The 9th Circuit Court of Appeals heard oral arguments in San Francisco Thursday in the case of transgender inmate in Idaho Adree Edmo, who sued to get sex reassignment surgery. A lower court judge ruled in her favor, but the state of Idaho appealed that decision.
This case hinges on Edmo proving that prison health care providers were being deliberately indifferent to her medical needs in denying her the surgery, and much of Thursday’s hearing was focused on that issue. Under the Eighth Amendment of the Constitution, such indifference would constitute cruel and unusual punishment.
In 2012 prison providers diagnosed Edmo with gender dysphoria — a condition where a person’s outward appearance of gender doesn’t align with their mental and emotional state.
State of Idaho attorney Brady Hall argues that there is medical disagreement about the treatment for gender dysphoria.
“Such a disagreement does not constitute deliberate indifference,” Hall says.
But Edmo’s attorney Lori Rifkin argues that, despite hormone treatment for gender dysphoria, Edmo has twice tried to castrate herself.
“Defendants have offered her zero additional treatment after either of those attempts,” Rifkin says. “They have ignored generally accepted medical standards, despite her actual harm.”
The defendants in the case are Idaho Department of Correction and Corizon Inc., the private health care company that contracts with the state to provide medical care to inmates.
Corizon attorney Dylan Eaton defended the state psychiatrist who evaluated Edmo.
“Dr. Eilason was not deliberately indifferent because he individually assessed Ms. Edmo for gender confirmation surgery,” he says. “He ultimately determined that she needed to stay on hormone therapy and continue counseling at that time.”
University of California-Davis law professor Courtney Joslin watched the oral arguments. She says the 9th Circuit judges seemed to understand the severity of Edmo’s gender dysphoria.
“The court did appreciate how much suffering she is experiencing every day as the result of the denial of this medically necessary treatment,” says Joslin. She says that’s an important aspect of the constitutional analysis that the court has to take into account in this case.
Some of the questions from the panel of three judges were about the responsibility of the individual medical providers named in the suit.
“What about the fact that some of these state officials in Idaho don’t seem to have been operating under evil intent?” asked Judge Robert S. Lasnik. "What about the fact that these seem to be officials who are trying to make the best of a very difficult situation?”
Each side had about 20 minutes for oral arguments before the 9th Circuit on Thursday. The judges also seemed to suggest that they may request additional attorney briefs before ruling.
The U.S. District Judge’s order requiring the state to provide the surgery is stayed until the 9th Circuit reaches a decision.
If Edmo prevails in the 9th Circuit, she’d become the first inmate in the nation to receive gender confirmation surgery through court order.
This story was produced by the Mountain West News Bureau, a collaboration between Wyoming Public Media, Boise State Public Radio in Idaho, KUER in Salt Lake City, KUNR in Nevada, and KRCC and KUNC in Colorado.
Copyright 2019 Boise State Public Radio
Find reporter Amanda Peacher on Twitter @amandapeacher.