A nearly two-decade legal fight by a convicted murderer in Massachusetts to get taxpayer-funded sex-reassignment surgery ended in failure Monday when the U.S. Supreme Court rejected her final appeal.

The justices did not comment in letting stand a lower-court ruling denying the surgery to Michelle Kosilek.

“This is a terrible and inhumane result for Michelle,” said Jennifer Levi, director of the Transgender Rights Project for Boston-based Gay and Lesbian Advocates and Defenders.

The state Department of Correction, which has fought the surgery, did not immediately respond to a request to comment.

State prison officials, who say the surgery could cost as much as $50,000, have said in the past they opposed the surgery because it would create security problems.

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Kosilek was known as Robert Kosilek when she was convicted of murdering her spouse, Cheryl, in 1990.

Kosilek, now 65, said in her legal fight against the state prisons department that her Eighth Amendment right against cruel and unusual punishment was being violated and the surgery is necessary to relieve the mental anguish caused by gender-identity disorder.

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