J Law Health. 2024;38(1):66-101.
In the U.S. Court of Appeals for the First Circuit adopted The World Professional Association of Transgender Health Standards of Care (WPATH SOC) as medical consensus on gender affirming care and held that Michelle Kosilek could access gender affirming care but that she did not meet the criteria for gender affirming surgery. In the U.S. Court of Appeals for the Fifth Circuit with a sparse record and no expert testimony denied Vanessa Lynn Gibson access to gender affirming surgery and incorrectly claimed that Kosilek did not support the WPATH SOC as representing the medical consensus on gender affirming care. Finally, the U.S. Court of Appeals for the Ninth Circuit held in that denying access to gender affirming surgery to an incarcerated transgender person suffering from severe gender dysphoria resulting in two attempts at self-castration, cutting to reduce genital distress, and suicidal ideation violated the Eighth Amendment. In doing so, the Ninth Circuit joined medical and scientific organizations who widely adopt The World Professional Association of Transgender Health Standards of Care (WPATH SOC) as medical consensus on gender affirming care. Nonetheless, 10 Ninth Circuit Judges dissented to the denial of rehearing . Although the Supreme Court denied certiorari (with Justice Thomas and Alito dissenting), the Supreme Court also denied certiorari in the Fifth Circuit case which denied access to gender affirming surgery and rejected the WPATH SOC without offering any alternatives. Transgender women are disproportionately incarcerated in the United States. Black transgender women are disproportionately represented even among incarcerated transgender women. The combination of transphobia and racism result in worse medical outcomes following a failure to provide adequate medical care. This article argues that rejecting the WPATH SOC disproportionately impacts Black transgender women. Failure to recognize the WPATH SOC as medical consensus will perpetuate medical and carceral racism and transphobia.
在美国第一巡回上诉法院采纳了世界跨性别健康专业协会（WPATH SOC）的标准作为性别肯定护理的医学共识，并裁定米歇尔·科西莱克可以获得性别肯定护理，但她不符合性别肯定手术的标准。在美国第五巡回上诉法院，记录稀疏，没有专家证言，拒绝凡妮莎·林恩·吉布森进行性别肯定手术，并错误地声称科西莱克不支持 WPATH SOC 作为性别肯定护理的医学共识。最后，美国第九巡回上诉法院裁定，拒绝向一名因严重性别焦虑而被监禁的跨性别者提供性别肯定手术，这侵犯了第八修正案。这样做，第九巡回上诉法院加入了广泛采用世界跨性别健康专业协会（WPATH SOC）的医学和科学组织，将其作为性别肯定护理的医学共识。尽管最高法院拒绝了复审请求（托马斯大法官和阿利托大法官持不同意见），但最高法院也拒绝了第五巡回法院的复审请求，该请求拒绝提供性别肯定手术，并拒绝 WPATH SOC，没有提供任何替代方案。跨性别女性在美国被不成比例地监禁。黑人跨性别女性在被监禁的跨性别女性中所占比例甚至更高。跨性别恐惧症和种族主义的结合导致在未能提供足够医疗护理的情况下，医疗结果更差。本文认为，拒绝 WPATH SOC 会不成比例地影响黑人跨性别女性。不承认 WPATH SOC 作为医学共识，将延续医疗和监禁中的种族主义和跨性别恐惧症。
