A three-judge panel is now considering the case of a Virginia inmate fighting to get a state-paid sex change surgery.
Ophelia De' Lonta has 'Gender Identification Disorder' and believes she's a woman, trapped in man's body.
The 4th Circuit Court of Appeals was asked Wednesday to reverse a lower court ruling which dismissed her case, and allow De' Lonta to move towards surgery.
De' Lonta's case ended up in appeals court because she says the lower court judge dismissed it without hearing any evidence.
Her lawyers say G.I.D. doctors should decide whether surgery is the next treatment, not a judge, prison officials, or public opinion.
The state routinely pays for major medical conditions for prisoners but, Ophelia De' Lonta says it's different for her because sex change surgery is considered distasteful and unusual.
"I want to be treated just like any other female. I'm here because I broke the law but while I'm here, treat me how I'm suppose to be treated."
In court, her attorneys accused the prison system of ignoring De' Lonta's symptoms by stalling and refusing to have her evaluated for surgery.
The state says she's already getting adequate medical treatment for her disorder.
"The problem is she isn't getting treatment that's effective at addressing her disorder. She continues to suffer extremely severe symptoms including uncontrollable compulsions to mutilate herself which could end up being fatal," said Rebecca Glenberg for the ACLU.
The AG's office claims De' Lonta gets consistent treatment that's guided by a G.I.D. specialist and said the inference that D.O.C. is not evaluating her is not a plausible argument.
Ophelia's attorneys say the current treatment of hormones and counseling no longer works and the state is obligated by the constitution to look for other treatments.
They also say the state is afraid an evaluation might prove the surgery is medically necessary and the state will have to pay for it.
It's a compelling case. The judges were engaged and had questions. The chief justice wanted evidence the state had actually evaluated De' Lonta.
Victor Glasberg and Bernadette Armand, De' Lonta's lawyers, left court feeling optimistic.
The 4th Circuit Court of Appeals is expected to issue a decision over the next two or three months.
If the ruling is favorable, De' Lonta's case will go back to district court where she can argue for a sex change operation paid for by the state.
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