Virginia inmate Ophelia De’lonta lives in an all-male prison facility but she takes female hormones, wears a woman’s prison uniform, has everyone address her by her proper gender, and gets psychotherapy to help with her transitioning. But the guards don’t allow her to grow out her salt-and-pepper hair and she knew that the state prison system would never pay for her a sex change operation, so she tried cutting off her penis using three disposable razors from the prison commissary. She ended up in the hospital infirmary and got 21 stitches to keep herself together. Now she’s suing the state in federal court, saying that the state is denying her a medical necessity. But her prospects for victory look bleak.
Jezebel writer Margaret Hartmann says:
Another transgender inmate filed a similar lawsuit in California, and a lawyer for the prison health system argued, “A prison is not required by law to give a prisoner medical care that is as good as he would receive if he were a free person, let alone an affluent free person.” And in response to De’lonta’s lawsuit, Virginia Del. Todd Gilbert says, “The notion that taxpayers are going to fund a sex change is just ridiculous.”
But the ostensible fiscal conservatism of these statements may disguise transphobia. Paying for gender reassignment is only “ridiculous” if you regard the surgery as illegitimate or unnecessary, and De’lonta’s disturbing self-injury reveals how very necessary it can be… State governments need to stop thinking of gender reassignment as a luxury, and recognize that for some, it can be a matter of life and death.
Ignorance of how to appropriately handle trans inmates has caused problems for transfolk: a Sydney prison put a suicidal MTF inmate in an all-male facility. Another isolated an MTF prisoner rather than house her with women because of her male genitalia. Then there’s the question of what trans surgeries to approve—genital reassignment, possibly, but how about hair removal?
Of course Italy, Germany and the UK have come up with progressive ways to make prison life more tolerable for trans inmates, but when will the US catch up?
How about we take this to the next level?
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Alex
Unfortunately I had the pleasure of reading this article first on Yahoo News. The comments on their news articles are generally a good indication of public sentiment, although one must filter out the obvious psycho nutjobs. Almost all of the comments for this story were trans-phobic at best and grotesque at worst. It really disappointed me. We seem to be making progress for gay folks but not bringing transgendered people with us. The prison officials, while definitely not known for their smarts, are sticking their heads in the sand in this case. Honestly, who would think it’s a good idea to keep a MTF person among the general male prison population?
Devington
Sorry, no sympathy from me. Prison is supposed to be a bad place for bad people, if the poor little incarcerated tranny is miserable, good. Maybe you should’ve thought of that before you got yourself locked up. Taxpayer money shouldn’t be going to fund some inmate’s cosmetic surgery. It’s a prison, not a Hilton.
Dr. Dick
@Devington: @Devington:
LOL wow,
how bloody buggering IGNORANT did you just make yourself sound?!?
Prisons waste gov’t + taxpayer money housing a large percentage of non-violent offenders who really need rehabilitation from drug additcion and psycholgical treatment.
By your own admission, prisons should “be bad places for bad people”,
like unsympathetic, generalizing ASSHOLES (ie. YOU).
sheesh, you’d think I was talking to a buncha smug, entitled, wealthy white pseudo-conservatives…..
oh wait! I am
Dr. Dick
@Devington: OMG ROFL, I totally forgot, “cosmetic surgery”??????? G A W D you’re stoopid.
I wish people like you would line up to jump off of bridges, instead of Tyler Clementi’s, et al.
hesmine
Where is the outcry for the victims of the crimes this inmate committed. This inmate’s felonies likely inflicted deep psychological wounds that for many never heal. I agree that prisoners must be treated in a humane way, but I also hold the belief that offenders of violent crimes should be punished. This prisoner’s cry for sympathy falls on deaf ears for me. I am more interested in if the victims of the offenses look over there shoulder every minute of everyday, do they still have nightmares and flashbacks, are they distrustful of everything and everyone, or if they will ever truly feel safe again. I fully support using taxpayer funds for this prisoner’s GRS to provide support for the true victims.
missanthrope
@ hesmine
You’re not advocating justice, you’re advocating retribution.
Ginasf
@hesmine:
“This inmate’s felonies likely inflicted deep psychological wounds that for many never heal.”
