Michelle Kosilek, sentenced to life in prison for the killing of her wife in 1990, has sued the Massachusetts Department of Correction (DOC) for not providing adequate treatment for her gender identity disorder.  Kosilek, who legally changed her name from Robert to Michelle in 1993, first sued the DOC in 2000, claiming that its refusal to permit her to have gender-reassignment surgery constituted cruel and unusual punishment, violating her Eighth Amendment rights.  Her most recent complaint has centered on the DOC’s denial of electrolysis and consultation with an endocrinologist.

Gender-reassignment surgery is certainly expensive (around $20,000), but gender identity disorder is a recognized condition and Ms. Kosilek’s testimony indicates that she is suffering anxiety and depression as a result of her lack of treatment.

Should inmates be barred from seeking treatment for mental illness when prison resources prove insufficient?  Similarly, should inmates be barred from receiving expensive medical treatments in general because of their incarcerated status?  Where is the line drawn between providing an unethical lower standard of care and providing a standard of care that unduly burdens taxpayers?