By John Diedrich
The Milwaukee Journal Sentinel
MILWAUKEE — Is it a disease if someone is born anatomically as one gender but yearns to be the other? And if so, what treatments should be given if that person is in prison?
Those questions were the focus Monday in a federal trial in Milwaukee with potential national implications.
The case pits three prisoners born male, who are taking hormones to become female, against the state’s top corrections official and others. The plaintiffs say a state law banning the hormones for prisoners amounts to punishment targeted to a class of people.
The Inmate Sex Change Prevention Act, which the state Legislature passed in 2005, is believed to be the only law of its kind in the nation. The inmates were taken off hormones for a short time after the law took effect in January 2006 but are receiving them after U.S. District Judge Charles Clevert issued an injunction.
In opening statements, attorneys differed in their assessment of what is known as gender identity disorder.
The prisoners’ attorney, John Knight, called it a “rare and debilitating disease” that is routinely treated with hormones. The 2005 law violates prisoners’ rights, he said. The inmates filed their lawsuit in 2006.
“Legislators are putting themselves between doctors and patients,” he said.
Jody Schmelzer, a state attorney, said the prisoners have a “situation.” Hormones aren’t necessary and can endanger such a person in a male prison, she said.
“Everyone must adapt their body to their own circumstances,” she said.
The plaintiffs’ case opened with Randi Ettner, a clinical psychologist, who said she has treated more than 2,500 sufferers over 30 years and called it the “most misunderstood of all areas of human behavior.” She said the disorder is rare but widely accepted, noting it is in the accepted manual of disorders.
She said roughly one out of 12,000 males is born with a strong desire to be female, or the thought that they are girls until told otherwise.
People with the disorder can be treated in three ways — with talk therapy, hormones and sex-change surgery — but many need hormones, she said.
“Psychology has never talked anyone out of GID. It is not a cure,” she said.
Without treatment, sufferers can act out violently, even castrating themselves. Hormones often cure the person, she said.
On cross-examination, Ettner said some sufferers change their minds about hormones, and some want hormones who don’t need them. She also said the disorder relies initially on self-diagnosis.
Schmelzer noted that one plaintiff is married and has two children. Ettner said that’s not unusual.
“They think, ‘If I marry, maybe I will lose this desire to dress like a woman,’ ” she said.
The next witness was Ettner’s husband, Frederick Ettner, a family physician whose practice includes transgender people. He prescribes hormones but does not perform surgery. He said hormones are an effective treatment for what he called a serious health condition.
“It is a bona fide treatment for a medical condition, like any medical condition,” he said.
Frederick Ettner said gender is 90% determined by the brain, so when a sufferer sees body changes from hormones, he or she improves.
Under cross-examination, he said the hormones have side effects in one-third of patients, and the side effects can be severe for patients who abruptly stop taking the hormones.
The case is being tried by the judge, without a jury, and is expected to last at least through Wednesday. Clevert will issue a decision sometime afterward.
Copyright 2007 The Milwaukee Journal Sentinel