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BOISE — Attorneys for Idaho prison officials argued Thursday that a transgender inmate who is suing for access to gender confirmation surgery is too mentally unstable to receive the irreversible medical procedure.

Lawyer Brady Hall told a three-judge panel of the 9th U.S. Circuit Court of Appeals that Idaho has no policy barring gender confirmation surgery for transgender inmates and that the Department of Correction specifically allows the treatment if it’s deemed medically appropriate.

“It’s the same policy that, for the last seven years, Ms. (Adree) Edmo has been closely followed and monitored by staff to meet her needs,” Hall said.

Edmo has been housed in a men’s prison since she first began serving time on a charge of sexually abusing a child younger than 16 in 2012.

She sued in 2017, contending that the state’s refusal to provide her with gender confirmation surgery amounts to cruel and unusual punishment and causes her severe distress because she has gender dysphoria. The condition occurs when the incongruity between a person’s assigned gender and their gender identity is so severe that it impairs their ability to function.

A federal judge ordered prison officials to provide the surgery earlier this year, and Idaho appealed.

Hall said Edmo’s medical professionals “universally agreed that she did not qualify for the surgery given her uncontrolled mental health issues” but that Edmo refused to participate in therapy that would have helped get her ready for the procedure.

Edmo’s attorney, Lori Rifkin, said Idaho officials are treating Edmo’s condition differently than they would any other medical concern. Prison officials wouldn’t be allowed to refuse life-saving treatment to an inmate with a tumor, and they shouldn’t be allowed to deny Edmo her needed treatment either, Rifkin said.

“They can say they were well meaning, but we have a person whose medical condition is being treated differently,” Rifkin said. “A safe, established, effective treatment and they continue to deny it.”

Rifkin said Edmo was receiving hormone therapy and counseling, but her suffering was so great that she twice tried to mutilate herself in her prison cell. She said that since those attempts, the state has offered Edmo no additional treatment.

“She shouldn’t have to attempt self-castration again or attempt suicide to get the care” she needs, Rifkin said. “Every day is a struggle to survive.”

The three-judge panel will issue a written ruling later.

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