Q: Does Kamala Harris help government-paid gender-affirming surgical procedure for jail inmates and immigrant detainees?
A: The federal government should present medical care to prisoners and immigrant detainees. Vice President Kamala Harris expressed help in a 2019 questionnaire for “medically essential” gender-affirming care, together with surgical care, for federal prisoners and detainees. She has not detailed her place within the present marketing campaign.
FULL QUESTIONS
Does Kamala Harris help authorities paid transgender surgical procedure for jail inmates and unlawful immigrants?
TV reveals an advert wherein Kamala Harris says all transgender inmates ought to have entry to medical care. Did she actually say this? Does that imply therapy and/or surgical procedure ?
FULL ANSWER
Este artículo estará disponible en español en El Tiempo Latino.
We’ve just lately acquired numerous reader questions on Vice President Kamala Harris’ stance on offering gender-affirming surgical procedures for transgender prisoners and immigrants, usually sparked by a marketing campaign commercial from her opponent, former President Donald Trump. A transgender particular person’s gender id doesn’t match their intercourse assigned at beginning.
The U.S. Structure requires that the federal government present wanted medical look after prisoners, according to a 1976 Supreme Court docket ruling. Transgender inmates in federal and state prisons have argued in courtroom that this consists of offering medically essential gender-affirming care. Some federal and state prisoners have acquired gender-affirming surgical procedures following authorized victories. To this point, this has included two federal prisoners within the custody of the Federal Bureau of Prisons, based on an e-mail from an company spokesperson.
There are additionally authorities policies supporting essential gender-affirming look after immigrant detainees, together with hormone remedy, though we have been unable to search out any coverage particularly recommending gender-affirming surgical procedure or any information of such surgical procedures having occurred.
When she was working to be the Democratic presidential nominee in 2019, Harris went on file in an American Civil Liberties Union candidate questionnaire as supporting medically essential gender-affirming look after federal prisoners and immigrant detainees, together with surgical care. She additionally expressed help for gender-affirming surgical procedure for California state inmates on different events during her 2019 presidential run, taking some credit score for working “behind the scenes” to get entry to those surgical procedures for prisoners.
Nevertheless, Harris has not clarified her actual place on gender-affirming look after prisoners and detainees throughout her present marketing campaign, and Trump and his marketing campaign have typically omitted data on when and in what context Harris spoke about these matters. Trump’s statements additionally lack context on the small variety of gender-affirming surgical procedures that prisoners have acquired and the authorized foundation for offering such care. Makes an attempt by a presidential administration to roll again entry to gender-affirming look after prisoners would seemingly meet authorized challenges.
“It’s exhausting to imagine, but it surely’s true. Even the liberal media was shocked Kamala helps taxpayer-funded intercourse modifications for prisoners and unlawful aliens,” a narrator says within the Trump marketing campaign advertisement. “Kamala’s for they/them. President Trump is for you.” The advert stitches collectively two totally different sections of a 2019 interview to point out Harris saying: “Surgical procedure for prisoners … each transgender inmate within the jail system would have entry.”
In that interview, Harris was particularly referring to her previous efforts in California to safe entry to gender-affirming surgical procedure for inmates in state jail, though, as we’ve mentioned, she did categorical help for entry to medically essential gender-affirming look after federal prisoners in her ACLU questionnaire response.
The Trump marketing campaign has spent greater than $11 million to run the advert on broadcast tv in all 50 states and Washington, D.C., based on AdImpact, an promoting monitoring service, in addition to round $361,000 to run it on digital platforms.
Trump additionally alluded to Harris’ questionnaire response through the presidential debate on Sept. 10, a day after CNN revealed a story about her 2019 solutions.
“Now she needs to do transgender operations on unlawful aliens which are in jail,” Trump said. “It is a radical left liberal that may do that.”
He has since referenced the topic repeatedly. “Why does Kamala need to give transgender operations to convicted unlawful migrants coming in and staying in detention cells?” Trump asked throughout a Sept. 27 marketing campaign occasion in Walker, Michigan. “She mentioned we’ll give them intercourse change operations. Now someone would have a look at me and say that’s loopy. I’m positive that’s not true. No, no it’s 100% true. She needs to, needed to, needs to offer them.”
“She even endorsed free intercourse modifications … and this was just lately, she endorsed free intercourse modifications for unlawful aliens in detention facilities throughout our nation at taxpayer expense,” Trump said at a Sept. 23 rally in Indiana, Pennsylvania.
In each of those two latest appearances, Trump additionally cited inflated prices for gender-affirming surgical procedure, which we’ll talk about later.
