Transgender woman serving time in a male jail and wanting gender reassignment loses her case KK claimed the Tavistock and Portman NHS Foundation Trust unlawfully refused to refer her for gender reassignment surgery

A transgender woman prisoner has lost her High Court battle for gender reassignment surgery.

Identified only as KK in court, she has been living as a woman for eight years while serving time in a man’s prison for downloading indecent photographs of children.

She claimed the Tavistock and Portman NHS Foundation Trust unlawfully refused to refer her for gender reassignment surgery because all her “real life experience” as a woman has been in prison.

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The trust argued KK, 60, was not referred because “the treating clinicians at a world-class clinic for gender dysphoria did not consider it clinically appropriate to refer her for surgery”.

Giving judgement in London on Friday, Mr Justice Supperstone said: “The expert clinical opinion in this case … is that a referral should not be made. The claimant has produced no evidence to the contrary.”

Previous behaviour

He added: “There is, in my view, no basis for the contention that the expert clinicians, having unanimously formed the view on medical grounds that a referral should not be made, should nevertheless have decided to refer because the claimant wished them to do so.”

Mr Justice Supperstone said the psychiatrist who originally referred KK to the trust’s London Gender Identity Clinic had noted that she “has a number of convictions for possessing or downloading indecent images of children, starting through the 1980s”.

A previous conviction in the 1990s of sexual assault on a girl over a four-year period, also helped the clinic reach its conclusion.

In a witness statement to the court, Dr James Barrett, lead clinician at the clinic stated: “The fact that she had a history of sexual offences was a seriously complicating factor.

“People with gender dysphoria feel imprisoned in the wrong body, convinced they are a woman living in a man’s body.

“Women who are living in female bodies do not normally groom children, still less perform oral sexual acts on 12-year-old girls. It is unusual and it made it much harder to accept her history at face value.”

Living as a woman

KK’s barrister David Lock QC said the refusal to refer his client was “solely based on the fact that the claimant has lived as a woman in prison for the last eight years as opposed to living outside of prison”.

He submitted that the trust refused to make the referral over “concerns that there was a possibility that the claimant may not wish to continue to live as a woman following her release from prison”.

Jenni Richards QC, for the trust, argued that “the fact that the claimant’s real life experience (as a woman) has been acquired in prison … is relevant to the determination of whether surgery is an appropriate intervention for her, at this stage and in her present circumstances”.