crime. They cite the
testimony of their experts and Kosilek herself that
her feelings of depression have diminished since she
began taking hormones.
Former
commissioner Kathleen Dennehy testified that allowing
Kosilek to complete the transformation into a woman
would present a security problem. Whether she stays in
a men's prison or is transferred to a women's prison,
she could become a target for sexual assault, Dennehy
testified.
Dennehy also said
prison officials cannot be influenced by Kosilek's talk
of suicide.
''The department
does not negotiate or respond to threats of harm or
suicide in an effort to barter,'' she said. ''You couldn't
run a prison with that kind of leveraging going on.''
(AP)