Publication Date



In December of 2014, the First Circuit Court of Appeals
held, en banc, that the Massachusetts Department of
Corrections was not constitutionally obligated to provide
Michelle Kosilek, a transgender prisoner, with sexual
reassignment surgery. Kosilek sued the prison, arguing
that her Eighth Amendment rights against cruel and
unusual punishment were violated. The First Circuit held
that Kosilek did not have a serious medical need, due to
the prison's alternative treatment, and that the prison was
not deliberately indifferent to that need. This Note argues
that the First Circuit erred in applying the "serious
medical need" prong of the cruel and unusual punishment
standard by ignoring the transgender medical
community's general acceptance of sexual reassignment
surgery as a medically necessary procedure in cases of
severe gender dysphoria. Specifically, the World
Professional Association for Transgender Health
Standards, the United States Tax Court, Medicare,
Medicaid, and private medical insurance companies have
all recognized, in some capacity, that sexual reassignment
surgery can be medically necessary for persons with severe
gender dysphoria