This week, following two landmark cases brought by Transgender Law Center, California became the first state in the country to adopt a policy for transgender people in prison to access gender-affirming surgery. The policy, which took effect Tuesday, sets criteria for transgender people in prison to access care, including a determination of medical necessity by medical and mental health professionals.

“By adopting this groundbreaking policy, California has set a model for the rest of the country and ensured transgender people in prison can access life-saving care when they need it,” said Kris Hayashi, Executive Director of Transgender Law Center, which represents two transgender women who sued the state after being denied the medical care they needed. “This is a huge and critical step at a time when transgender people, and particularly transgender people of color, are incarcerated at shockingly high rates. With this policy, California is sending a message that reaches beyond the prison system, telling transgender people that our lives, needs, and identities are as valid as anyone else’s.”

“I suffered for decades as my identity, my medical needs, and my very humanity were denied by the people and system responsible for my care,” said Michelle Norsworthy, one of the transgender women whose cases anticipated this week’s announcement. “I am beyond proud to have been part of the movement to make this policy happen, and I know it will change and save the lives of so many women still fighting for survival in men’s prisons.”

In April 2014, Transgender Law Center won a historic preliminary injunction for Michelle Norsworthy, ordering the state to provide her with “adequate medical care,” including surgery, “as promptly as possible.” Although the state appealed this decision and released Michelle on parole before the appeal could be heard, the case of another prisoner represented by Transgender Law Center, Shiloh Quine, moved forward. The state settled with Shiloh in August, agreeing to provide her with gender-affirming surgery and to move her to a women’s facility. Shiloh will be the first transgender woman to access gender-affirming surgery while incarcerated.

“We are thrilled that our work with Michelle and Shiloh brought about this historic change in California prison policy, and Transgender Law Center looks forward to working with the California Department of Corrections and Rehabilitation to ensure transgender people in prison aren’t denied medical care, commissary items, or safe housing just because of who they are,” said Flor Bermudez, Transgender Law Center’s Detention Project Director. “There are absolutely some details, such as compliance with the Prison Rape Elimination Act and the qualifications of the experts making the assessment, which require more work and consideration, and we hope to continue that discussion with CDCR.”

The full policy is available below.


Transgender Law Center changes law, policy, and attitudes so that all people can live safely, authentically, and free from discrimination regardless of their gender identity or expression.

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