Yes, that medical treatment, like the majority of other necessary inmate treatment will be paid for by the general fund -- aka, taxpayer dollars.

But it is not a free for all, actually, quite the opposite. Inmates who wish to be considered for either hormone treatment or gender reassignment surgery will be evaluated by the facility's health care staff. Their evaluations will be passed along to the new Gender Dysphoria Collaborative Review Committee, who will then review the case file and determine if treatment is a medical necessity for the inmate.

Inmates suffering from gender dysphoria can also be considered for things like isolated cells, separate shower times and other adjustments to ensure their safety. And Michigan is catching up to national standards in this sense.

The U.S. Department of Justice's Prison Rape Elimination Act put in place back in 2012, a measure that prohibited prison facilities from housing prisoners solely based on external genital anatomy -- instead, housing for transgender inmates should be on a case by case basis. But most states neglected to adhere by this law, Michigan included.

"Previously, and currently, all prisoners are housed based on their assigned gender at birth," Spokesperson for MDOC, Chris Gautz said.

Gautz said they do handle each case individually, but currently, none of their 50 identified transgender prisoners are housed with the genders they identify with.

The department knew revisions to current policy were necessary, according to Gautz. Prior to the revision that went into place officially on June 26, 2017, transgender inmates could only have access to treatment if they were already on it prior to incarceration.

The MDOC expects necessary gender reassignment surgeries to be few and far between, if any at all. Nationally, there has only been one gender reassignment surgery conducted on an inmate to date. Gautz did not have an estimate for how much these surgeries would cost, but said hormones can cost between $50 and $70.

The fight for a change started with an inmate named Jami Naturalite. She identifies as a female, and MDOC initially denied her access to hormones. Naturalite wrote to the Southern Poverty Law Center and the Michigan ACLU for help. Less than a year later, Naturalite has been approved by the committee and has now started hormone treatment. But Gautz said it is important to note that less than 10 of the 50 known transgender inmates in Michigan are receiving hormone treatments.

That's the major change to policy, Gautz said, but beyond that the revision serves to treat each transgender inmate on a case by case basis -- taking the necessary steps to treat inmates in a way that both ensures their safety and their health.

David Dinielli, SPLC deputy legal director, said that Michigan's new policy is one of the "more progressive" that their organization has seen, but still it is years behind the DoJ's measure. Dinielli said that is due to a lack of enforcement at the federal level.

Dinielli also said it is important to note that not every transgender person has medical needs, only those suffering from gender dysphoria typically need to seek treatment. So, this policy essentially recognizes gender dysphoria as any other medical condition.

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