Bloomberg Law
Free Newsletter Sign Up
Bloomberg Law
Free Newsletter Sign Up

Ruling Recognizing Inmate’s Right to Gender Confirmation Stands

Feb. 10, 2020, 8:01 PM

A ruling that Idaho prison officials violated a transgender prisoner’s constitutional rights by failing to provide her gender confirmation surgery will remain in place after the Ninth Circuit declined Monday to reconsider a panel decision.

A three-judge panel of the U.S. Court of Appeals for the Ninth Circuit in August 2019 held that the prison violated a prisoner’s Eighth Amendment rights against cruel and unusual punishment by failing to provide gender confirmation surgery as a medically necessary treatment for her gender dysphoria.

When the medically necessary treatment for a prisoner’s gender dysphoria is gender confirmation surgery and prison officials refuse to provide it, knowing of the prisoner’s suffering, they violate the Eighth Amendment’s prohibition on cruel and unusual punishment, the court said, ruling on an issue of first impression and creating a circuit split.

The ruling requires that the state take steps within its power to provide the surgery to Adree Edmo, including finding a surgeon and scheduling a surgical evaluation.

Edmo, formerly Mason Dean Edmo, is a male-to-female transgender prisoner in the custody of the Idaho Department of Correction.

Edmo sued the DOC, the prison’s medical care provider, Corizon Inc., and Corizon’s director of psychiatry, Dr. Scott Eliason.

Judge Diarmuid F. O’Scannlain and several other judges who favored full-court review said the panel erred in relying on the standards of care of the World Professional Association for Transgender Health in determining that surgery was necessary.

The WPATH standards aren’t a consensus opinion, but are merely one side of a medical debate over sex reassignment surgery, he wrote.

Judge Daniel P. Collins, in a separate dissent from the denial of full-court review, said whether the prison’s psychiatrist was negligent or not, his treatment decisions don’t amount to cruel and unusual punishment.

Judge Patrick J. Bumatay in another dissenting opinion said the panel’s decision “elevates innovative and evolving medical standards to be the constitutional threshold for prison medical care.”

O’Scannlain was joined by Judges Consuelo M. Callahan, Carlos T. Bea, Sandra S. Ikuta, Ryan D. Nelson, Bridget S. Bade, Daniel A. Bress, Lawrence VanDyke, and Bumatay.

Bumatay was joined by Judges Callahan, Ikuta, Nelson, Bade, and VanDyke.

Hadsell Stormer & Renick LLP represented Edmo.

Parsons Behle & Latimer represented Corizon and Eliason.

Moore Elia Kraft & Hall LLP represented the Idaho Department of Corrections.

The case is Edmo v. Corizon Inc., 9th Cir., No. 19-cv-35017, 2/10/20.

To contact the reporter on this story: Peter Hayes in Washington at

To contact the editors responsible for this story: Rob Tricchinelli at; Patrick L. Gregory at