You know what happens when we assume. Considering the race of the woman involved, there’s pretty much a 7 out of 10 chance this has to do with drugs (the vast majority of African American prisoners are incarcerated for drug-related offenses). And because she’s a trans woman, there’s at least the very least a 2 out of 10 chance she’s in the slammer for some aspect of sex work. No, I don’t know why she’s incarcerated any more than you do, but at least I have statistical probability on my side… you just seem to be pulling your “facts” out of your bottom.
hesmine
@missanthrope
A felony prison sentence serves many purposes. Removal of a menace to protect society tops the list. Deterrence and rehabilitation are others, and debate rages on the effectiveness of either. There is no debate about one facet of incarceration. The act of surrendering one’s freedom to atone for heinous acts perpetrated against (wo)mankind is punitive. The word retribution evokes sinister imagery of vicious and sadistic treatment. However, as I stated earlier I condone civil treatment of all prisoners. The iota of compassion I feel escaped De’lonta during the commission of a crime that likely changed lives forever (not only the direct victim(s), but also the repercussions forced on their loved ones). So yes I advocate retribution, and note the very word is a synonym for justice. Contrition and remorse from this prisoner for harm visited unto a fellow human being is much more appropriate than playing the victim.
hesmine
@Ginasf
——-
No, I don’t know why she’s incarcerated any more than you do, but at least I have statistical probability on my side… you just seem to be pulling your “facts” out of your bottom.
——
Perhaps if you spared the two seconds to Google the fact the convictions are for robbery, drug and weapons possession you would know why. Robbery, whether committed with implicit or explicit force is a crime of violence. This is not statistical probability but a fact. There is no need to quote incarceration rates for African Americans. The debate over racism, transphobia, and marginalization and the effect they played on De’lonta turning to a life of crime and drugs ended with the violation of another human being. My sympathy goes out to the teller who went to work that day just to do their job. That victim’s right to not have their well being and security threatened was violated by this person.
This bears repeating “You know what happens when we assume.”
Matt_miami
If prisons did this type of surgery than they would have to also provide other elective surgeries. e.g. liposuction.
Shannon1981
@Devington: GID is a recognized medical condition. IT isn’t “cosmetic surgery.”
scott ny'er
It all stems on “Medically necessary.” And it is hard for me to think that this is similar to a tumour or cancer or even a hernia. I have to say… I have a hard enough time with prisoners getting cable tv and stuff that people who are not in prison can’t afford… so when I think of how much a surgery of this magnitude must cost… I’m not in favor of this.
Think about all the trans people who AREN’T in jail and can’t afford the operation and yet didn’t commit any crimes. What do they do? Do they try to castrate themselves? Do they get the state to pay for the operation?
Matt_miami
@Shannon1981: so is herion addiction but they are giving heroine to inmates.
If she could not afford the surgery before going into prison, than there is no reason to give it to her for free. because had she not gone to prison she would still be without the surgery. Had she not commited the crime she would be a free person still wanting SRS. Giving her the SRS would be rewarding her for commiting a crime.
If Fat people got free liposuction in prison would the sentiment of this board be the same?
Shannon1981
See, Matt, this is where straight people don’t what the hell they are talking about. Transitioning isn’t a choice. What you just said is completely insulting, comparing being trans to being fat. Good god, what a callous, heartless asshole enjoying your hetero privilege you are.
Shannon1981
Now, that I am done addressing ignorance, as too the matter at hand: no, she shouldn’t get the same surgery that other trans people can’t afford for free. She should receive hormones and be allowed to shave her legs,etc, and grow her hair. But GRS? Not until she can afford it on her own. Plenty of MTF folks live with penises, and plenty of FTM live with vaginas.
However, to compare transexxuality to obesity is just ridiculous. Just wow. Get some education before spewing verbal diarrhea about something you know nothing about.
TheRealAdam
@hesmine: Agreed.
Matt_miami
@Shannon1981: Really shannon? I thought we went over a lot of this stuff at the hangover 2 article. You should know that I am very trans friendly, so your statement is for this new audience and a new attempt to mount an attack. But I will fall for you tricks one more time and waste my time trying to unravel complicated issue so you will calm down.
GRS or SRS is not life threatening. Others on this board have tried to make the link that it is medically necessary for the state to provide this surgery. While others attempted to fight the fiscal aspects of this surgery, I brought up the moral hazard aspect. If you provide this surgery for one than you have created a legal precedent to provide it to all who need it. Once that has been established than any TS person whom cannot afford GRS or SRS(sorry the lingo changes weekly)can legally get it for free from the state if they are an inmate than you would see TS people commiting crimes to be sent to prison so they can claim there legally protect right to free SRS. It could then be easily argued that morbidly obese inmates have a medical need for liposuction surgery.
