Michelle-Lael Norsworthy, a transgender woman, is currently an inmate housed at Mule Creek State Men's Prison located in Ione, California. She was sentenced to state prison in the late-1980s. In the mid-1990s, Norsworthy received a medical diagnosis of gender dysphoria and began hormone replacement therapy. While in prison, she has been raped six times, including an incident in 2009 in which she was gang raped by nine inmates over a six-hour period. She subsequently developed hepatitis C. The high level of estrogen she had been prescribed for more than 15 years has now been substantially reduced as a result of the hepatitis, as it could cause further damage to her liver. Unfortunately, the treatment Norsworthy has received to date has not resolved the significant anxiety and distress she experiences as a result of gender dysphoria.
The World Professional Association for Transgender Health's Standards of Care for the health of transsexual, transgender, and gender nonconforming people is the recognized criteria worldwide for the provision of health care to trans-identified individuals. In the latest edition, the WPATH SOC state that for some people surgery is "essential and medically necessary to alleviate their gender dysphoria." This standard is recognized by nearly every medical organization worldwide, including the American Medical Association. The California Department of Corrections and Rehabilitation has a blanket policy denying gender confirmation surgery for inmates and has denied this medically necessary care to Norsworthy.
After a lawsuit filed by the Transgender Law Center and the law firm of Morgan Lewis and Brockius LLP, on April 2, U.S. District Court Judge Jon Tigar granted a preliminary injunction ordering the CDCR to provide gender confirmation surgery to Norsworthy, "as promptly as possible." The judge's ruling also stated that CDCR's continual denial of Norsworthy's requests for surgery demonstrated officials being "deliberately indifferent" to her medical needs, disregarding her treatment physicians. Federal courts in several cases around the country have held that it is unconstitutional for a prison to deny medical treatment �" including surgeries �" that has been determined necessary to treat a transgender inmate's case of gender dysphoria.
Nine states, including California, already require private insurers to cover medical care related to gender transition and public insurance programs like Medicare and Medicaid cover this type of care. The University of California system's insurance plan covers these procedures for all faculty, staff and students, as do more and more of the nation's largest corporations. The City of San Francisco employee health plan has covered transition-related care, including gender confirmation surgeries, since 2001 and now provides universal health care for all transgender enrollees in Healthy San Francisco.
On April 5, California Attorney General Kamala Harris, who is running for retiring Senator Barbara Boxer's (D-California) seat next year, filed an appeal with the federal appeals court to overturn Tigar's ruling. There is no logical reason, financial or medical, for her to have done this. It can only have been political.
In 2003, Harris ran for, and won, her race for district attorney of San Francisco. I was one of the co-chairs of the Alice B. Toklas LGBT Democratic Club at the time. Alice was the first political organization in San Francisco to endorse Harris in this election. Alice members walked precincts for her and I recall accompanying her on a merchant walk in the Castro to gain the critical support of the LGBT community. She overwhelmingly won the election with strong support from LGBT populated precincts. Alice and our community have continued to support Harris is every subsequent election she has run and won since 2003. Our community has been loyal to Harris.
San Francisco elects political leaders, in part, based on whether their values reflect our values, San Francisco values. Boxer, House Minority Leader Nancy Pelosi (D-San Francisco), Representative Jackie Speier (D-San Francisco/San Mateo) are but a few who have proudly carried those values to Washington, D.C. We need to ensure that Harris will indeed be one of those elected leaders. In today's world, it is less heroic for an elected official to fully embrace the concept of marriage equality or to oppose a proposed initiative that is essentially the legalization of a gay turkey-shoot. Yet in the case of the proposed initiative that would allow people to kill gays, Harris has gone to court in an effort to prevent it from being on the ballot.
It takes a great deal of courage, though, to face down institutional discrimination such as that displayed by the CDCR when it comes to trans-identified inmates. Ask gay state Senator Mark Leno (D), who has been on the tip of the sword for trans-rights since his first term in the Assembly in 2002. Time and time again, against difficult odds, Leno fought and won numerous legislative battles on our behalf. We need Harris to be our Leno in Washington, particularly in this time of record homicides and increasing youth suicides in the trans community.
Typically, LGBT Democratic clubs consider early endorsements for certain political leaders who are champions of our community and values. The leaders of Alice and the Harvey Milk LGBT Democratic Club are probably discussing this possibility right now when it comes to Harris and her bid to replace Boxer in the Senate. Before considering her for this early endorsement process, it is imperative we are absolutely certain she does share our values. We need to know why she filed an appeal in the Norsworthy case and to explain her reasoning for doing something so counter to one of our fundamental beliefs, health equality for all.
Loyalty is also a core value we San Franciscans embrace. It's like my grandfather, a lifelong Missouri mule-trader, told me, "Always leave the dance on the mule that brung ya." We are currently at the dance and Harris needs to decide who is going to carry her to a successful finish.
Theresa Sparks is the executive director of the San Francisco Human Rights Commission. The views expressed here are hers alone and do not represent those of the SFHRC or any other organization with which she is affiliated.