A Shoshone-Bannock citizen could be the first prison inmate to have court ordered gender confirmation surgery. The 9th Circuit Court of Appeals agreed with a lower court judge, ruling that by denying Adree Edmo the surgery while in custody, the Idaho Department of Corrections is violating her constitutional rights. Edmo argues having the surgery is life-saving. She had previously attempted suicide. One 2015 study from the National Center for Transgender Equality found more than half of the Native transgender people included in a larger, national survey said they attempted suicide. We’ll explore the legal implications for the federal court decision and expand the discussion to the factors that go into a person’s decision to have sex reassignment surgery.