Between abuse, pain, and frustration, Ashlee Inscoe has dealt with a lot during her last few years in prison. On Wednesday, she finally experienced some desperately sought relief.
For more than a year, Inscoe, a transgender woman who was born intersex, had been pleading with prison officials to allow her to undergo surgery to correct a painful, life-threatening situation that required doctors to remove undeveloped reproductive tissue inside her abdomen. Her requests were repeatedly turned down until this summer, when two visits to an emergency room within the span of 10 days indicated that inaction was no longer an option.
In mid-August, a review board finally granted approval, and on Wednesday, Inscoe was taken to UNC Hillsborough, where she underwent the roughly two-hour procedure to remove the excess reproductive tissue. Inscoe believes the procedure was the first time N.C. prison officials have allowed such a surgery for a transgender or intersex inmate.
“Over the past few years, I’ve had a lot of pain from it,” Inscoe, 41, told The News & Observer this week after being released from the hospital and returning to Nash Correctional Institution in Nashville, about 45 miles east of Raleigh. “It started getting worse and worse as time progressed on, just from having that pressure on my abdomen.”
Last year, Inscoe told the N&O she grew up believing she was male, until she reached puberty and began her menstrual cycle. Genetic testing revealed she had two X chromosomes, and doctors later discovered the undeveloped excess tissue. Despite Inscoe being intersex, her mother continued raising her as a boy.
Being housed in a male prison
For much of her adult life, Inscoe has been in and out of prison on a litany of charges including breaking and entering, hit and run, larceny, speeding to elude arrest, habitual felon, and possession of a firearm by a felon. She’s also a registered sex offender for a 2000 conviction of indecent liberties with a 13-year-old, when she was 18.
During each of those sentences, Inscoe was assigned to male prisons, which she said led to almost constant verbal and physical abuse.
Since July 2017, Inscoe has been serving a maximum sentence of 13 years and 10 months, first at the Avery-Mitchell Correctional Institution near Spruce Pine, about 120 miles northwest of Charlotte, and since February, at Nash Correctional Institution.
In April 2020, Inscoe submitted her first request to prison officials to be transferred to a women’s prison, citing regular harassment she was receiving for being intersex. As part of the request, Inscoe had two doctors confirm that she was both intersex and transgender. The request was ultimately denied.
Beginning in the summer of 2021, Inscoe tried to increase pressure on N.C. Department of Public Safety officials to address her complaints about treatment by inmates and guards and to approve her requests for surgery and a transfer to a women’s prison. In April 2021, the review board gave initial approval for Inscoe to undergo an orchiectomy, but later withdrew approval so that a DPS committee that considers accommodations for transgender inmates could make a decision, according to Inscoe’s attorney, Elizabeth Simpson.
When a doctor submitted a medical request for surgery in June 2021, the review board told Inscoe’s attorneys the request would not be approved since officials considered the procedure to be “gender affirming care” instead of “medically necessary,” The N&O reported.
Simpson said the delays with the surgery caused Inscoe’s physical and mental health to deteriorate.
“Ashlee has needed this surgery for a very long time, and she has suffered without it. Unfortunately, North Carolina incarcerates far too many people in its state prisons and it has not provided adequate resources to take care of all their medical needs,” Simpson said in an email. “In particular, transgender incarcerated people are suffering without necessary medical care and without respectful and humane conditions of confinement.”
Misgendered during medical examinations
At one point, Inscoe said, an official reviewing her requests told her the surgery wouldn’t be approved because it would open the door to other inmates requesting similar procedures. When she has been examined at the prison, nurses have described her in prison records as a male.
Brad Deen, a spokesperson for DPS, said federal and state laws prevent officials from commenting on specific details about an inmate’s prison record, including their medical or health records. Deen also said DPS does not comment on claims “concerning quality of care and treatment while in custody.”
Asked if Inscoe’s surgery was the first of its kind to be approved for an inmate in North Carolina, Deen said the department’s Division of Adult Correction “has not approved surgery for the express purpose of treating gender dysphoria” but pointed out that many surgeries can be performed to treat “a variety of conditions.”
“Specifically, surgeries which can be performed in the treatment of transgender patients are also performed in the treatment of conditions which arise in non-transgender patients,” Deen said in an email.
Visits to emergency room lead to surgery
Approval for the surgery came relatively quickly after Inscoe suffered from abdominal pain and bleeding in her genitals this summer, causing officials to transport her twice to a nearby hospital, once on July 16, and again on July 26. After being examined during the first visit to the emergency room, a doctor wrote that Inscoe was suffering from “vaginal bleeding.”
Inscoe also complained of not being able to urinate, and was given a catheter during her second visit to the hospital.
As part of her treatment, doctors told her to use menstrual pads and take specific medication. But when she returned to prison, Inscoe said, staff would only allow her to use an adult diaper, which they said was in accordance with protocol for a male prisoner.
After being released from the hospital on Wednesday, Inscoe returned to her dormitory at Nash Correctional Institution, which houses approximately 100 people out of the full 654-person capacity of the prison. As she recovers from the surgery, there’s still a lot of pain, for which she was prescribed oxycodone, and swelling. She feels relief, but said it’s still frustrating to remain in a men’s prison.
“Here I am, a woman, after having surgery, and I’m still stuck with men,” Inscoe said.
For more North Carolina government and politics news, listen to the Under the Dome politics podcast from The News & Observer and the NC Insider. You can find it at https://campsite.bio/underthedome or wherever you get your podcasts.
Read the full article here