Government, being “the only thing we all belong to,” is a peculiar institution with unique responsibilites. It’s like a club, you see, but you don’t get to choose to join, and the club president happens to have the power to kill or imprison you without a trial. But membership has its benefits, and having protected us from the tyrannies of communism and fascism, some now expect protection from the tyranny of biology itself. And that goes for murderers, too:

In a first-of-its-kind ruling, a federal judge in Boston has ordered Massachusetts authorities to provide a taxpayer-funded sex-change operation for a transgender prisoner. Chief U.S. District Judge Mark Wolf said he based his ruling on the recommendations of doctors at the commonwealth’s Department of Correction who prescribed sex-reassignment surgery as “the only form of adequate medical care” for Michelle Kosilek.

Kosilek, who used to go by “Robert,” is serving life in prison without the possibility of parole for the 1990 murder of his wife. Judge Wolf, describing his 126-page order as “unprecedented,” said that denying Kosilek the surgery was a violation of the Eighth Amendment’s prohibition on cruel and unusual punishment. (WSJ)

Several news stories don’t mention the circumstances of his wife’s death, but the National Law Journal has a brief line:

Kosilek murdered his wife, Cheryl McCaul, in 1990 after she expressed anger upon finding Kosilek wearing her clothes. The two met in a drug rehabilitation facility, where McCaul was a volunteer. According to the ruling, she told Kosilek that “a good woman” could cure his transexualism.

The court’s ruling is, of course, just the sort of compassionate governance Sandra Fluke would support, breaking down the persistent barriers of heteronormativity and gender bias which bear consideration, presumably, even for convicted criminals. On that, isn’t Fluke right? The cost alone of these surgeries shouldn’t be grounds to deny them, inmates get (admittedly often poor) cancer treatment and costly care for plenty of other ailments, why not cover gender dysphoria too? If you concede that prisoners should be cared for and treated humanely, it’s hard to argue they shouldn’t receive the surgery, especially if a prisoner who doesn’t receive it is likely to be found hanging from his or her shoelaces.

Fluke, the activist and Georgetown Law student who has become the poster child for state-subsidized birth control–not reproductive rights writ large, she remains conspicuously silent about whether or not women have the right to purchase contraceptives over the counter–will speak tonight at the Democratic National Convention. She argued for taxpayer-funded sex changes as recently as 2011, as Charles C. Johnson reminds us:

Fluke and co-editor Karen Hu advocated remaking U.S. law to remove what they called a “gender bias” at the root of denying coverage for “transgender medical needs,” describing it as “a prime example of direct discrimination.”

“Transgender persons wishing to undergo the gender reassignment process frequently face heterosexist employer health insurance policies that label [gender-reassignment] surgery as cosmetic, or medically unnecessary and therefore uncovered,” Fluke and Hu wrote for the Georgetown Journal of Gender and the Law. The review article was titled “Employment Discrimination Against LGBTQ Persons” and appeared in print in 2011.

By some estimates, sex change operations can cost between $15,000 and $20,000; the cost for some procedures can be as high as $50,000. Fluke and other advocates want insurers to cover all such operations. In general, assuming the costs of new coverage mandates tends to raise rates for all enrollees in a given health-care plan.