Federal Judge Orders State to Pay for Sex Change

[Symmetry]

Surely the state has made a decision to defer to the doctors it employs as to what is or isn't necessary. If an illness of any kind is politically unsavoury to the politicos in charge, should it go untreated when diagnosed and treatment is recommended?

The state already has an obligation to pay for medical treatment of those that it imprisons. The deciders of what or what isn't proper medical treatment shouldn't depend on politicians, but on medical diagnosis by medical professionals.

Why?

Why what?

Do you object to the state paying for the medical expenses of its prisoners? The alternative is a gulag.

Or do you object to medical professionals deciding what is or isn't medically necessary?

The issue is not whether the prisoner gets treatment. The issue is whether the state pays for the treatment. I think the government is fully able to and should be fully able to determine whether it must pay for the treatment, whether the doctor says it's necessary or not.

That seems like a rather disturbing principle. Essentially you're saying that medical diagnoses should be left to popular consensus rather than medical expertise with regards to implementation.

The issue, of course, is whether the prisoner gets treatment.

[jimboston]

blah, blah, blah

Why?

Why what?

Why did you bump this topic when it was essentially dead?

Why have you not answered Jim's question? Are you afraid?

[thegreekdog]

Surely the state has made a decision to defer to the doctors it employs as to what is or isn't necessary. If an illness of any kind is politically unsavoury to the politicos in charge, should it go untreated when diagnosed and treatment is recommended?

The state already has an obligation to pay for medical treatment of those that it imprisons. The deciders of what or what isn't proper medical treatment shouldn't depend on politicians, but on medical diagnosis by medical professionals.

Why?

Why what?

Do you object to the state paying for the medical expenses of its prisoners? The alternative is a gulag.

Or do you object to medical professionals deciding what is or isn't medically necessary?

The issue is not whether the prisoner gets treatment. The issue is whether the state pays for the treatment. I think the government is fully able to and should be fully able to determine whether it must pay for the treatment, whether the doctor says it's necessary or not.

That seems like a rather disturbing principle. Essentially you're saying that medical diagnoses should be left to popular consensus rather than medical expertise with regards to implementation.

The issue, of course, is whether the prisoner gets treatment.

I wish you would stop framing the issue as one about who gets to make the diagnosis when I've already indicated multiple times that this is not the issue. The doctor absolutely should make the diagnosis. I'm certainly not suggesting that anyone other than the doctor should make the diagnosis. The issue is not whether the prisoner gets treatment. The prisoner could be diagnosed with a brain tumor by a doctor; the prisoner should have it operated on. The question then becomes who should pay for it. Does the patient pay for it? Does the doctor pay for it? Does the state pay for it? States make determinations as to who gets what money on a daily basis. I'm fairly sure you're familiar with how that works, so I'm struggling as to why this is so difficult for you to grasp right now.

[BigBallinStalin]

Because he doesn't want to argue about government provision v. not government provision?

[thegreekdog]

Because he doesn't want to argue about government provision v. not government provision?

WHAT? Are you saying he would prefer to argue about the propriety of perscribing sex change operations in general rather than the government paying for something? Is that what you're saying? I would never believe that of Symmetry! Of all people!

[PLAYER57832]

Surely the state has made a decision to defer to the doctors it employs as to what is or isn't necessary. If an illness of any kind is politically unsavoury to the politicos in charge, should it go untreated when diagnosed and treatment is recommended?

The state already has an obligation to pay for medical treatment of those that it imprisons. The deciders of what or what isn't proper medical treatment shouldn't depend on politicians, but on medical diagnosis by medical professionals.

Why?

Why what?

Do you object to the state paying for the medical expenses of its prisoners? The alternative is a gulag.

Or do you object to medical professionals deciding what is or isn't medically necessary?

The issue is not whether the prisoner gets treatment. The issue is whether the state pays for the treatment. I think the government is fully able to and should be fully able to determine whether it must pay for the treatment, whether the doctor says it's necessary or not.

