Dear Friends,
A federal district court in Alaska recently ordered state prison officials to refer an inmate for sex-change surgery consultation. The judge acknowledged that Alaska’s doctors had sound medical reasons for not recommending the consultation, but he felt legally bound by a flawed court precedent to overrule them anyway.
Idaho joined Indiana in leading a multi-state coalition asking the Ninth Circuit to reverse that order. Because Idaho sits in the Ninth Circuit, its decisions have a much more direct impact on our laws and federal court cases.
In Alaska, state medical professionals evaluated this inmate and concluded the surgery wasn’t medically necessary. They determined that other treatments such as mental health care and hormone therapy, which Alaska provides, were more appropriate given the circumstances. The district court agreed Alaska’s medical reasoning was sound. But the judge felt the precedent required him to order the referral anyway, overriding Alaska’s medical team.
These aren’t proven medical interventions. They’re experimental procedures with serious risks and uncertain benefits, and doctors legitimately disagree about whether they’re appropriate treatment. The medical community remains deeply divided over whether these surgeries are safe, effective, or even appropriate. Major international health authorities have reviewed the evidence and sharply restricted these procedures. The U.K.’s National Health Service and Sweden’s National Board of Health and Welfare both found the proof insufficient. Recent internal documents revealed that advocacy organizations manipulated their standards to support predetermined outcomes rather than following the evidence.
On top of all of that, Alaska doesn’t even have a single licensed surgeon who performs these procedures. Twenty-three other states are in the same position. The surgery is unavailable to anyone in nearly half the country. States would be forced to pay for out-of-state transfers and surgeries using taxpayer dollars for procedures that aren’t even available locally and are not paid for by taxpayers to the general public.
The Eighth Amendment prohibits prison officials from being deliberately indifferent to serious medical needs, but it doesn’t require providing every experimental procedure a prisoner demands. Prison officials meet their constitutional duty when they ensure adequate medical care based on professional judgment, even when prisoners disagree with the treatment. Deliberate indifference means ignoring serious medical needs with reckless disregard, not providing every controversial surgery a prisoner wants. But the Ninth Circuit’s decision in Edmo v. Corizon erased that distinction, and courts have been bound by it ever since.
Edmo was decided in 2019 under Idaho’s previous Attorney General. In that case, the previous Attorney General’s office stipulated—without requiring any proof—that standards from the World Professional Association of Transgender Health (WPATH) were the appropriate benchmark for medical necessity. Both sides agreed to treat WPATH’s guidelines as settled fact. That strategic mistake meant the court never examined whether those standards were medically sound, widely accepted, or based on reliable evidence. The court simply applied what the parties had already agreed was true.
That mistake not only cost the State $2.397 million in attorney’s fees, but it also produced a bad precedent that’s now binding courts across the West like in this case in Alaska.
We’re asking the Ninth Circuit to reverse the district court’s order and limit Edmo to its unique facts. In Edmo, both parties agreed WPATH standards were appropriate, so the court never examined whether they were reliable. That stipulated record shouldn’t control cases where the medical evidence is actually contested. We’re asking the court to recognize that when medical professionals disagree about whether a treatment is appropriate, and major health authorities have restricted it based on insufficient evidence, the Eighth Amendment doesn’t require states to provide it.
Idaho supports Alaska’s authority to follow its own medical professionals’ judgment. When doctors disagree about whether a treatment is appropriate, the Constitution doesn’t require states to override their medical experts based on a precedent built on stipulated facts.
Read more from Fox News here.
