Crouched in her cell, Ophelia De'lonta hoped three green disposable razors from the prison commissary would give her what the Virginia Department of Corrections will not — a sex change.
It had been several years since she had felt the urges, but she had been fighting them for weeks. But like numerous other times, she failed to get rid of what she calls "that thing" between her legs, the last evidence she was born a male.
Months after the October castration attempt, De'lonta filed a federal lawsuit Friday claiming the state has failed its duty to provide adequate medical care because it won't give her the operation. She says the surgery is needed to treat her gender identity disorder, a mental illness in which people believe they were born the wrong gender.
If she wins, De'lonta would be the nation's first inmate to receive a state-funded sex change operation. Similar lawsuits have failed in a handful of other states, and lawmakers in some states are trying to ban the use of taxpayer money for the operations.
If she loses, she says she will continue to try self-surgery — acknowledging another attempt could kill her.
"That's a possibility," the 50-year-old said during a recent prison interview, pausing then smiling contently. "But at the end I would have peace."
Some physical changes have already taken place. Hormones won under a 2004 court order have caused her to develop noticeable breasts. Her eyebrows are perfectly plucked, and makeup accentuates her smooth cocoa complexion.
Still, special allowances such as feminine clothing and psychotherapy aren't enough to keep her mind off wanting to become the woman she says she was born. She longs for permission to grow out her short salt and pepper hair like female inmates, even though she's housed in the all-male Buckingham Correctional Center.
Experts say that De'lonta's behavior is an unusual — but not surprising — manifestation of her disorder. At least 12 other inmates in Idaho, Wisconsin, Massachusetts, New York, Virginia, Oregon, Kentucky and North Carolina have castrated themselves over the past 14 years, and several others have tried, said psychiatry professor George R. Brown at East Tennessee State University.
"This is not a choice. Transsexuals are born and not made," said Brown, an expert in gender identity disorder. "If you didn't have this condition, why would you want to have your genitals removed, if not by a competent surgeon but by your own hand?"
While many with gender identity disorder wish to get rid of their genitals, the majority never act — often because hormones and other treatments help make them feel more comfortable, Brown said.
According to research by Brown, about 27,000 people nationwide have gender identity disorder. Experts estimate 500 to 750 Americans undergo the surgery each year, with hundreds more seeking the procedure abroad.
Treatment is more readily available outside prison, though dozens of other inmates nationwide have won the right to hormones and psychotherapy. Based on counts of inmates with gender identity disorder in a half dozen states and personal correspondence with inmates during his research, Brown estimates that at least 750 of the more than 2 million prisoners nationwide had gender identity disorder in 2007, his latest count.
Inmates in Massachusetts, Wisconsin, Colorado, California and Idaho also have sued to try to get the surgery, making arguments similar to De'lonta's that denying treatment violates the Eighth Amendment's protection against cruel and unusual punishment. All but one of those have failed; a decision in the decade-old Massachusetts lawsuit by convicted killer Michelle — born Robert — Kosilek is still pending.
Kosilek says that for her, sex reassignment surgery is a medical necessity, not a frivolous desire to change her appearance.
"Everybody has the right to have their health care needs met, whether they are in prison or out on the streets. People in the prisons who have bad hearts, hips or knees have surgery to repair those things," Kosilek told The Associated Press in a recent phone interview from a state prison in Norfolk, Mass.
"My medical needs are no less important or more important than the person in the cell next to me."
Federal courts have said prisons must provide adequate medical care, and that they must protect inmates from themselves. But correctional officials and lawmakers balk at using taxpayer money for sex-change operations that can cost up to $20,000.
A Massachusetts bill to ban the use of public funds for sex change procedures, hormones and other treatments has been before a joint committee since January. Wisconsin lawmakers passed the Inmate Sex Change Prevention Act in 2006, but a federal judge declared it unconstitutional last year. The state appealed, and a decision is expected soon.
Republican Virginia Del. Todd Gilbert says he would seek state legislation if De'lonta's lawsuit is successful.
"The notion that taxpayers are going to fund a sex change is just ridiculous," says Gilbert.
Harold Clarke, who became Virginia's corrections director last year, says it would be a security risk to allow the surgeries because Virginia's inmates are housed according to their gender at birth, not anatomy. While De'lonta sleeps and showers alone, she is not segregated from male inmates. Her lawsuit also asks that she be moved to a women's prison.
Federal courts have said mental health professionals — not prison officials — should dictate treatment.
But Rudolph Alexander, an Ohio State University professor who has studied the treatment of inmates with gender identity disorder, believes mental health providers are reluctant to say the surgery is medically necessary because they fear for their jobs. Almost always, the deciding physician is a state employee or has a contract with it.
Advocates argue that treating repeated self-mutilations costs more than the surgeries. De'lonta, for example, has needed expensive airlifts three times for self-inflicted wounds.
The hormones and other treatments had kept her urges in check for years. She snapped Oct. 8 when an officer used a male pronoun toward her, despite a court order that prison workers refer to her as a woman.
"I screamed 'She, damnit!' becoming so overwhelmed it was hard to breathe," De'lonta said.
Looking down, she felt repulsed and helpless. She cried herself to sleep, then hours later she prepared for her surgery attempt by covering her cell door's window with paper and putting towels around the commode.
Using knowledge gained from mail-order anatomy books, De'lonta cut on and off for three hours before she passed out. It took 21 stitches to repair the damage.
"It's like if this doesn't exist, then I won't have any more problems," she said.
Born Michael Stokes, she didn't understand from an early age why other girls' names were different from hers, or why she felt no connection to the boys in her gym class.
She constantly looked in mirrors and couldn't understand why the reflection was so unlike how she envisioned herself.
Years ago she legally changed her name. Ophelia was chosen for the Shakespearean woman who died for love; De'lonta because it was the last name of a slain friend; middle name Azriel for the angel who helps one cross over.
De'lonta first tried to cut herself when she was 12. By 17, she was robbing banks with the hopes of getting enough money to have a sex change operation. By 18, she was in prison, sentenced to more than 70 years for robbery, drugs, weapons and other charges.
She is eligible for parole this year, but a wide range of prison infractions mean it's unlikely she'll be released any time soon. Asked why she can't just wait until she's free to get the surgery, De'lonta says she would if she could.
"This is not something that I have any control over," she says. "This is just how I was born."
Associated Press Writer Denise Lavoie contributed to this story from Boston.