A transgender woman serving a prison sentence for sexual abuse in Idaho has undergone gender affirmation surgery, after a years-long legal battle and two attempts to castrate herself behind bars.

Adree Edmo had pursued a successful legal challenge against Idaho and Corizon Health Inc, the provider of healthcare for the state prison system, over the refusal to permit her surgery.

She underwent surgery on July 10, according to the Idaho Press, after successfully arguing that depriving her of treatment violates the constitution’s ban on “cruel and unusual punishment”.

The surgery is estimated to cost between $20,000 and $30,000 — far less than the state is believed to have poured into legal battles to prevent it from taking place.

Edmo was sentenced to ten years behind bars in 2011 for sexual abuse of a minor after performing a sex act on a male 15-year-old. She was 22 at the time.

Surgery: Governor Brad Little has repeatedly denied transgender inmate Adree Edmo's request for surgery
Governor Brad Little has repeatedly denied transgender inmate Adree Edmo’s request for surgery

The inmate was diagnosed with gender dysphoria by prison doctors in 2012, but was denied access to gender affirmation surgery, leading her to attempt self-castration while in prison on two occasions.

She sued for the right to undergo surgery in 2017, and was ultimately victorious in federal district and appellate courts.

Idaho’s Republican governor Brad Little had sought to appeal the ruling even further, to the US Supreme Court, but it declined to take up the case and permitted the lower court ruling to stand.

Despite burning through taxpayer dollars fighting the legal action, Little had argued: “The hardworking taxpayers of Idaho should not be forced to pay for a convicted sex offender’s gender reassignment surgery when it is contrary to the medical opinions of the treating physician and multiple mental health professionals.”

Appeals court found that denying treatment causes ‘ongoing harm’.

The ninth circuit court of appeals found that prison doctors “knew of and disregarded an excessive risk to Edmo’s health by rejecting her request”, causing “ongoing harm” to her.

The ruling doesn’t mean that all trans inmates in Idaho will be eligible for state-funded gender-confirmation surgery, but it could set a standard for providing surgery to certain inmates with severe gender dysphoria like Edmo.

Edmo is is scheduled for release in 2021.

A trans woman serving a sentence for murder in California became the first inmate to be permitted gender affirmation surgery in 2017. As of 2019, a total of seven inmates in California have undergone gender affirmation surgery, according to public records.