The obligation of the state is to maintain your health and attempt to rehabilitate the inmate while in the care of the state. It is the responsibility of the state to cause no harm to you during your prison sentence. there is no higher moral obligation to the prison system than there is to any hospital emergency room. meaning if you went to an emergency room with this condition would they treat you. If the answer is no, than neither should a prison.
The use of liposuction is a way to test the objectivity of the argument. To test the original theory with emotion and personal opinion removed. Liposuction is of an equally necessary medical procedure to obese people who cannot lose weight. Their personal identities are linked to their outward appearance. People stare and mock at the morbidly Obese.(More than a TS person, because they are harder to recognize) Obese people are also prejudged by their outward appearance. Isn’t the fat mans weight a life threatening condition. There can be many connection made between extremely obese people and transgender people if you just remove your own bias and prejudice. Once again the people that claim they want equality among all people are the first to take it away from someone else. remove the sexual component to obesity and the connections are obvious, even for you shanon.
Shannon I know your smart enough to understand my point, this moral outrage is not fooling anyone.
Shannon1981
@Matt_miami: You’re an arrogant prick. Trans/gay friendly doesn’t earn you a pass to the club. IMO you pass far too much judgement to be a straight man on a gay site. It isn’t moral outrage. And I’ve been overweight all my life, save when I was bulimic. I am also gender variant. Believe me, the gender variance is a lot more agonizing than being fat ever was. Apples to oranges. Don’t talk about what you do not understand.
Matt_miami
@Shannon1981: what judgement would that be Shannon. Any judgement I did make you agreed with. Your objection is me making an analogy to obese people having a similar claim to liposuction as TS people to SRS surgery. Than you claim to be Overweight yourself.
For your information Shannon your not Trans friendly. You mock and belittle your own kind. you bring up the issue of others not being a “true” transgender. You make reference to Psycho babble Benjamin Scales that are useless for the majority of transgenders. You make references to how being a transgender is not a choice but than claim someone is a “Fake TS” because they aren’t seeking psychological help for their condition. stop hating Shannon. It is obvious you are having a hard time with your own acceptance. so you act out where and when you can. I am not going to resort to name calling. But let me know where I have judged to much, because the only one in this conversation that has judged anyone has been you.
Ginasf
@hesmine:
She was sentenced to 70 years in prison at age 18. Did she physically hurt anyone… no. I don’t excuse her actions or what she did but until society actually accepts young gender variant kids… especially those from poor communities I’m not going to judge her either. People from poverty who have strong trans feelings have precious few options to deal with their intense situation… pretty much sell their bodies (which many do… and often die in the process) or, unfortunately, turn to crime like she did. It was absolutely the wrong choice but I also understand how crazy being gender dysphoric can make you.
You haven’t lived in her shoes so kindly stop being so smug and feeling superior.
Matt_miami
@Ginasf: If we are going to give free GRS to people, than lets start with people not in jail for the next 70 years. Lets reward people for doing good things not bad. 70 years is a life sentence. what does that say to the honest hard working tax paying TS individual who desperately needs this procedure and can’t get it and someone serving life in prison does.
it’s nice to have compassion, but lets agree that people serving life in prison are at the back of the line for free GRS.
hesmine
@Ginasf
Whether the age was 18 or 80, robbery is still a crime of violence. Many victims of violent crime physically heal, but the emotional wounds linger. It’s not mental mathematics to understand that my sympathy ends when subjugating a fellow citizen to violence. Please enlighten on exactly which one of those hardships grants the right to violate another human being’s sense of security. Does this apply across the board to all downtrodden people, or do we play the Oppression Olympics to determine who ‘wins’ the right to commit criminal acts with impunity? Where is the line drawn and who or what is fair game? Hetero couples who just met can, in a matter of minutes, form a union that has more legal standing than a loving same sex relationship of 50 years, is this fair? By your logic brandishing a weapon to terrorize and snatching their possessions is an acceptable response to this injustice, or one not worthy of passing judgement on? I can think of two instances where I would willingly commit a violent act on another person, self-defense and defense of others. I happily accept the smug with a superiority complex label for not wanting to harm an innocent person because ‘life’s s not fair and I got dealt a shitty hand’ or ‘I wanted to go to San Fran and get worked on’.