However as we mentioned beforehand, Harris has not expressed her present views, and her feedback on gender-affirming look after detainees are 5 years previous.
Within the Sept. 9 CNN article that introduced the ACLU questionnaire again into the information, a Harris marketing campaign spokesperson declined to specify what her present place is on the difficulty.
The subsequent day, when responding to a query concerning the ACLU questionnaire on Fox Information the morning of the talk, the Harris marketing campaign’s communications director, Michael Tyler, said, “That questionnaire — this isn’t what she is proposing, it’s not what she’s working on.”
The marketing campaign didn’t present additional remark in response to our questions.
Harris’ Historical past on Gender-Affirming Surgical procedure for Prisoners in California
As a former California lawyer basic, Harris has been concerned in authorized circumstances on gender-affirming surgical procedure for state prisoners.
Her workplace represented the California Division of Corrections and Rehabilitation because it tried to block gender-affirming surgical procedure for a state inmate in 2015. The division in the end got here to an agreement to revise its coverage on offering medically essential gender-affirming surgical procedure to jail inmates that very same yr, following a authorized loss. In 2017, a transgender inmate in California grew to become the first prisoner within the U.S. to be offered gender-affirming surgical procedure.
As of December 2022, 20 California inmates had received gender-affirming surgical procedure, based on the nonprofit information group CalMatters. Inmates in state prisons in search of gender-affirming surgical procedures have since succeeded in courtroom cases in other states, resulting in some gender-affirming surgical procedures.
Throughout a January 2019 information convention on the outset of Harris’ first presidential run, the Washington Blade asked Harris about her file of “in search of to disclaim surgical procedure for trans inmates” in California. Harris responded that as lawyer basic, “there are sadly conditions that occurred the place my purchasers took positions that have been opposite to my beliefs.”
Nevertheless, she took “full accountability” for her workplace’s actions, earlier than additional indicating her help for gender-affirming look after inmates. “However on that subject I’ll inform you I vehemently disagree and in reality labored behind the scenes to make sure that the Division of Corrections would enable transitioning inmates to obtain the medical consideration that they required, they wanted and deserved,” Harris mentioned.
Harris or her representatives through the 2019 marketing campaign continued to reiterate her work “behind the scenes” on the eventual California coverage to supply gender-affirming surgical procedure to some inmates.
This included an interview posted in October 2019 between Harris and Mara Kiesling, then govt director of the Nationwide Middle for Transgender Equality Motion Fund. Snippets of the interview are quoted within the Trump advertisement that’s presently airing.
Within the interview, Kiesling requested why transgender individuals ought to vote for Harris. As a part of a for much longer reply, Harris recalled studying that the California Division of Corrections was “standing in the way in which of surgical procedure for prisoners.”
After studying concerning the case, Harris mentioned, “I labored behind the scenes to not solely be sure that that transgender girl acquired the companies she was deserving. So it wasn’t solely about that case. I made positive that they modified the coverage within the state of California so that each transgender inmate within the jail system would have entry to the medical care that they desired and wish.”
Harris’ Document on Gender-Affirming Take care of Federal Prisoners
Though Trump’s commercial takes Harris’ 2019 feedback on transgender inmates out of context, she did give broader help for gender-affirming look after prisoners in response to the 2019 ACLU questionnaire.
The ACLU questionnaire requested, “As President will you employ your govt authority to make sure that transgender and nonbinary individuals who depend on the state for medical care — together with these in jail and immigration detention — can have entry to complete therapy related to gender transition, together with all essential surgical care? If sure, how will you accomplish that?”
Harris checked a field answering “Sure,” earlier than elaborating:
Harris, 2019 ACLU questionnaire: It’s important that transgender people who depend on the state for care obtain the therapy they want, which incorporates entry to therapy related to gender transition. That’s why, as Lawyer Common, I pushed the California Division of Corrections and Rehabilitation to supply gender transition surgical procedure to state inmates. I help insurance policies guaranteeing that federal prisoners and detainees are capable of receive medically essential look after gender transition, together with surgical care, whereas incarcerated or detained. Transition therapy is a medical necessity, and I’ll direct all federal companies chargeable for offering important medical care to ship transition therapy.
On the time, no federal prisoner had acquired gender-affirming surgical procedure. The primary gender-affirming surgical procedure was offered to a U.S. federal prisoner in 2022, after a federal courtroom ruling acknowledged that the federal government was required to supply this care. A second surgical procedure came about in 2023.