That seems like a rather disturbing principle. Essentially you're saying that medical diagnoses should be left to popular consensus rather than medical expertise with regards to implementation.

The issue, of course, is whether the prisoner gets treatment.

I wish you would stop framing the issue as one about who gets to make the diagnosis when I've already indicated multiple times that this is not the issue. The doctor absolutely should make the diagnosis. I'm certainly not suggesting that anyone other than the doctor should make the diagnosis. The issue is not whether the prisoner gets treatment. The prisoner could be diagnosed with a brain tumor by a doctor; the prisoner should have it operated on. The question then becomes who should pay for it. Does the patient pay for it? Does the doctor pay for it? Does the state pay for it? States make determinations as to who gets what money on a daily basis. I'm fairly sure you're familiar with how that works, so I'm struggling as to why this is so difficult for you to grasp right now.

Except, in today's world, you cannot really seperate those two.

The law is that prisoners, being held by the state and essentially "in our care" should get what is considered humane treatment, which has also been ruled to include what doctors consider mandatory. This was not one rule, it was a series of rulings.. I am summarizing. I think you have better access than I to the original briefs should you wish to review them.

Anyway, all that was established already. The sole issue the judge had to rule upon was whether this particular procedure met those criteria. The judge felt It did. The doctor ruled it a necessity, and other rulings dictated that the state has to pay necessary care for prisoners. (Jimbo -- Whether the judge liked the rule, the judge's personal opinion on transgender treatment or even payment of advanced prisoner medical treatments was irrelevant. The prior rulings directed his current assessment of what the law dictated.)

That is why I interjected my assertion way back.. that the law itself needs to be changed. I disagreed with Symmetry in that I think we not only can, but must set reasonable limits, because we plain cannot afford to just pay for everything, even those deemed medically necessary -- we cannot do so for free, working and tax paying citizens, never mind convicted murderers.

Off hand, I think we need independent boards to go over standards of care for prisoners.. for all areas of society, to be honest. It should include doctors involved with the populations (in this case prisoner's doctors, though perhaps retired or folks in other states), as well as ethicists, "budget" types, and yes... legal experts. However, seems like the last time such was mentioned, it was condemned as "death panels". Folks get hyped up and hysterical about limiting care, (unless its the "A" bit of course.. ironic, that.. but that is for other threads).

However, one thing we DON'T need is to have judges have to cater to every last whim of special interests. Judges should rule on the law. Whether that rule is popular or not is irrelevant.

[john9blue]

if you believe that the state should pay for psychiatric rehabilitation of criminals, then it's not unreasonable to believe that the state should pay for this procedure, provided that it can be proven that it can actually lead to rehabilitation.

[Funkyterrance]

Except, in today's world, you cannot really seperate those two.

The law is that prisoners, being held by the state and essentially "in our care" should get what is considered humane treatment, which has also been ruled to include what doctors consider mandatory. This was not one rule, it was a series of rulings.. I am summarizing. I think you have better access than I to the original briefs should you wish to review them.

Anyway, all that was established already. The sole issue the judge had to rule upon was whether this particular procedure met those criteria. The judge felt It did. The doctor ruled it a necessity, and other rulings dictated that the state has to pay necessary care for prisoners. (Jimbo -- Whether the judge liked the rule, the judge's personal opinion on transgender treatment or even payment of advanced prisoner medical treatments was irrelevant. The prior rulings directed his current assessment of what the law dictated.)

That is why I interjected my assertion way back.. that the law itself needs to be changed. I disagreed with Symmetry in that I think we not only can, but must set reasonable limits, because we plain cannot afford to just pay for everything, even those deemed medically necessary -- we cannot do so for free, working and tax paying citizens, never mind convicted murderers.

Off hand, I think we need independent boards to go over standards of care for prisoners.. for all areas of society, to be honest. It should include doctors involved with the populations (in this case prisoner's doctors, though perhaps retired or folks in other states), as well as ethicists, "budget" types, and yes... legal experts. However, seems like the last time such was mentioned, it was condemned as "death panels". Folks get hyped up and hysterical about limiting care, (unless its the "A" bit of course.. ironic, that.. but that is for other threads).