I am curious to know do you identify as much perpetrator of a violent act when the victim is gender variant? After all some of those folks are marginalized and without many options?
TheRealAdam
@Ginasf: It’s interesting that because someone expresses sympathy for the victim and ultimately condemns the perpetrator for breaking the law, that they are somehow “smug and feeling superior.” Really? What kind of lens is that through which to view a criminal, and the criminal justice system that ultimately put this trans person in her situation?
You can’t make exceptions for her simply because she is a double (or triple) minority. It’s fine that you understand “how crazy being gender dysphoric” can make a person, but that is not an excuse for withholding judgment from her simply because you empathize with her, and simply because society does not completely accept such individuals. And that is exactly what you are doing, and what you said you are not doing. So, you are contradicting yourself.
Shannon1981
@Matt_miami: I have NEVER made references to fake TS’s. You are confusing me with sweetbrandigirl and I demand an apology.
Shannon1981
@Matt_miami: As far as I am concerned you don’t know what you are talking about and you do not belong here. I have never referenced any sort of Benjamin Scale- in fact, I have railed sweetbrandigirl for her HBS Trolling many a day before you ever showed up here. Get your facts straight. Do not address me again until you apologize for telling lies about me.
redball
Eesh, what a story.
@Matt_miami:
“If she could not afford the surgery before going into prison, than there is no reason to give it to her for free. because had she not gone to prison she would still be without the surgery.”
By that logic, if someone could not afford primary health care before prison then they should not receive it while in prison. I don’t think that’s something most of us want to argue (I don’t, at least).
Like you said, it seems to hinge on what is “medically necessary.” Recent stories of trans people’s struggles (like Chaz Bono and others) with clinical depression, addictions, and other traumatic experiences tell me that GRS may be not only medically important but also necessary for some trans people (depending on how central it is to any one trans person’s gender expression).
So as far as I’m concerened the Jezebel writer above got it right.
Also: like Scott mentioned, you don’t hear about poor trans people outside of jail castrating themselves–so I would think that some serious mental health care is also in order for the woman of this article.
It’s heartening that some European countries have figured this out better than we have! So there is hope for us….
lemon-lime
@Shannon1981, @redball, @Matt_miami: I’m with Matt on this one. (Ironically I just posted on another article about Obama hating teh gays.) His argument is logically sound. His argument is that healthcare in the prison system should be, and is, in fact, limited to procedures which are either imminently life threatening or substantively hindering the inmates day-to-day ability to function.
I am, as I’m sure Matt is, very sympathetic to the realities that from a psychological perspective, the surgery is 100% required, but the truth is that in the United States, the system of Justice is very much built on the idea that jail terms are there as much as a deterrent for future crimes as to both rehabilitate and punish the offender. An apt analogy, since people are freaking out about the comparison to obesity, would be providing a neural implant to a deaf person instead of giving them a hearing aide. Too expensive. They are continuing to provide her with female hormones. She’s got her “hearing aide”. It’s not ideal, and the medical community can certainly offer her something much closer to an ideal reflection of her inner psyche, but that is not what prison is for, and Matt is 100% correct in saying that this creates a moral hazard. Giving her state-of-the-art medical treatment would not only nullify the deterrent, but would provide people with limited means an incentive to commit violent crimes in order to gain access to superior health care than the shitty US health system can provide its citizens.
This is not about whether GRS is medically necessary, it’s about whether it’s imminently necessary for physical health to be maintained.
——
I realize that she did try to get put in the right place, but I think the real issue here is that she’s stuck in a Men’s prison. This, to me, is unacceptable. If they characterize her hormone treatment as medically necessary for her mental well-being, put her in the damn Women’s facility already.
Shannon1981
@lemon-lime: Matt is dead to me until he acknowledges that he told gross lies about me, equating me with that transphobic HBS troll. Hes on here talking about shit he knows nothing about. My issue isn’t with the arguments at hand. Its with his condescending, prickish attitude that has carried through two articles now.
Matt_miami
@Shannon1981: Oh Sh@t. Your right Shannon I did confuse you with that self hating Brandi. i did make a mistake, if I could, i would go back an edit my previous posts to reflect the confusion. I hope we can move on together and find some common ground to work together without resorting to name calling. Shannon, if I removed your name and replaced it Bradi’s than everything I said about her would be true. I didn’t tell any gross lies about you, I told the true about someone else and mistook you for her.
there is a difference. For the confusion on my part I apologize for my mistake.
