Content area
Full Text
I. INTRODUCTION
Developed and organized along a strict gender binary assumption, the United States prison system network is arguably the single most sexually segregated institution in the United States.1 Contextualized by this rigidly classified system, transsexual prisoners face unique challenges both within correctional facilities and in America's courts. In recent decades, transsexual prisoners have become a significant subpopulation in U.S. prisons,2 and many transsexual prisoners have challenged prison conditions through a series of lawsuits, primarily by bringing Eighth Amendment claims for access to transition-related healthcare. Several of these lawsuits represent landmark victories in defining the scope of prisoners' right to health care as applied to transsexual prisoners. Of these landmark suits, Kosilek v. Spencer3 most widely expands the scope of what a federal court may consider a "serious medical need" under the Eighth Amendment. At first blush, Kosilek appears to open the door for some transsexual prisoners t o receive sex reassignment surgery. However, this Note explores the ambiguities of Kosilek and discusses the control that departments of correction (DOCs) retain, post -Kosilek, in providing transitional surgeries such as facial feminization and sex reassig nment surgeries. The United States District Court for the District of Massachusetts was the first court in the country to order a DOC to provide sex reassignment surgery to a transsexual inmate; the Massachusetts DOC therefore has no case law directly on p oint to inform it of the scope of its duties under the ruling. Nevertheless, this Note argues the Massachusetts DOC's duty, post -Kosilek, may be determined through the Eighth Amendment jurisprudence that concerns a prisoner's access to other unique medical treatments and surgeries, as well as through the body of case law on delayed provision of medical treatment.
Part I provides some background on transgenderism and the extent to which the medical and legal communities have recognized transsexualism. This s ection describes the American Psychiatric Association's (APA) controversial, but crucial, classification of transsexualism as a medical condition, and the standardized treatment methods. This section also discusses the incarceration experience for transsexual prisoners. Part II relates the United States Supreme Court's Eighth Amendment jurisprudence, particularly as it applies to prisoners' medical needs. In addition to discussing the background of the Eighth Amendment, this section describes the various requirements a...