Rebecca Boone Associated Press

BOISE – The Idaho Department of Correction has settled lawsuits with two transgender inmates who castrated themselves after they were denied feminizing hormone therapy.

The terms of the settlements were not disclosed, but the department has changed its policy for identifying and treating transgender inmates. The policy now limits the time inmates must wait for treatment, specifies how they may be diagnosed, and clarifies when they qualify for hormone therapy.

Josephime Von Isaak sued the state in 2006, and Jenniffer Ann Spencer sued the following year. Both inmates, who were born with male anatomy but consider themselves female, contended they were subjected to cruel and unusual punishment because they were denied treatment for gender identity disorder.

Spencer was serving time on a 2000 conviction for possession of a stolen car and escape when she cut off her own testicles with a disposable razor blade in 2004 an apparent effort to rid her body of testosterone. Spencer survived the self-castration, and prison doctors prescribed testosterone replacement therapy – refusing to prescribe the estrogen Spencer wanted.

Isaak, who is serving a life sentence for second-degree murder, said she was also compelled to remove her own testicles with a razor in 2004 after the state failed to diagnose and treat her disorder. Even then, Isaak said in the lawsuit, she went without the estrogen treatment she wanted, and a year after self-castrating she amputated the tip of her penis with a razor blade.

The state cited Isaak’s birth gender and schizophrenia diagnosis when it denied her female hormones and a surgical sex change. In Spencer’s case, the state said a diagnosis of gender identity disorder wasn’t warranted and that Spencer had lied about living as a woman and taking birth control pills before her incarceration.

Isaak’s lawsuit was formally dismissed in the wake of the settlement Wednesday. Spencer’s lawsuit has not yet been formally dismissed, but both Spencer’s and the state’s attorneys signed a stipulated dismissal request that was filed in court Monday.

Shannon Minter, legal director of the National Center of Lesbian Rights and the attorney who represented both Spencer and Isaak, could not be immediately reached for comment.

Idaho Department of Correction spokesman Jeff Ray said he couldn’t comment on the details of the settlements because it was a confidential legal matter. However, Idaho Department of Correction Director Brent Reinke said the department changed its policy on transgender inmates to create a more detailed standard operating procedure.

“It gives the staff more clarity in the specific steps that we’re required to follow,” Reinke said.

The old policy – six pages long and last revised in 2003 – calls for a Management and Treatment Committee made up of prison doctors and mental health workers to approve the diagnosis of gender identity disorder and to come up with a treatment plan. Inmates who come into the prison already taking cross-sex hormone therapy can continue the treatment, if approved by the prison committee.

The new policy says inmates must be given information about available treatment for gender identity disorder, that inmates can’t be harassed by staffers for having been evaluated for the disorder, and that they must be moved to appropriate housing units while they are evaluated. It also spells out that outside consultants may assist in the diagnosis and that a recommendation for treatment must be completed within two months of a gender identity disorder diagnosis.

Also under the new policy, if an inmate is taking cross-sex hormones when entering prison, the inmate will be allowed to continue unless another medical condition makes it unsafe or inadvisable to continue.

Four of the approximately 7,300 inmates in Idaho’s prison system are diagnosed with gender identity disorder, Reinke said.