However, one thing we DON'T need is to have judges have to cater to every last whim of special interests. Judges should rule on the law. Whether that rule is popular or not is irrelevant.

Thank you, PLAYER.
I completely agree with your statement and it more succinctly addresses what I was alluding to earlier: the creation of this thread and it's original premise can be reduced to symptoms of "kicking the dog" syndrome.

[Symmetry]

if you believe that the state should pay for psychiatric rehabilitation of criminals, then it's not unreasonable to believe that the state should pay for this procedure, provided that it can be proven that it can actually lead to rehabilitation.

Well put, medical treatment for any number of psychiatric problems are important- say schizophrenia, for example. It's worth noting that in the case provided by the OP part of the motivation for the murder was gender-disassociation. That doesn't justify the murder, not at all, but treatment for it would surely be part of the rehabilitation process.

Aside from that, I still believe that the state has a responsibility for medical care of those it takes custody of. Giving the state the right to imprison a person is closely tied to a responsibility of proper care beyond simple rehabilitation.

[jimboston]

Updates...

1) The judge has ordered the State to pay for this guy's electrolysis (per doctor review / expert review).

2) The judge has announced he's retiring (going part time I guess)... but it has NOTHING to do with this case.

[Funkyterrance]

Updates...

1) The judge has ordered the State to pay for this guy's electrolysis (per doctor review / expert review).

2) The judge has announced he's retiring (going part time I guess)... but it has NOTHING to do with this case.

Well, like player pointed out, we can't just be ok with a system until something like this comes up which rubs us the wrong way and affects our personal sensibilities. There is a system in place and this case is just one product of that system, perhaps a necessary evil, but for all intensive purposes, a just ruling. If the judge is semi-retiring because of heat from this issue it doesn't necessarily mean he did the wrong thing, given the letter of the law. It appears he was just doing his job. He is a scapegoat, which is never a valid situation.

[jimboston]

Updates...

1) The judge has ordered the State to pay for this guy's electrolysis (per doctor review / expert review).

2) The judge has announced he's retiring (going part time I guess)... but it has NOTHING to do with this case.

Well, like player pointed out, we can't just be ok with a system until something like this comes up which rubs us the wrong way and affects our personal sensibilities. There is a system in place and this case is just one product of that system, perhaps a necessary evil, but for all intensive purposes, a just ruling. If the judge is semi-retiring because of heat from this issue it doesn't necessarily mean he did the wrong thing, given the letter of the law. It appears he was just doing his job. He is a scapegoat, which is never a valid situation.

If Player did point this out it was buried in 1000 words of other crap, so I never read it.

I am not and haven't been "OK" with the system. Just that more often life gets in the way, and it takes something extraordinarily ridiculous to raise my ire... and the ire of the "silent majority".

Also... it's just YOUR opinion that the judge made the right ruling. Just because that was his ruling... it DOES NOT mean it was the RIGHT ruling. He's a human being and certainly capable of making mistakes.

[jimboston]

Oh... and please note how in my poll I jokingly suggested that laser hair removal would be the next "medical necessity" dictated by the courts.

It's sad that my joke turned out to be a reality.

So let me ask... if this man is converted into a woman via hormones and surgery... and then we (the taxpayers) are asked to also foot the bill for his/her laser hair removal.

Should we not also pay for the laser hair removals for hirsute women in the general population?

[Funkyterrance]

Oh... and please note how in my poll I jokingly suggested that laser hair removal would be the next "medical necessity" dictated by the courts.

It's sad that my joke turned out to be a reality.

So let me ask... if this man is converted into a woman via hormones and surgery... and then we (the taxpayers) are asked to also foot the bill for his/her laser hair removal.

Should we not also pay for the laser hair removals for hirsute women in the general population?

Also... it's just YOUR opinion that the judge made the right ruling. Just because that was his ruling... it DOES NOT mean it was the RIGHT ruling. He's a human being and certainly capable of making mistakes.

