CHICAGO (CN) - The Indiana Department of Corrections maintained to a dubious Seventh Circuit panel on Wednesday that a lower court shouldn't have greenlighted an inmate's gender-affirming surgery.

The inmate, Autumn Cordellione, requested sexual reassignment surgery in 2022 and was subsequently evaluated by a department psychologist who declined to move forward with the surgery. She is currently serving a 55-year sentence for murdering her infant stepdaughter and has been incarcerated since 2002.

Indiana requires the corrections department to provide medical and mental health care services to prisoners, but those services are limited to what is medically necessary - including surgeries. The state previously allowed prisoners to undergo gender reassignment surgery so long as the department's Gender Dysphoria Review Committee deemed it medically necessary.

In 2023, Indiana passed a law banning the use of state resources toward gender-affirming surgery for inmates, even in cases where it is medically necessary. Cordellione says that law violates the Eighth Amendment right against cruel and unusual punishment, and the Fourteenth Amendment right to equal protection.

The U.S. District Court for the Southern District of Indiana agreed and granted Cordellione a preliminary injunction in 2024. The injunction expired and she applied to extend it in December, which the Indiana Department of Corrections ultimately appealed.

James Barta, a solicitor general for Indiana, argued before the panel Wednesday that the federal court didn't address the variety of evidence from medical professionals who initially deemed Cordellione unfit for gender reassignment surgery.

In its order granting Cordellione the injunction, the federal court found that the standards from the World Professional Association of Transgender Health are internationally recognized guidelines for treating gender dysphoria.

Barta argued that the federal court should have considered the opinions of other medical professionals and in treating the association's standards as the ultimate arbiter of the Eighth Amendment.

U.S. Circuit Judge John Lee, a Joe Biden appointee, noted that the federal court reviewed the testimony of the department's medical professionals.

"Aren't you just asking us to reweigh the evidence?" Lee asked.

"No, Your Honor," Barta replied. "The standard here is not which expert has the best view of how this particular plaintiff should be treated. The standard is there genuine debate, and the district court did not address any of the medical literature showing there is a debate, it just said 'I am more persuaded by the plaintiff's expert.'"

Cordellione's attorney Kenneth Falk argued that the case has nothing to do with the World Professional Association of Transgender Health standards, or differences in medical opinions.

Lee asked Falk if it would still violate the Eighth Amendment if the medical professionals provided good faith reasons why the surgery isn't medically necessary and the state department of corrections decided against the surgery.

Falk, an attorney with the Indiana chapter of the American Civil Liberties Union, maintained that is not the case. He said the doctors that the corrections department relied on in their briefs admitted that they didn't have experience in diagnosing or treating gender dysphoria, and therefore the federal court didn't credit their testimony.

"We'd be in a completely different place if this was a case of an expert A, expert B, and what have you, but that's not this," Falk said.

"What this is really, as the court has noted, this is a clear error case," he continued. "At no point does the DOC claim that the findings the district court made that gender-affirming surgery is safe, effective and medically necessary - at no point do they say that's clear error. And they'd have a hard time doing that because prior to this law, the DOC allowed and approved of prisoners to obtain gender-affirming surgery under a standard thats specifically required it to be medically necessary."

U.S. Circuit Judge Joshua Kolar, a Joe Biden appointee, asked if Indiana could effectively ban this procedure.

Falk replied that the state could only ban a medical procedure if there was another procedure that was proven to be equally efficacious.

U.S. Circuit Judge Nancy Maldonado, also a Biden appointee, joined Lee and Kolar on the panel. The panel did not indicate when it might issue a ruling.

Source: Courthouse News Service