Michelle Kosilek, born as Robert, is a transgender individual who identifies as female and who wishes for her physical sex to match her gender. The problem is, she murdered her wife in 1990.
The Massachusetts Department of Correction does not wish to pay for sexual reassignment surgery. Kosilek argues that not doing so amounts to cruel and unusual punishment. She has twice previously attempted suicide and self-castration (all while awaiting trial for murder) and lesser treatments (hormones and psychotherapy) have not relieved her mental anguish over her gender identity disorder.
In 2012, U.S. District Court Judge Mark Wolf ordered the state to pay for the surgery. Earlier this year, a split First Circuit panel upheld that decision, 2-1. But today, an en banc court reversed in an opinion penned by the original panel's dissenter, while the two majority judges from the prior panel decision penned dissents.