Actions taken through the Biden-Harris administration have indicated some help for essential medical look after transgender inmates. The Division of Justice has offered statements of interest in cases wherein state prisoners have sought gender-affirming care. These statements notice that, amongst different authorized bases, the Eighth Modification’s prohibition of merciless and strange punishment requires satisfactory look after prisoners, together with these with gender dysphoria. Gender dysphoria is a diagnosis that some however not all transgender individuals have, and refers to intense misery over the mismatch between an individual’s intercourse assigned at beginning and their gender id.
In 2022, the BOP brought back a Transgender Offender Manual for the best way to deal with federal prisoners, following a Trump-era hiatus for the doc. In response to questions on gender-affirming care, a BOP spokesperson despatched us a hyperlink to this doc. Amongst different insurance policies, the doc now addresses gender-affirming surgical procedure.
“For transgender inmates in Bureau custody, surgical procedure will be the closing stage within the transition course of and is usually thought of solely after one yr of clear conduct and compliance with psychological well being, medical, and programming companies on the gender affirming facility,” the doc reads, whereas acknowledging that not all transgender inmates even need these surgical procedures.
Neither is asking for gender-affirming surgical procedure a assure {that a} federal prisoner will get it. The handbook merely says that the requests will probably be thought of. The BOP spokesperson confirmed to us that two federal inmates have gotten these surgical procedures to this point. There are 1,461 transgender feminine prisoners and 770 transgender male prisoners presently within the custody of BOP, according to the company.
Context on Gender-Affirming Take care of Immigrant Detainees
In his latest feedback on free “intercourse change” surgical procedures, Trump has usually centered on the concept that Harris needs to offer these surgical procedures to immigrant detainees.
Nevertheless, as we’ve mentioned, we weren’t capable of finding a file of immigrant detainees having gotten these surgical procedures.
Immigrants who’re detained whereas attempting to enter the U.S. could also be held by Customs and Border Patrol. These detainees ought to “typically not be held for longer than 72 hours in CBP maintain rooms or holding services,” according to the company. A report discovered that folks have been in custody for a median of 62 to 74 hours between October 2022 and June 2023, relying on the kind of CBP facility.
Folks could also be in U.S. Immigration and Customs Enforcement custody for longer, however stays are nonetheless alleged to be comparatively quick. The average size of keep for an individual detained by ICE in 2024 up to now is 47 days. As of Sept. 8, there have been 231 transgender detainees booked into ICE custody in 2024, and there are presently 47 transgender individuals in custody, based on ICE statistics, though teams that advocate for transgender individuals in detention have said the ICE statistics are most likely an undercount.
In a press release to FactCheck.org, an ICE spokesperson talked about emergent care wants, a phrase usually used to check with well being care that’s wanted instantly to stave off important hurt. “The company acknowledges that detained transgender noncitizens have distinctive wants whereas in ICE custody,” the spokesperson mentioned in an e-mail. “In response to these wants, we’ve got developed buildings inside our operation to safeguard their rights and guarantee their emergent care wants are met from the second they arrive and all through the whole lot of their keep.”
Gender-affirming surgical procedure is just not normally a fast course of. As we’ve mentioned, there’s a ready interval of 1 yr earlier than federal inmates may even search gender-affirming surgical procedure. Specialists additionally told The nineteenth, a nonprofit information web site that writes about gender points, {that a} ready interval for gender-affirming surgical procedure is frequent whether or not somebody is in a jail or not.
A 2015 ICE memorandum outlines insurance policies for transgender detainees, together with some suggestions on gender-affirming care, Dr. Elizabeth Kvach, a Colorado household doctor with expertise offering medical care to transgender people in immigration detention, informed us. This includes suggestions that detainees be given entry to “psychological well being care and different transgender-related well being care and medicine (resembling hormone remedy) based mostly on medical want.”
Kvach mentioned that in her expertise in Colorado, transgender detainees are given entry, if desired, to “analysis for initiation and/or continuation of hormone remedy for affirmation of their gender id whereas detained.” Nevertheless, she was not conscious of cases of care extending to gender-affirming surgical procedure.
“To the very best of my information, within the decade I’ve been doing this work in Colorado there have been no transgender detainees who’ve sought or acquired gender affirming surgical procedures whereas in immigration detention,” Kvach mentioned, whereas acknowledging that she “can not converse to practices in different detention services or states.”
Elana Redfield, federal coverage director on the Williams Institute on the UCLA College of Legislation, additionally shared a latest report indicating that some transgender and different detainees had hassle getting hormone remedy or different medical care, “not to mention surgical therapies,” she mentioned, though she famous that solely a small variety of individuals have been interviewed.