Well, I'm feeling a bit of deja-vu but IMO it most likely was the right ruling since he is an appointed judge and it stands to reason he has a pretty firm grasp of the law. He's got the credentials. Is he being investigated for incompetency?
Jim, I have to say that I don't know for certain whether or not the ruling was "fair", all things considered, but I do think that it was just. People go to jail who are innocent but this doesn't mean that in a court of law they were treated unfairly. It's an imperfect system of course but it's the best we have until we change it. I personally agree with you that an inmate getting laser hair removal surgery is really pushing the proverbial envelope but I don't think our opinions about this specific case are the issue.

[thegreekdog]

Oh... and please note how in my poll I jokingly suggested that laser hair removal would be the next "medical necessity" dictated by the courts.

It's sad that my joke turned out to be a reality.

So let me ask... if this man is converted into a woman via hormones and surgery... and then we (the taxpayers) are asked to also foot the bill for his/her laser hair removal.

Should we not also pay for the laser hair removals for hirsute women in the general population?

Also... it's just YOUR opinion that the judge made the right ruling. Just because that was his ruling... it DOES NOT mean it was the RIGHT ruling. He's a human being and certainly capable of making mistakes.

Well, I'm feeling a bit of deja-vu but IMO it most likely was the right ruling since he is an appointed judge and it stands to reason he has a pretty firm grasp of the law. He's got the credentials. Is he being investigated for incompetency?
Jim, I have to say that I don't know for certain whether or not the ruling was "fair", all things considered, but I do think that it was just. People go to jail who are innocent but this doesn't mean that in a court of law they were treated unfairly. It's an imperfect system of course but it's the best we have until we change it. I personally agree with you that an inmate getting laser hair removal surgery is really pushing the proverbial envelope but I don't think our opinions about this specific case are the issue.

Are judges in Massachusetts elected or appointed? Either way, judges are fallible and not always qualified.

[jimboston]

Oh... and please note how in my poll I jokingly suggested that laser hair removal would be the next "medical necessity" dictated by the courts.

It's sad that my joke turned out to be a reality.

So let me ask... if this man is converted into a woman via hormones and surgery... and then we (the taxpayers) are asked to also foot the bill for his/her laser hair removal.

Should we not also pay for the laser hair removals for hirsute women in the general population?

Also... it's just YOUR opinion that the judge made the right ruling. Just because that was his ruling... it DOES NOT mean it was the RIGHT ruling. He's a human being and certainly capable of making mistakes.

Well, I'm feeling a bit of deja-vu but IMO it most likely was the right ruling since he is an appointed judge and it stands to reason he has a pretty firm grasp of the law. He's got the credentials. Is he being investigated for incompetency?
Jim, I have to say that I don't know for certain whether or not the ruling was "fair", all things considered, but I do think that it was just. People go to jail who are innocent but this doesn't mean that in a court of law they were treated unfairly. It's an imperfect system of course but it's the best we have until we change it. I personally agree with you that an inmate getting laser hair removal surgery is really pushing the proverbial envelope but I don't think our opinions about this specific case are the issue.

I didn't use the term "fair" or "unfair"... I said it was "WRONG".

You can go on believing that this judge MUST be correct because he has credentials etc.

I am sure we could put this case in front of many other judges in many other states and we would get a different ruling. I am sure not ALL judges would agree with this ONE judge's ruling.

You go on beliving power is always right.

I will go on believing he was wrong.

[jimboston]

Are judges in Massachusetts elected or appointed? Either way, judges are fallible and not always qualified.

Sad to say... but I believe I recall reading this ass was appointed by Reagan.

[Funkyterrance]

I didn't use the term "fair" or "unfair"... I said it was "WRONG".

You can go on believing that this judge MUST be correct because he has credentials etc.

I am sure we could put this case in front of many other judges in many other states and we would get a different ruling. I am sure not ALL judges would agree with this ONE judge's ruling.

