A case concerning a “transgender” inmate has struck a chord with folks across the nation, LGBT supporters and those against, which could influence future rulings for elective surgery. At the least, it begs the question of how our prison systems should function.

Michelle Kosilek, previously named Robert Koselik, murdered his wife, Cheryl, in 1990 and is currently serving a life sentence in Boston.

Kosilek has received hormone treatments but lives in a manner more like a woman in an all-male prison — don’t even get me started on the prison slang “punk” jokes.

U.S. District Judge Mark Wolf ruled 12 years ago Kosilek would receive treatment for gender-identity disorder, due to Kosilek’s claim he is a woman living in a man’s body.

On Sept. 4, after Kosilek had tried to castrate himself and twice attempted suicide during his incarceration, Wolf ruled the state of Massachusetts will foot the bill for sex reassignment surgery, to a tune that could cost up to $20,000.

Wolf’s 126-page ruling is partly explained by the following excerpt: “There is no less intrusive means to correct the prolonged violation of Kosilek’s Eighth Amendment right to adequate medical care,” and that the surgery is the “only adequate treatment” option.

Kosilek cannot keep a job to pay for the surgery himself. So taxpayer money is basically the only option. But the big question is whether the surgery is necessary as a medical procedure.

Gender reassignment surgery for Kosilek will not save his life. It might make him less apt to attempt suicide as a result of still having a penis but doesn’t guarantee his mental state does not continue to cause suicidal thoughts.

On the other hand, the mental anguish Kosilek is suffering from being a transgendered person trapped in the “wrong” body does make it cruel to deny him surgery, given the hormone treatments and mental evaluations are not cutting it and even murderers have rights.

Do we continue to use ineffective treatments to help him, hoping it will one day pay off, or do we support such surgeries to deal with the physical aspect, while the mental aspect remains an issue?

I have to say I don’t support the surgery. I don’t support it because transgendered persons without financial means, who abide by the law, are not given such assistance. If Kosilek is suffering such mental anguish, maybe noncriminals who feel trapped in the wrong body suffer similar problems.

A survey found 41 percent of 6,450 transgendered respondents to have attempted suicide, compared to the rate of 1.6 percent suicide attempt rate for the whole of the population, according to the 2011 report of the National Transgender Discriminatory Survey: “Injustice at Every Turn.”

It usually takes a fair bit of mental anguish to attempt suicide, so maybe sex reassignment surgery should be something funded partly under health care provided adequate mental evaluation has been undertaken. To receive hormone therapy for gender dysphoria, psychiatric evaluation must be undertaken, and if it is determined the person is only able to continue on with the surgery, then surgery seems like a lifesaving issue.

But in Kosilek’s case, I have to ask how much his mental anguish is his penis problems, and how much is prison. The man murdered his wife. Ask any soldier out there how killing a person can weigh on you, and you can imagine how the act of murder could mess with your head.

And what about the harassment, physical and mental, Kosilek likely receives in the prison for his female qualities. Being a “punk” in prison tends to result in some dropping the soap incidents — OK, I couldn’t help getting at least one prison slang joke in.

Where do you put Kosilek when the surgery is done? Is “he” still a “he” or is “he” now a “she”? There is not a concrete legal system for transgendered people to establish what sex they are, with or without surgery; the only norm is to be socially polite and refer to the person by whatever gender they wish to be.

In any case, Kosilek’s harassment will likely not diminish in an all-male prison, nor would it should he be moved to an all-female one.

So what does this surgery accomplish apart from making a murderer possibly feel better?

Though subjecting murderers to mental and physical torment is not OK legally, giving opportunities to them that are not afforded to those law-abiding citizens outside prison strikes me as something of a problem.

What this case really brings to light is the need for reassessment of prisoner rights and treatment, and the need to change the already insanely high incarceration rates for U.S. citizens. Maybe the $20,000 surgery wouldn’t seem so dramatic if we weren’t wasting several billions of dollars each year to lock up potheads.

Maybe I just wanted to sneak in a comment about how marijuana should be legal. But maybe, maybe I have a point about how our prison system needs altering.

Editor’s Note: The original publication of the article mistakenly used the term “gender” instead of “sex” during a portion of the article. It has been corrected for clarity. The author regrets the error. The original paragraph appears below:

“There is not a concrete legal system for transgendered people to establish what gender they are, with or without surgery; the only norm is to be socially polite and refer to the person by whatever gender they wish to be.”