Photo: getty
She removed one of her own testicles in 2016.
By Rebekah Kuschmider — Written on Aug 29, 2019
An inmate in an Idaho prison will be getting gender confirmation surgery after a court ruled that the procedure constituted a remedy to "extreme suffering and medical needs." Adree Edmo has been in prison since 2012 and has been asking for gender confirmation surgery for at least five years. She has twice attempted to remove her own genitals with a razor blade.
The prison refused the surgical treatment but two different courts have now ruled that gender reassignment surgery is medically necessary for Edmo. The state plans to appeal the latest ruling.
Who is Adree Edmo and why does she need surgery? Read on for all the details.
1. Assigned male at birth
Adree Edmo is 31-years-old and, though she was assigned male at birth, she says she has been living as a woman since her early twenties. NPR reports that she has a diagnosis of gender dysphoria, which the APA defines as "a conflict between a person's physical or assigned gender and the gender with which he/she/they identify. People with gender dysphoria may be very uncomfortable with the gender they were assigned, sometimes described as being uncomfortable with their body (particularly developments during puberty) or being uncomfortable with the expected roles of their assigned gender." According to the ruling from the 9th Circuit Court of Appeals this week, "Edmo has viewed herself as female since age 5 or 6. She struggled with her gender identity as a child and teenager, presenting herself intermittently as female, but around age 20 or 21 she began living fulltime as a woman." The ruling went on to explain that Edmo did not know the clinical terms for her condition until around the time she was incarcerated and she received an official diagnosis from a psychiatrist at the prison. After that, she went through the process of legally changing her name and the markers on her birth certificate to reflect her affirmed gender.
2. Unlikely civil rights figure
Edmo is not a typical hero for trans rights. She is currently serving a 15 year sentence for sexual assault of a child under 16-years-old. According to a man who was previously in a relationship with Edmo, that relationship was marked by both physical and sexual abuse. Despite the clear evidence of her crimes, however, there is an understanding that her status as a prisoner doesn't exempt her from human rights and it is explicitly stated in the 8th Amendment to the Constitution that the states are prohibited from implementing cruel or unusual punishment. It's long been accepted that the 8th Amendment includes ensuring that inmates are given appropriate medical treatment.
The 9th Circuit ruled in Edmo's favor.
3. Treatment for gender dysphoria
The APA lists various approaches to managing gender dysphoria, saying: "It can change the way a person wants to express their gender and can influence behavior, dress and self-image. Some people may cross-dress, some may want to socially transition, others may want to medically transition with sex-change surgery and/or hormone treatment." Not all people choose to take a surgical approach to gender dysphoria but for those who do, there is an established standard of care. The Washington Post reports that the process recommended by World Professional Association for Transgender Health (WPATH), includes "A diagnosis of gender identity disorder or gender dysphoria and a letter of recommendation from the therapist allows a person to begin hormone therapy with a doctor. That is usually followed by a period of living publicly as a member of the opposite sex and, finally, surgery to alter the genitalia and other body parts."
4. Edmo's attempts at mutilation
Edmo meets the criteria for gender dysphoria and was formally diagnosed with the condition in 2012. She started hormone replacement therapy at the time and took steps to make her gender presentation align with her identity including feminine hair and dress — for which she was reprimanded by the prison according to court documents — and changed her name and official documents to reflect her female gender. She had also requested gender confirmation surgery, which was repeatedly denied by the prison on the grounds that the doctors there didn't think she needed it. They did not dispute the efficacy of the surgeries — they just didn't think Edmo needed it. However, Edmo was so determined to alter her body to fit her affirmed gender that she attempted to remove her own testicles not once but twice. The first attempt in 2015 was unsuccessful but in 2016 she managed to partially castrate herself before losing so much blood that she was forced to call for help, according to the AP.
Edmo was represented by the NCLR.
5. Fighting for her rights
Edmo has been requesting the surgery for five years and sued for the surgery in 2017. In December 2018, the U.S. District Court for the District of Idaho ordered IDOC to provide the surgery. The IDOC appealed to the 9th Circuit Court of Appeals and the panel ruled that the original decision had been correct and the IDOC needs to provide treatment to Edmo, saying that she “has a serious medical need, that the appropriate medical treatment is GCS [gender confirmation surgery], and that prison authorities have not provided that treatment despite full knowledge of Edmo’s ongoing and extreme suffering and medical needs.” The Court went on to say that “the responsible prison authorities have been deliberately indifferent” to Edmo's gender dysphoria in violation of the Eighth Amendment of the United States Constitution, which prohibits “cruel and unusual punishment.” For her part, Edmo is relieved to have the ruling come down in her favor yet again, saying: "I am relieved and grateful the court recognized my right to necessary medical treatment, and that I will get the surgery I need. I hope my case helps the State of Idaho understand that they can’t deny medical care to transgender people.”
6. Not done yet
The prison system has argued that Edmo's doctors don't think she actually needs the surgery but the courts have found fault in that reasoning because the doctors haven't re-evaluated her case adequately since her second — and successful — attempt at castrating herself. At the time, she told the medical staff that she tried to remove her own testicles because of "feeling angry/frustrated that [she] was not receiving the help desired related to [her] gender dysphoria. Inmate Edmo’s actions were reported as a method to stop/cease testosterone production in Edmo’s body." The Court found that the medical reasoning behind the denial of surgery was faulty and Edmo would benefit from gender reassignment, writing "It is enough that [her doctor] knew of and disregarded an excessive risk to Edmo's health by rejecting her request for [gender confirmation surgery] and then never re-evaluating his decision despite ongoing harm to Edmo."
7. The Governor of Idaho is not on board
However, the Governor of Idaho isn't willing to stop trying to block treatment to Edmo, saying in a statement: "The hardworking taxpayers of Idaho should not be forced to pay for a convicted sex offender's gender reassignment surgery when it is contrary to the medical opinions of the treating physician and multiple mental health professionals." Gender reassignment surgery of this kind costs about $20,000-30,000, which is probably far less than the cost of appealing the case to the Supreme Court.
The state of Idaho has 90 days to files their intent to appeal the case, which the Governor has indicated that they will do.
Rebekah Kuschmider has been writing about celebrities, pop culture, entertainment, and politics since 2010. Her work has been seen at Ravishly, Babble, Scary Mommy, The Mid, Redbook online, and The Broad Side. She is the creator of the blog Stay at Home Pundit and she is a cohost of the weekly podcast The More Perfect Union.