California's corrections department must provide a transgender inmate with sex reassignment surgery, a federal judge ruled yesterday. It marks the first time such an operation has been ordered in the state and just the second time nationwide that a judge has issued an injunction directing a state prison system to provide the surgery. US District Judge Jon Tigar ruled that denying the surgery to 51-year-old Michelle-Lael Norsworthy—birth name Jeffrey Bryan Norsworthy—violates her constitutional rights. Norsworthy, who was convicted of murder, has lived as a woman since the 1990s and has what Tigar termed severe gender dysphoria—a condition that occurs when people's gender at birth is contrary to the way they identify themselves.
A prison medical care spokeswoman says it's not known how much the surgery would cost, but it could run as high as $100,000. The Transgender Law Center called the estimate "a gross exaggeration" and said Medi-Cal, California's health care program for low-income residents, has covered the procedure for years. Corrections officials argued that Norsworthy has received proper medical and mental health care for more than 15 years and is in no immediate medical danger if the surgery isn't performed. And the sex change surgery would prompt practical problems, the CDCR says: Keeping Norsworthy in the all-men's prison could invite violence, including possible assault and rape. But she could also face danger at a women's prison—or pose a threat herself—because she had a history of domestic violence before her murder conviction, the department adds. CDCR officials say they're considering an appeal.