You go on beliving power is always right.

I will go on believing he was wrong.

I don't think I ever wrote anything like that and I would appreciate if you post evidence when making accusations like that...
I'm not an anarchist though, that much I will admit to.
I think ignoring the entire system that lead to the deliberation is more or less avoiding the issue. Complaining and shouting your opinion has no weight whatsoever, at least in the mind of anyone else but you. You've got to be more elaborate if you expect anyone to understand where you are coming from or regard your opinion as anything but that.

[jimboston]

I didn't use the term "fair" or "unfair"... I said it was "WRONG".

You can go on believing that this judge MUST be correct because he has credentials etc.

I am sure we could put this case in front of many other judges in many other states and we would get a different ruling. I am sure not ALL judges would agree with this ONE judge's ruling.

You go on beliving power is always right.

I will go on believing he was wrong.

I don't think I ever wrote anything like that and I would appreciate if you post evidence when making accusations like that...
I'm not an anarchist though, that much I will admit to.
I think ignoring the entire system that lead to the deliberation is more or less avoiding the issue. Complaining and shouting your opinion has no weight whatsoever, at least in the mind of anyone else but you. You've got to be more elaborate if you expect anyone to understand where you are coming from or regard your opinion as anything but that.

Clearly I am expanding / slightly changing what you actually said... this is tradition and SOP here in these CC Forums.

I've articulated quite clearly why I am opposed to this BAD decision many times.

The short answer is that it is an expansion of the definition of what is/is not "cruel and unusual". I simple don't think it's "cruel and unusual" to NOT pay for someone else's sex change.

I am further opposed to this because I see a "slippery slope" in the recognition of this "condition" as something that is so awful it MUST be IMMEDIATELY corrected (and therefore paid for) by the Dept. of Corrections (DOC). As I explain earlier... I jokingly suggested that "if sex change operations were something the must pay for, what's next laser hair removal". Come to find out, my joke was prophetic, and the judge has now ordered that the DOC is responsible for laser hair removal.

So what will the DOC next be on the hook for???? Laser hair removal for any convicted woman who is a bit hirsute?

[Funkyterrance]

I am further opposed to this because I see a "slippery slope" in the recognition of this "condition" as something that is so awful it MUST be IMMEDIATELY corrected (and therefore paid for) by the Dept. of Corrections (DOC). As I explain earlier... I jokingly suggested that "if sex change operations were something the must pay for, what's next laser hair removal". Come to find out, my joke was prophetic, and the judge has now ordered that the DOC is responsible for laser hair removal.

So what will the DOC next be on the hook for???? Laser hair removal for any convicted woman who is a bit hirsute?

Thanks for clarifying, jim.
The slippery slope argument is a pretty good one but if this is more or less an isolated case I wonder if anything really needs to be changed? I suppose to me it all depends on the frequency of these types of rulings and the widespread nature. Is this going to become a precedent for many other cases or is it an oddball situation? This should really be considered as well.
There are quite a few things you could argue shouldn't be allowed to inmates but they get anyway since it can create another slippery slope when we deny inmates of care.
Besides, I'm assuming the laser hair removal was to remove hair from his more "manly" parts like his face, ass, back etc.? It was part of the treatment of his "condition" not just a cosmetic procedure, according to his doctor I am assuming?

[PLAYER57832]

Updates...

1) The judge has ordered the State to pay for this guy's electrolysis (per doctor review / expert review).

2) The judge has announced he's retiring (going part time I guess)... but it has NOTHING to do with this case.

Well, like player pointed out, we can't just be ok with a system until something like this comes up which rubs us the wrong way and affects our personal sensibilities. There is a system in place and this case is just one product of that system, perhaps a necessary evil, but for all intensive purposes, a just ruling. If the judge is semi-retiring because of heat from this issue it doesn't necessarily mean he did the wrong thing, given the letter of the law. It appears he was just doing his job. He is a scapegoat, which is never a valid situation.

If Player did point this out it was buried in 1000 words of other crap, so I never read it.

