24 states back challenge to transgender inmate surgery ruling with nationwide stakes

FIRST ON FOX: Idaho and Indiana filed an amicus brief challenging a federal ruling requiring Alaska to provide sex reassignment surgery for prison inmates in a case that could reshape policy nationwide.

Alaska is appealing the decision to the Ninth Circuit, seeking to overturn a ruling that found denying sex reassignment surgery to a transgender inmate violated the Eighth Amendment's protection against cruel and unusual punishment. Twenty-four states now warn that if upheld, the judge's ruling could force prisons across the country to provide transgender medical procedures.

Idaho Attorney General Raúl Labrador said that if the lower judge's ruling is upheld, it could create a dangerous "precedent."

"A federal court ordered Alaska to refer a prisoner for sex-change surgery consultation, which threatens to set a precedent that forces other states to provide these procedures using taxpayer dollars," Labrador said. "Idaho supports Alaska in defending state medical decisions against judicial overreach. The Eighth Amendment ensures basic medical care for prisoners, but it doesn't require states to provide experimental gender transition surgeries."

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Magistrate Judge Matthew Scoble had argued that Alaska acted with "deliberate indifference" when prisoner Emalee Wagoner, who was diagnosed with gender dysphoria, was barred from receiving surgery. However, Alaska   Wagoner is currently serving a 40-year prison sentence for sexual abuse of minors.

In a 32-page brief, Labrador, Idaho Solicitor General Michael Zarian, Indiana Attorney General Todd Rokita and Solicitor General James Barta rejected the magistrate judge's argument that the Alaska Department of Corrections is in violation of the Eighth Amendment because the requested medical procedure is not a "minimal civilized measure of life’s necessities," meaning it is unnecessary. This assertion is based on the fact the operation "is not available to free citizens in half of the Nation."

"The Eighth Amendment stops cruel and unusual punishment. It doesn’t give prisoners the right to demand risky, optional surgeries when doctors and scientists still strongly disagree about whether they’re safe or even helpful," said Rokita.

"If courts force states to provide these expensive, controversial procedures in one prison, it will open the floodgates everywhere—putting Hoosier taxpayers and families across the country on the hook for hundreds of thousands of dollars per surgery in virtually every state." 

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In the brief, the state officials also pointed to a lack of consensus among medical professionals over the efficacy of reassignment surgery in treating those with gender dysphoria. They cited a 2016 Centers for Medicare and Medicaid Services review of studies on the effectiveness of sex-change surgeries, finding the selected studies "did not demonstrate clinically significant changes or differences in psychometric test results after" surgery.

The amicus brief expressed scrutiny of the World Professional Association for Transgender Health, claiming that the organization "has changed its medical guidance to accommodate external political pressure."

"Despite WPATH’s insistence on surgeries, nothing in the Eighth Amendment’s text or history allows prisoners to demand whatever medical interventions they desire," the amicus brief stated. "Nor does anything in its text or history require States to provide risky, controversial medical procedures of uncertain benefit to prisoners."

Fox News Digital reached out to WPATH and Wagoner's legal team for comment.

Following Scroble's ruling in October, Wagoner's attorney Richard Saenz praised the decision, telling the Alaska Beacon that his client "should not have to continue to wait for the care that the court and her treating doctor and experts have said is medically necessary for her to receive." 

Saenz told the outlet the ruling will likely affect a relatively small number of transgender people but that it will be significant for them. 

"I think that is so important — that gender dysphoria, which is a medical condition that the department itself recognizes needs treatment, should not be treated in an exceptional way. It should be treated like other medical conditions, and that the treatment that clinical guidelines say are needed, should be followed," he said.