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Kosilek’s lead attorney, Frances Cohen, called the decision courageous and thoughtful.
"We feel very grateful that the judge listened very carefully to the medical experts and has given Michelle Kosilek what the prison doctors had recommended," Cohen said.
Ben Klein, a senior attorney at the Boston-based legal group Gay & Lesbian Advocates & Defenders, said Wolf’s ruling recognizes what some medical experts have said for years: that sex-reassignment surgery can be a "legitimate life-saving medical treatment for transgender people."
Klein said other inmates seeking the surgery can cite Wolf’s ruling, but they would still have to prove that prison officials showed deliberate indifference to their medical needs.
"Not everybody will be able to prove it, but at the same time, the prisons’ decisions have to be based on proper medical care and not bias," Klein said.
In Kosilek’s case, the judge said, female hormones have "helped somewhat," but the inmate "continues to suffer intense mental anguish" because she truly believes she is a woman trapped in a man’s body.
"That anguish alone constitutes a serious medical need," Wolf wrote. "It also places him at high risk of killing himself if his major mental illness is not adequately treated."
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