Opinion ID: 2761209
Heading Depth: 2
Heading Rank: 3

Heading: The DOC offers treatment

Text: The DOC responded to Kosilek I by revamping its policy for GID treatment. In the past, the DOC had adopted a policy of freezing a prisoner's treatment at whatever level that prisoner had attained prior to incarceration. Hormonal treatment, for example, would be available only to prisoners who had been prescribed hormones prior to incarceration. In place of this freeze-frame policy, after Kosilek I the DOC adopted a plan that allowed prisoners to receive additional treatment beyond the level of that received before entering prison, when such care was medically required. Under this new plan, medical recommendations would be made by the University of Massachusetts Correctional Health Program (UMass), a health-services provider contracted by the DOC. The DOC Commissioner and the DOC Director of Health Services were responsible for assessing whether any change in treatment would create increased security concerns. Kosilek was evaluated by Dr. David Seil, a gender- identity specialist, who prescribed a course of treatment to alleviate the mental distress -- often referred to as dysphoria -- associated with her GID. In line with Dr. Seil's recommendations, in 2003 the DOC began providing Kosilek with significant ameliorative treatment aimed at directly addressing the -6- mental distress caused by GID. In addition to continued mental health treatment, she was provided female, gender-appropriate clothing and personal effects, and electrolysis was performed to permanently remove her facial hair.2 Kosilek also began a course of hormonal treatments recommended by an endocrinologist. These treatments resulted in breast development and shrinkage of her testicles. All of the treatments described continue to be offered to Kosilek to the present day.