For the report, representatives of nonprofit organizations interviewed 41 LGBTQ+ and HIV-positive immigrants pursuing asylum and held by CBP and ICE, including 14 individuals figuring out as transgender. 4 transgender detainees reported hassle getting hormone remedy, whereas a transgender girl who had beforehand gotten breast implants told a narrative of receiving delayed and insufficient medical care after one in every of her implants burst whereas in ICE custody.
“What we’re seeing there is a gigantic unmet want for even fundamental well being care,” Kellan Baker, a well being companies researcher with experience in cost-related points and transgender well being, informed us of the expertise of immigrants in detention. Baker is govt director of Whitman-Walker Institute, a analysis and coverage institute affiliated with a Washington, D.C., group well being heart. The institute’s mission is “advancing the well being and wellbeing of LGBTQ+ individuals, individuals dwelling with HIV, and different teams dealing with obstacles to high quality care.”
“Nobody is making the most of being in a jail system or in immigration detention to attempt to get care that they don’t want,” he mentioned.
Trump Exaggerates Price of Gender-Affirming Surgical procedure
In latest appearances, Trump has talked about the price of offering “intercourse change” surgical procedure. However Baker mentioned that his estimates are too excessive.
“They’re in a detention cell and a person needs to transition into womanhood, and [Harris] is keen to do this and provides very costly operations, by the way in which, a whole lot of hundreds of {dollars},” Trump said throughout his Sept. 27 look in Walker, Michigan.
Trump was much more particular in his Sept. 23 Indiana, Pennsylvania, speech. “You’re being held in a detention heart, and also you say, ‘I need to change. I need to change into a lady.’ They usually need to provide the operation. Which is an immensely costly operation on prime of the whole lot else — $250,000 not less than, after which all of the medication concerned and the whole lot else,” Trump mentioned.
As we’ve mentioned, we didn’t discover studies of anybody getting gender-affirming surgical procedure in CBP or ICE detention, though a restricted variety of these surgical procedures have been achieved in state and federal prisons.
Baker mentioned that there’s “little or no knowledge” on costs paid for medical care inside jail programs. However his personal research on quantities paid by personal insurers for these surgical procedures discovered that the common price for vaginoplasty within the U.S. is round $50,000.
Given that personal insurance coverage “tends to reimburse higher” than a public program would, $50,000 “might be considerably above what the price of the same process within the jail system could be,” Baker mentioned.
Baker additionally identified that there aren’t that many transgender individuals in jail to start with and that not each particular person goes to want gender-affirming surgical procedure. “Sometimes what of us want in incarceration settings are simply fundamental provides and helps, like the correct of clothes … and drugs – so hormone remedy, for instance, in addition to psychological well being help, in the event that they want it,” he mentioned. Additional, particularly in contrast with another medication a prisoner may want for medical care generally, he mentioned, hormone remedy is “unbelievably low cost.”
Editor’s notice: FactCheck.org doesn’t settle for promoting. We depend on grants and particular person donations from individuals such as you. Please contemplate a donation. Bank card donations could also be made via our “Donate” page. When you choose to offer by examine, ship to: FactCheck.org, Annenberg Public Coverage Middle, 202 S. thirty sixth St., Philadelphia, PA 19104.
Sources
Aldrich, Jennifer et al. “Gender-Affirming Care, Incarceration, and the Eighth Amendment.” AMA Journal of Ethics. June 2023.
Federal Bureau of Prisons Spokesperson. Electronic mail with FactCheck.org. 25 Sep 2024.
Norwood, Candice and Kate Sosin. “Has the Biden Administration Made Gender-Affirming Surgery Accessible for Federal Prisons? Officials Won’t Say.” The nineteenth. 9 Mar 2023.
Homan, Thomas. “Transgender Care Memorandum.” U.S. Immigration and Customs Enforcement. 19 Jun 2015.
“ACLU Rights for All Candidate Questionnaire 2019.” ACLU web site. Accessed 4 Oct 2024.
Gilchrist, Tracy E. “Kamala Harris on Denying Gender Affirmation Surgery to Trans Inmates.” Advocate. 20 Sep 2019.
NCTE Motion Fund (@ncteactionfund5828). “Transform the White House: Sen. Kamala Harris.” YouTube. 18 Oct 2019.
“Entry.” AdImpact. Accessed 4 Oct 2024.
Kaczynski, Andrew. “KFILE: Harris Pledged Support in 2019 to Cut ICE Funding and Provide Transgender Surgery to Detained Migrants.” CNN. 9 Sep 2024.