I still respect your right to be angry, but I respect your right to be happy, even more.
Shannon1981
@Matt_miami: Like I said in the hangover post…you’re a good guy. You mean well, but I kind of think…you dismiss our pain because you can’t fathom it, and that makes it hurt even more.
I’m sorry, but what have I got to be happy about again?
Matt_miami
@Shannon1981: Now that the confusion is over.
I have never said being transgender is a choice, neither did I say being fat is a choice.
We both agree that this inmate should not receive SRS. We both agree that the prison system is ill prepared to handle the issue of transgender inmates. I don’t see much difference in your opinion on this article and mine. We have come to basically the same conclusion using completely different life experience. Yet my conclusion is invalid in your opinion because i am not transgender.
People everyday are asked to and required to pass judgement on issue that they have little or no personal experience. Opinions that have grave consequences. It is Our legal system of justice and those people are called jurors. So Shannon, If i ever say something that is inaccurate or wrong, than please let me know. I can admit when I am wrong. But to continue to attack me on issues based solely on the fact that I am not a transgender and therefore have no idea what i am talking about is ignorant. My position has been from the state not the transgenders. I never commented on her, her condition, he state of mind, or her treatment. I only commented on the states legal responsibilities to this inmate and the moral hazard of providing SRS to inmates.
Matt_miami
@Shannon1981: I don’t believe I have ever dismissed your pain or any other transgenders pain. Every transgenders situation is extremely unique. I have erred on the side of caution and tried to avoid the issues of personal turmoil. For the exact reasons that you continue to point out about me. I truly hope that you can find some happiness and love in your life Shannon.
Shannon1981
@Matt_miami: I don’t think you mean to. But it sometimes comes across that way. Agree to disagree, as I cannot argue any further.
Matt_miami
@Shannon1981: It is understandable Shannon. In this new age of equality you cannot have an honest racial/gay discussion without someone being called a racist/homophobe. I do hope that we can continue with our honest debate, and i won’t mistake you for another again.
Ginasf
@redball: You not hearing about it means you and Scott aren’t in the community of trans women… I’ve heard of many trans women try to castrate themselves. Moreover, I’ve heard trans children trying to castrate themselves in various different ways. Google actress Aleshia Brevard and you’ll hear one such story. In a world where the overwhelming number of trans people have to pay for their medical care out of pocket and many if not most of those people are living low income lives, are marginalized and even self-medicating because of their intense depression of being gender dysphoric, there are many people who are desperate enough to try and do it themselves.
Maybe it sounds crazy to you but, can you admit you really don’t know what it’s like being born with genitalia that seem categorically wrong (and it’s true that not all people in the trans community feel that way… but many do) and how traumatic pubertal masculinization is for someone who feels intrinsically female. Try to remember how it felt being a closeted gay teen, multiply that times 10 and that’s what she’s likely gone through.
scott ny'er
@Ginasf: I’m glad you’re here to try and get the trans point across. But I still maintain that there are many things that people need in life (healthcare, housing, jobs) that they do not have access to… people who do not commit crimes and go to jail (for whatever the reason). So why should these hard working people not get the free operation, free jobs, free housing.
Life is not fair and it should not be better for those in jail versus those that aren’t. I’m sorry, I cannot abide those in jail getting things that those not in jail cannot get.
That said, using my argument, life isn’t fair… in all probability she’ll win her lawsuit and will get the operation. With taxpayer money.
Oh and this is to whomever mentioned that jail is a place to rehabilitate prisoners. Sadly, I think most of the time the opposite is true and they come out hardened, tougher, bigger, stronger and commit more crimes. Prison is a complicated issue.
Jaime Renee
While I feel for her, I’m not too keen on anyone getting surgery that many of us can’t afford to get while we’re obeying the law and staying out of trouble. I’ve spent time in the hospital after trying to take matters into my own hands as well many years ago, I had to pay for that too. I work hard, try to do what’s right and I can’t get surgery until I can pay for it myself, so why should she be able to get it with taxpayer money while being punished for crimes committed?
redball
@Ginasf: Great points! And, yes, my ignorance re: stories of trans women self-castrating reflects the limitations of the news that I usually watch and read. Thank you for educating me.
redball
@lemon-lime: I just saw your post now and I think I agree. In the end, a lot of these problems have origins in US transphobia and lack of access to affordable quality health care for the poor (among many other issues).
