- In 2019, Vice President Kamala Harris did express support for a policy that would give access to trans people who depend on state-funded health care — including inmates and detained immigrants — to gender-affirming care, which includes surgery.
- Harris and her campaign have declined to say whether she still supported it in 2024.
- However, it has been the policy in federal prisons since at least 2016, according to Bureau of Federal Prisons' guidance issued in 2016 and updated in 2022. Both President Donald Trump and President Joe Biden have maintained it. The policy follows the medical recommendations of every major medical association in the U.S.
- In 2022, a court ordered the first gender-affirming surgery for a trans federal inmate, affirming this long-standing policy. In 2023, the U.S. Supreme Court allowed an appeal to stand that ruled gender dysphoria could be included in the Americans with Disabilities Act.
As the 2024 U.S. presidential election drew near, supporters of Republican former President Donald Trump and his campaign released a video advertisement accusing his opponent, Democratic Vice President Kamala Harris, of supporting gender transition surgery for undocumented immigrants in custody:
Narrator: Under liberal borders czar Kamala Harris, illegal aliens are pouring into our country, including murderers, rapists and even terrorists. Instead of paying for their crimes and receiving justice, Kamala will give criminal illegal aliens taxpayer-funded transgender surgeries.
Harris: "surgery for prisoners for prisoners. Every transgender inmate would have access."
Narrator: Crazy liberal Kamala is for they/them President Trump is for you.
Make America great. Again, inc is responsible for the content of its advertising.
Trump previously made that accusation during his Sept. 10, 2024, debate against Harris. The video clip of the debate circulated widely on social media:
This X post (archived) had amassed 12.4 million views and 167,000 likes as of this writing. During the debate, Trump added, "this is a radical left liberal that would do this." Later, X and Tesla owner Elon Musk shared a video of Harris asserting the same thing.
The rumor also appeared in a separate TV advertisement for the Trump campaign at the end of September 2024 that claimed "even the liberal media were shocked" by Harris' stance on gender-affirming surgery for inmates (archived):
Voice-over: Kamala supports taxpayer funded sex changes for prisoners.
Harris: … surgery for prisoners, for prisoners, every transgender inmate in the prison system would have access.
Voice-over: It's hard to believe, but it's true, even the liberal media was shocked. Kamala supports taxpayer funded sex changes for prisoners and illegal aliens.
Harris: Every transgender inmate would have access.
Voice-over: Kamala is for they/them. President Trump is for you.
Trump: I'm Donald J. Trump and I approve this message.
The claim is true. During her first presidential campaign in 2019 and 2020, Harris endorsed gender-affirming surgery for people who depend on the state to receive health care. In a 2019 questionnaire for the American Civil Liberties Union, Harris answered "yes" to question 14, which asked:
As President will you use your executive authority to ensure that transgender and nonbinary people who rely on the state for medical care — including those in prison and immigration detention — will have access to comprehensive treatment associated with gender transition, including all necessary surgical care? If yes, how will you do so?
After ticking the "yes" box, she elaborated, adding that she had already supported those policies in her capacity as attorney general of California (emphasis ours):
It is important that transgender individuals who rely on the state for care receive the treatment they need, which includes access to treatment associated with gender transition. That's why, as Attorney General, I pushed the California Department of Corrections and Rehabilitation to provide gender transition surgery to state inmates. I support policies ensuring that federal prisoners and detainees are able to obtain medically necessary care for gender transition, including surgical care, while incarcerated or detained. Transition treatment is a medical necessity, and I will direct all federal agencies responsible for providing essential medical care to deliver transition treatment.
By definition, people who are held in federal detention facilities for migrants and federal prisons depend on the state for medical care, which is therefore funded with taxes. It is the position of all reputable medical associations in the U.S. that gender-affirming care is health care, and that the course of treatment should be agreed on by a patient (and their family if they are young) and their doctor. The Federal Bureau of Prisons of the Department of Justice issued guidance in 2022 regarding the treatment of transgender offenders, and it outlines the procedure for inmates to request surgery:
9. Surgery
While not all inmates who identify as transgender may be interested in seeking surgical intervention, such a decision does not preclude them from obtaining other accommodations as described in this Program Statement. For transgender inmates in Bureau custody, surgery may be the final stage in the transition process and is generally considered only after one year of clear conduct and compliance with mental health, medical, and programming services at the gender affirming facility. Once that period elapses, an inmate may submit a request to his or her Warden requesting surgical consideration. The Warden will forward the request to the TEC [Transgender Executive Council]. The TEC is the sole body who may determine that all milestones and individual goals for surgical consideration have been met. When this occurs, the case is referred to the agency's Medical Director for medical consideration. He or she may review existing records and/or interview the inmate, institution staff, and members of the TEC. After this individualized assessment, the Medical Director will determine if the surgery is medically appropriate for referral to a gender affirming surgeon.
In effect, providing gender-supporting care in federal detention facilities, including surgery, was already the policy by the time this claim began to spread. In fact, these policies have been in place since at least 2016, according to the BOP.
In 2022, a district court affirmed this policy by ruling that a federal inmate should receive gender-reassignment surgery. In 2023, the U.S. Supreme Court allowed an appeal to stand that ruled gender dysphoria could be included in the Americans with Disabilities Act.
In an interview on CNN at the end of August 2024, Harris outlined some of ways she changed her policy proposals, but she also added that her "values have not changed." As of this writing, the campaign hadn't said whether she maintained her support of giving trans inmates access to gender-affirming care, including surgery, only that "that questionnaire is not what she is proposing or running on," the Harris campaign's communications director, Michael Tyler, said on Fox News on Sept. 10, 2024.