A 57-year-old California inmate named Shiloh Heavenly Quine has become the first U.S. inmate to receive a state-funded sex-reassignment surgery, according to a report from the Associated Press.

Quine, who is currently serving a life sentence without possibility of parole for a first-degree murder, kidnapping, and robbery for ransom, first sued the state of California for access to this surgery as well as gender-affirming clothing and cosmetics that she had been denied in 2014. She has been living openly as a woman since 2008.

The precedent-setting decision comes a year and a half after the U.S. Department of Justice released a brief acknowledging that prisons have the obligation of treating prisoners for gender dysphoria just as they would any other medical or mental health condition.

Quine has been living in a men’s prison until this point but will be transferred to a facility for women after her recovery, reflecting on a systematic issue trans persons in prisons face. In addition to the emotional distress of being constantly misgendered and often being placed in isolating solitary confinement as a protective measure, the experience of serving time in the wrong prison can be very dangerous for trans inmates. A study conducted in 2013 found that nearly 60 percent of trans women housed in men’s prisons within the state of California had been sexually assaulted, a rate 15 times higher than that of non-transgender inmates.

In the 35 years Quine has been serving time in a men’s prison, she has attempted to commit suicide five times, an experience that is far from unique.

Just yesterday, a British inmate who had become ill and apparently depressed after she was denied female hormones in a men’s prison was found hanged in her cell. Chelsea Manning, perhaps the most high-profile transgender inmate in the U.S., brought increased attention to the issue of after she attempted suicide (also in a men’s prison) this past summer.

While a spokesperson representing the state of California’s prison medical care said the cost of these kinds of surgeries could hit $100,000, it’s a high estimate that has caused controversy in the past. Quine’s lawyers have previously estimated the true cost to fall between $15,000 and $25,000/

According to the Los Angeles Times, there are nearly 400 transgender inmates receiving hormonal treatment in California alone.