California prison officials agreed in August 2015 to pay for the surgery for Shiloh Heavenly Quine, who was convicted of first-degree murder, kidnapping and robbery for ransom and has no possibility of parole.
Quine's case led the state to become the first to set standards that will allow other transgender inmates to apply to receive state-funded sex-reassignment surgery.
It also prompted a federal magistrate to require California to provide transgender female inmates housed in men's facilities with more female-oriented items such as nightgowns, scarves and necklaces.
"For too long, institutions have ignored doctors and casually dismissed medically necessary and life-saving care for transgender people just because of who we are," said Kris Hayashi, executive director of the Transgender Law Center, which represents Quine and other transgender inmates.
Completion of the surgery not only fulfills a landmark legal settlement but marks a victory "for all transgender people who have ever been denied the medical care we need," Hayashi said.
Quine will be moved to a women's prison after the operation, which was performed at a hospital in San Francisco, her attorneys said.
The daughter of Quine's victim said she objects to inmates getting taxpayer-funded surgery that is not readily available to non-criminals, regardless of the cost.
"My dad begged for his life," said Farida Baig, who tried unsuccessfully to block Quine's surgery through the courts. "It just made me dizzy and sick. I'm helping pay for his surgery; I live in California. It's kind of like a slap in the face."
Quine and an accomplice kidnapped and fatally shot 33-year-old Shahid Ali Baig, a father of three, in downtown Los Angeles in February 1980, stealing $80 and his car during a drug- and alcohol-fueled rampage.
California was legally required to pay for the operation, corrections spokeswoman Terry Thornton said.
"The Eighth Amendment of the US Constitution requires that prisons provide inmates with medically necessary treatment for medical and mental health conditions including inmates diagnosed with gender dysphoria," Thornton said in a written statement.
California corrections officials had fought in court for years to avoid paying for sex-reassignment surgeries. In one high-profile case, the state paroled Michelle-Lael Norsworthy in 2015, just one day before a federal appeals court was to hear her request for state-funded surgery.
Quine told a prison psychologist who recommended her for the operation that it would bring a "drastic, internal completeness."
She expects it will end a dysfunction and depression so deep that she tried to cut and hang herself in prison five times, most recently in 2014 when she was initially told she could not have the operation.
Quine said she tried unsuccessfully to amputate her genitalia when she was about 19, three years before she went to prison and roughly the same time she tried self-medicating with illegally purchased female hormones.
Joyce Hayhoe, a spokeswoman for the federal court-appointed official who controls California's prison medical care, said the cost of sex-reassignment surgeries could approach $100,000, including procedures and medications before and after the operation.
Attorneys at the Oakland-based Transgender Law Center said that figure is exaggerated.
A portion of the state's expense will generally be reimbursed by the federal government, Hayhoe said. The percentage varies depending on individual circumstances, but it can cover up to 95 percent of allowable charges.
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