Special to Indian Country Today
A transgender Idaho inmate and citizen of the Shoshone-Bannock Tribes is on track to receive sex reassignment surgery next month following a ruling that sets precedent for much of the American West.
The U.S. Supreme Court declined the state’s request to suspend prisoner Adree Edmo’s surgery, which is now slated to take place in July.
The 7-2 decision is another landmark victory for Edmo, who initially won her case in federal court in Idaho in late 2018. Edmo then prevailed again in August after the state appealed the decision to the 9th U.S. Circuit Court of Appeals.
Incarcerated since 2012, Edmo suffers from gender dysphoria, a diagnosis given when a person’s gender identity conflicts with their sex assigned at birth. Prison doctors authorized mental health and hormone treatment, but Edmo said it was insufficient to quell her suffering.
Edmo twice attempted to castrate herself with a razor while in prison. She requested that prison doctors assess her for sex reassignment surgery, also known as gender confirmation surgery. When doctors said that treatment was not medically necessary, she sued.
Independent physicians who were brought in by Edmo’s legal team to assess her condition agreed that surgery is appropriate treatment.
A panel of three 9th Circuit judges unanimously agreed with the lower court’s finding that denying Edmo the surgery constitutes cruel and unusual punishment.
“It is no leap to conclude that Edmo’s severe, ongoing psychological distress and the high risk of self-castration and suicide she faces absent surgery constitute irreparable harm,” the judges wrote.
The 9th Circuit ordered the state to move forward with providing the surgery. The state appealed to the U.S. Supreme Court and applied for a stay that would have put the surgery on hold.
The high court could still decide to hear the appeal but is unlikely to do so ahead of Edmo's impending surgery.
“The Court’s denial of the stay clears the way for Adree Edmo to get medically necessary surgery that she has needed for years,” said National Center for Lesbian Rights senior staff attorney, Amy Whelan, co-counsel for Edmo. “The lower courts found, based on extensive evidence and proof, that the Idaho Department of Correction and (private health care contractor) Corizon Health are violating Ms. Edmo’s constitutional rights by withholding this critical medical care.”
The win may open up the option for gender confirmation surgery to other prisoners with gender dysphoria in the nine western states that fall within the 9th Circuit.
“If there’s another transgender patient in, say, Montana that makes a similar claim, then the court would be bound by precedent,” said Josh Blackman, Constitutional Law professor of the South Texas College of Law-Houston.
The Edmo case has already caused some prison administrators to rethink policies for how transgender inmates should be treated. For example, after Edmo sued, Idaho’s corrections agency changed its policies to allow transgender women to access makeup, bras and other commissary items normally available only to inmates housed in the women’s prison.
“I think the Edmo decision certainly got people's attention,” said Wally Campbell, chief psychologist for the Idaho Department of Correction. “It's very clear that states all over are taking a very close, serious look at how they're managing transgender inmates and medical services for those diagnosed with gender dysphoria.”
Edmo grew up on the Shoshone-Bannock Indian reservation in remote eastern Idaho. At age 22, she was convicted of sexual abuse of a 15-year-old and sentenced to serve up to 10 years in prison. She is ineligible for parole, and is scheduled to be released in July 2021.
Edmo’s lead attorney, Lori Rifkin, says she doesn’t know what Edmo’s plans are after release, but that her ties to her tribe are strong.
“Having grown up on the reservation, Adree has really strong connections to her tribe and to that culture,” Rifkin said. “And so I think that is important for her.”
In a 2019 letter printed in the Sho-Ban News, the tribes’ weekly newspaper, Edmo asked for support from her fellow tribal members, as a Two-Spirit person.
“Unfortunately, in today’s society, our young Native people are willingly following mainstream societal concepts of the binary gender system of male and female,” Edmo wrote. “As a transgender woman, I continue walking through these prison hallways/units subject to male prison inmates yelling obscenities, gawking and sometimes hurling immature, disrespectful remarks. The disturbing facts is some of these individuals are members of my own tribe.”
Edmo’s case is controversial in Idaho, where Gov. Brad Little has repeatedly said gender confirmation surgery is not medically necessary and taxpayers should not have to pay for it.
Clyde Hall, a retired judge and Shoshone-Bannock elder, said many Fort Hall residents are aware of Edmo’s case, and many support her.
“It's good that she prevailed,” Hall said. “It's really most excellent that she gets to do this because she's like a vanguard. Not just necessarily for Indians, but anybody that feels displacement in their sexual orientation.”
The Idaho Correction Department's policy is to house inmates according to physical anatomy. The agency said it could not comment on whether Edmo would be transferred to a women’s prison following the procedure.
Amanda Peacher is a reporter for the Mountain West News Bureau and host of the podcast LOCKED: a disturbing crime, a desperate act, and how one case could change the way prisons treat transgender inmates.
This story has been corrected to show that Edmo is being held at the Idaho state prison and is not a federal prisoner.