NBC Information (@NBCNews). “WATCH: Presidential Debate: Harris v. Trump Hosted by ABC News.” YouTube. 10 Sep 2024.
Washington Submit (@WashingtonPost). “Trump delivers remarks in New York.” YouTube. 26 Sep 2024.
FOX 4 Dallas-Fort Price (@fox4news). “Trump Rally in North Carolina: FULL SPEECH.” YouTube. 21 Sep 2024.
“Donald Trump Rally on 9/18/24 in Uniondale.” Rev.com. 19 Sep 2024.
Donald J Trump (@DonaldJTrumpforPresident). “LIVE: President Trump in Walker, MI.” YouTube. 27 Sep 2024.
Donald J Trump (@DonaldJTrumpforPresident). “LIVE: President Trump in Indiana, PA.” YouTube. 23 Sep 2024.
“Kamala Harris’ policy reversals in the spotlight ahead of presidential debate.” Fox Information. 10 Sep 2024.
St. John, Paige. “Inmate Who Won Order for Sex Reassignment Surgery Recommended for Parole.” Los Angeles Occasions. 21 Might 2015.
Pérez-Peña, Richard. “California Is First State to Adopt Sex Reassignment Surgery Policy for Prisoners.” The New York Occasions. 21 Oct 2015.
“Norsworthy v. Beard.” Transgender Legislation Middle web site. Accessed 4 Oct 2024.
Thompson, Don. “APNewsBreak: California Funds 1st US Inmate Sex Reassignment.” AP Information. 7 Jan 2017.
Sosa, Anabel. “More California Prisoners Are Requesting Gender-Affirming Health Care, Including Surgeries.” CalMatters. 26 Jun 2023.
Vielmetti, Bruce. “Judge Orders Wisconsin to Provide Inmate with Long-Sought Gender Confirmation Surgery.” Milwaukee Journal Sentinel. 11 Dec 2020.
Rose, Andy and Hollie Silverman. “A Transgender Female Inmate Received Her Gender Confirmation Surgery after a Three-Year Court Battle.” CNN. 29 July 2020.
Colombo, Hayleigh. “Federal Judge Rules Transgender Indiana Inmate Can Receive Gender-Affirming Surgery.” Indianapolis Star. 17 Sep 2024.
Diaz, Jaclyn. “A Trans Inmate Wins Health Care and Will Move to Women’s Prison after Suing Minnesota.” NPR. 1 June 2023.
Clark, Moe Okay. “Trans Women in Colorado Prisons to Receive Improved Care, Housing Standards under Historic Legal Settlement.” Denver Submit. 2 Feb 2024.
Johnson, Chris. “Harris takes ‘full responsibility’ for briefs against surgery for trans inmates.” Washington Blade. 21 Jan 2019.
Johnson, Chris. “Despite Harris deal, few surgeries granted to trans inmates in California.” Washington Blade. 20 Nov 2019.
Ramirez, Marc. “Transgender Prisoner Who Fought for Gender-Affirming Care for All Inmates Undergoes Surgery.” USA In the present day. 6 Apr 2023.
“Ashley Diamond, Plaintiff, v. Timonthy Ward, et al., Defendants. Statement of Interest of the United States.” 22 Apr 2021.
“Jane Doe, Plaintiff, v. Georgia Department of Corrections, et al., Defendants. Statement of Interest of the United States.” 8 Jan 2024.
Sosin, Kate. “Biden Administration Releases New Transgender Federal Prison Policy.” The nineteenth. 26 Jan 2022.
Federal Bureau of Prisons. “Transgender Offender Manual.” 13 Jan 2022.
“Short Term Detention.” Homeland Safety. 11 Jan 2023.
“Detention Management.” ICE web site. Accessed 4 Oct 2024.
ICE spokesperson. Electronic mail with FactCheck.org. 26 Sep 2024.
Kvach, Elizabeth. Electronic mail with FactCheck.org. 26 Sep 2024.
Doubossarskaia, Liza et al. “‘No Human Being Should Be Held There,’ The Mistreatment of LGBTQ and HIV-Positive People in U.S. Federal Immigration Jails.” Jun 2024.
Redfield, Elana. Electronic mail with FactCheck.org. 26 Sep 2024.
Baker, Kellan. Cellphone dialog with FactCheck.org. 27 Sep 2024.
Baker, Kellan and Arjee Restar. “Utilization and Costs of Gender-Affirming Care in a Commercially Insured Transgender Population.” The Journal of Legislation, Drugs & Ethics. 2022.