Yeah.. anything you don't want to hear you dismiss as "crap". Too bad you think that is intelligent debating...and too bad a large segment of US society seems to think so as well (on ALL sides, that! I have probably MORE disdain, not less for supposedly liberal folks who cannot be bothered to even listen to anyone with seemingly conservative ideas or actually conservative ideas).

That said:

I am not and haven't been "OK" with the system. Just that more often life gets in the way, and it takes something extraordinarily ridiculous to raise my ire... and the ire of the "silent majority".

Being opposed to the system is irrelevant to this issue. You declared the judge an "activist judge" for making a ruling you dislike, My whole point is that the judge is essentially not allowed to have "likes and dislikes" in his rulings. He has to rule according to the law, wich includes precedents, whether you, I or he likes it or not.


I ALSO made the point that if you dislike the law, then the procedure is to get the law changed. The ironly here is that if this judge HAD ruled as you would like, then he would be an "activist judge". Instead, he followed the law.

YOUR task, if you dislike this, is to get the law changed. BUT.. that involves actually understanding a bit of the issues and not just " I think transvestites are wackos and anyone who says different is a wacko, too". You were too busy telling everyone how idiotic the whole idea of gender surgery was to even bother to understand the real issues... and THAT is a very, very big problem.

Also... it's just YOUR opinion that the judge made the right ruling. Just because that was his ruling... it DOES NOT mean it was the RIGHT ruling. He's a human being and certainly capable of making mistakes.

The LAW determines if it was the correct ruling, not whether you like the outcome or not. In this case, the judge followed the law. THAT is the part you continually seem to ignore.

It is the law that you can say is "wacko", not the judge.

Now... for green, etc... I am "on the fence" about gender surgery. MY basic statement is that when average, not convicted people cannot get such surgeries covered by insurance for which they pay, then we have no obligation to provide it for prisoners. BUT.. that needs to be changed through the law, not judges excercising personal opinions.

[Symmetry]

blah, blah, blah

Why?

Why what?

Why did you bump this topic when it was essentially dead?

Why have you not answered Jim's question? Are you afraid?

Why are you referring to yourself in the third person? Why are you a cook with a subscription? How long do you think it'll be before the mods notice?

So many questions, so few answers.

[jimboston]

Why are you a cook with a subscription?

What does this have to do with the debate?

AD HOMINEM

[jimboston]

Yeah.. anything you don't want to hear you dismiss as "crap".

No. I only dismiss what YOU say as crap.

and too bad a large segment of US society seems to think so as well...

I can't speak for a large segment of US society... but I would venture to guess that a large segment of CC Society also thinks that most of what you say is crap.

You declared the judge an "activist judge" for making a ruling you dislike,

I actually I called him an activist judge not for making a ruling I personally dislike... I called him an activist judge for making a ruling that the VAST MAJORITY OF THE AMERICAN POPULATION would disagree with and find ridiculous on its' face.

The ironly here...

I don't know what ironly is... can you explain this concept to me???

Does our discussion have to be well pressed or something?

is that if this judge HAD ruled as you would like, then he would be an "activist judge". Instead, he followed the law.

Correction... he followed HIS interpretation of the law. Bending or stretching the law is "bench activism". I am sure there is no law that states "the DOC must provide sexual reassignment surgery (SRS) to all who request it". The law does say that (paraphrasing) that the DOC must provide reasonable health care... I just don't think that SRS would be reasonable to THE VAST MAJORITY of people... and therefore, ordering it is activism.

The Constitution states that punishments must not be "cruel and unusual"... I don't see how NOT providing SRS is either "cruel" or "unusual".

I also will refer to recent posts regarding the slippery slope of this ruling... which only one poster has addressed.

[Funkyterrance]

Jb, I can relate with you on at least part of the issue but I can't help but point something out:

Why are you a cook with a subscription?

What does this have to do with the debate?

AD HOMINEM

The ironly here...

I don't know what ironly is... can you explain this concept to me???

Does our discussion have to be well pressed or something?