COMMENTARY | Americans have been in a frenzy for the last few days about Michelle Kosilek, formerly known as Robert, a transgender prisoner convicted of murder in 1990. On Tuesday, a judge ruled that Kosilek could receive full transition therapy, including sex-reassignment surgery, while incarcerated. It's no wonder that people are outraged: we live in a nation in which many people can't afford basic health care, yet we're seeing a murderer obtain a procedure that many would regard as cosmetic and unnecessary. The fury is as predictable as it is understandable, because it combines three nearly universal experiences: a valid disdain for murderers, a misunderstanding of transgenderism, and the overall agony of a country in which many can't afford basic medical care.
I share the same gut reaction that many have when reading the story of Michelle Kosilek. I'm a self-employed, working-class citizen and have many times struggled to pay for my own basic health care. In fact, I've shelled out a whopping 40 percent of my income to cover my own minimal medical needs just in the last six months. There have been times that I've had to choose between buying groceries or paying for a prescription -- never an easy choice, but one millions of us have had to make. Of course I feel angry that a murderer is getting better medical care than me, at the expense of the tax payer -- yet I also understand why she's receiving it, and I support her right to have the sex-changing therapy she needs to be healthy.
A nation in which Kosilek would be forced to go without treatment is actually far more frightening than the nation in which we live, where she will receive it at taxpayer expense. We, thankfully, live in a civilized country where our prisoners are generally given the medical care they need to survive. Infections get treated. Rotten teeth get pulled. Prisoners with severe mental health disorders are given access to the medications they need to remain stable. If we didn't provide life-saving treatments to our prisoners, we would not only have the public health hazard of prisons teeming with infectious disease, but we would also be guilty of violating basic human rights.
While it's commonly believed that the treatments involved in transitioning, or "sex change," are cosmetic, this is hardly the case. Transgender people who go without these treatments have extremely high rates of suicide. It takes years of detailed clinical diagnosis to determine if a person does, indeed, have gender identity disorder, and even more detailed evaluation to determine if transitioning is the best course of action for preserving the patient's mental health. An article in Current Psychiatry, detailing just how severe a condition must be to warrant this treatment, demonstrates just part of the painstaking and specific process involved in determining the necessity of transition therapy for individuals like Michelle Kosilek.
Considering that Kosilek has already made multiple suicide attempts related to her gender identity disorder, according to the Associated Press, and that multiple experts have deemed her need "medically necessary," we have an obligation as a civilized society to ensure that she has access to necessary treatments. Am I happy that this heartless monster, guilty of killing someone's daughter, is receiving this treatment with my tax dollars? No. I'm also not happy that my tax dollars are paying for cancer treatment for incarcerated child molesters, or for blood pressure medications for convicted rapists. But we don't get to choose which prisoners receive health care, as if selecting from a menu. Prisoners with medical needs might not "deserve" treatment, but we are obligated as a society to ensure that they receive it.
Perhaps, instead of unleashing our fury about Michelle Kosilek's sex-changing operation, we should consider where these feelings of anger are really coming from. Our nation is plagued with inequality. We see those who need health care -- kids with cancer, seniors barely able to afford food -- going without it, while the most wicked people in the world are receiving it for free. We have every right to be angry -- not at the prisoners receiving health care, but at the system that makes it so difficult for hard-working, respectable citizens to afford it. If we lived in a nation where every individual -- rich or poor, "good" or "bad," incarcerated or free -- had access to affordable health care, we wouldn't have so much animosity toward a prisoner who is also receiving it. I may be angry at Michelle Kosilek for murdering her wife, but I am not angry at our legal system for providing the medical care she needs to survive.
Juniper Russo is a health advocate, freelance writer, activist, and dedicated mom living in Chattanooga, Tenn.
