Mass. Transgender Inmate Seeking Electrolysis

BOSTON - A transgender inmate who won a court order for taxpayer-funded sex-change surgery has no medical need for further electrolysis treatments, a prisons department psychiatrist testified Monday.

Dr. Robert Diener testified during a hearing in U.S. District Court on Michelle Kosilek's request to have additional hair-removal treatments. Diener, chief psychiatrist for the state Department of Correction, said he evaluated Kosilek in 2010 and again last month and concluded that Kosilek's anxiety level hasn't changed, even though she hasn't had electrolysis treatments since 2008.

"I continue to believe that it's not medically necessary for this patient," said Diener, chief psychiatrist at MHM Services, Inc., a company subcontracted by the state Department of Correction to provide mental health services.

Under questioning by Kosilek's lawyer, Diener acknowledged that he had not published any articles or conducted any research on gender-identity disorder, a diagnosis given to Kosilek. Diener also said he was told that the reason prison officials stopped giving Kosilek electrolysis after seven treatments is because it was too expensive.

Kosilek's lawyer, Frances Cohen, said prison officials' refusal to allow Kosilek to have additional treatments is "simply another incident of deliberate indifference" to Kosilek's medical needs.

The department has said it discontinued the treatments after finding she had already received significant hair removal and saying her remaining hair could be removed by shaving or depilatories.

Judge Mark Wolf didn't immediately rule on the request.

In September, Wolf ordered the state to provide sex-reassignment surgery, saying it is the only way to treat Kosilek's "serious medical need."

Kosilek was born male but has received hormone treatments and now lives as a woman in an all-male prison. Kosilek was named Robert when convicted in the 1990 murder of wife Cheryl Kosilek.

In his ruling, Wolf noted that Kosilek's gender-identity disorder has caused Kosilek so much anguish that she has twice tried to commit suicide. Wolf said Kosilek "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.

The Department of Correction has appealed Wolf's order.

The judge also heard arguments Monday on the department's request to put the order on hold while the appeal is pending.

Kosilek's lawyers also asked Wolf to revise his ruling to change his use of male pronouns to female pronouns when referring to Kosilek. Wolf said he would consider the request.