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The Boston Globe



Free sex change for prisoner is distasteful, but justified

The public is certainly justified in feeling outraged that a convicted murderer might get a sex-change operation at taxpayer expense, while private insurers are free to deny coverage to law-abiding citizens who seek such surgery. Basic fairness suggests that prisoners shouldn’t get better care than law-abiding citizens — but the sad reality is that they do all the time. Prisoners are covered; more than 15 percent of the national population is not.

But federal Judge Mark Wolf’s painstakingly argued decision makes a persuasive case that, under the law, the prisoner now known as Michelle Kosilek is entitled to the surgery because it is medically necessary, not an elective procedure. Any backlash, as understandable as it may be, should be directed instead at the vast inequities in the health care system — and at the lack of clear standards about how far states must go in providing health services to prisoners.

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