Cj M
@hesmine: I like how you assume violence. Possession of most pharmaceuticals and illicit drugs ALSO count as felonies. Simple possesion of a *straw* used to do cocaine is a felony.@scott ny’er: Yes, you entitled fuck,sometimes we DO castrate ourselves. By questioning the validity of THIS woman’s condition, you sully the validity of suzy q. whitebread-who-never-broke-one-law’s condition.
Look, I’m not even sure i think that the prison system should have to provide SRS. As a transwoman, (Hey hey, @Matt_miami ) I think just about the worst thing that could ever happen to me is to be incarcerated, so it’s hard for me to really even consider the ramifications. Also, that little theory about all the transsxeual blogs telling you how to get the right sentence to get srs is…well that’s just stupid and ridiculous. I’m agog you’d even say something so staggeringly moronic.
What i do know is that by making this debate about the validity of a medical diagnosis, we are reducing the most painful, agonizing, and ultimately self-affirming thing that innumerable LAW-ABIDING transwomen will ever do to…cosmetic surgery? That really sticks in my craw. Just because THIS woman is guilty of violent crimes, we decide that ALL transpeople are just going to get a little work done, ho-hum?
Trust me, you have NO idea. And the agony begins LONG before the scalpel touches skin.
Perhaps yuppie entitled sons of the patriarchy should keep their mouths shut when they know naught of what they speak. But if that was true, most elected officials would be mute…
Maybe i’m onto something.
Matt_miami
@Cj M: Here is a link. http://news.yahoo.com/s/yblog_thelookout/20110621/ts_yblog_thelookout/man-robs-bank-to-get-medical-care-in-jail
Some people who need medical care but can’t afford it go to the emergency room. Others just hope they’ll get better. James Richard Verone robbed a bank.
Earlier this month, Verone (pictured), a 59-year-old convenience store clerk, walked into a Gaston, N.C., bank and handed the cashier a note demanding $1 and medical attention. Then he waited calmly for police to show up.
He’s now in jail and has an appointment with a doctor this week.
Because he only asked for $1, Verone was charged with larceny, not bank robbery. But he said that if his punishment isn’t severe enough, he plans to tell the judge that he’ll do it again. His $100,000 bond has been reduced to $2,000, but he says he doesn’t plan to pay it.
He’s already seen some nurses and is scheduled to see a doctor on Friday. He said he’s hoping to receive back and foot surgery, and get the protrusion on his chest treated. Then he plans to spend a few years in jail, before getting out in time to collect Social Security and move to the beach
I know some people may think that my ideas are moronic but there are not too far from reality. Start giving free SRS to transgenders in jail and this could be a reality.
I do think that hormone treatment should have been an option for this inmate. I do think the state failed in protecting this person from herself. It is sad that this still happens today, prisons should have programs implemented for these types of prisoners.
Destiny
(Bear in mind- I have lived with a transgedered person, I have multiple friends who are transgendered, some who HAVE had the surgery and some who have NOT. ) My argument for being against such a surgery IN THIS CASE- I know people who have gone through it. It is a multi-year process, with doctors, psychologists, therapists, hormonal treatments, cosmetic treatments(hair removal, shaving Adam’s apple, minor facial reconstruction) I’ve SEEN what my friends have gone through-and THEY PAID FOR IT THEMSELVES. NONE of them were on any type of insurance that would cover these procedures OR the SRS itself.
One thing that a dear friend of mine was told.”You will not qualify, now or at any other time because you have attempted to harm yourself, you have been hospitalized for psychological issues and are therefore too unstable to have the procedure.” Self-mutilation, in other words, was WHY she was hospitalized- she tried to do precisely what this prisoner did-remove her penis- but in the confines of her own home.
These steps that a person undergoing SRS has to undergo- whether I agree or not- are for their protection. It gives the person ample time to be CERTAIN.
Aside from the emotionally/mentally stable aspect- one requirement for SRS is the ability to live as the selected gender for at least one year. For obvious reasons- this person in Virgina cannot do so. Any attempt to try -I expect to hear she has died from injuries sustained in sexual assaults.
Yes- I’ve seen both sides of the fence. This person is in jail because she committed felonies,(and yes- I Will try to use appropriate pronouns) I simply do not see how the SRS falls under “appropriate medical treatment”