The unusual case of Wagoner v. Dahlstrom et al. is scheduled for trial on May 12 in the U.S. District Court for the District of Alaska.
The plaintiff, Emalee Wagoner — born Emmanuel Cancel — is a biological male who says he identifies as female. Currently incarcerated at Goose Creek Correctional Center, a men’s prison, Wagoner is serving a 40-year sentence for multiple child sexual abuse convictions.
He is now suing the State of Alaska for allegedly failing to provide “gender-affirming surgery” while he serves his prison term.
The lawsuit names former Alaska Department of Corrections Commissioner Nancy Dahlstrom (now Lieutenant Governor) and other DOC officials, alleging deliberate indifference to Wagoner’s “serious” medical needs, particularly treatment for gender dysphoria.
In 2017, Cancel legally changed his name to Emalee Wagoner, but he has remained incarcerated in a male facility. The lawsuit, filed in 2018, seeks damages, declaratory relief, and injunctive relief. Wagoner claims repeated denials of hormone replacement therapy (HRT) from 2016 through 2022, in violation of what he says are medical standards for treating gender dysphoria.
Court documents reference the 2017 Gender Dysphoria Clinical Care Guide and assert that the DOC failed to enforce policies ensuring necessary care for transgender inmates. Wagoner argues this inaction exacerbated his condition, led to self-harm, and constituted a violation of his Eighth Amendment rights.
At one point, he attempted to castrate himself, allegedly to gain transfer to a women’s prison or to seek early release.
The defendants, including Dahlstrom and former DOC Health and Rehabilitation Services Director Laura Brooks, maintain that they were not deliberately indifferent. They point to the 2017 care guide and the implementation of Policy & Procedure 807.23 in July 2022 as evidence of efforts to address gender dysphoria within the prison system.
One of the legal questions before the court is whether vaginoplasty — a surgery that constructs a vaginal canal using penile or other tissue, such as colon tissue — is medically necessary in Wagoner’s case. Such procedures, which can cost between $20,000 and $100,000, are among the most complex and controversial forms of gender-affirming care. While some legal precedents exist, such as Edmo v. Corizon, Inc. (2019), which found the denial of surgery unconstitutional, the current case will test those boundaries further.
Notably, the court documents and filings refer to Wagoner as female. However, for biological accuracy, this article refers to Wagoner using male pronouns.
Wagoner’s criminal record raises additional complexities in the case. As Emmanuel Cancel, he was indicted in 2011 on 45 counts related to the sexual abuse of minors. Victims ranged in age from 7 to 20. According to court documents, Cancel threatened to kill his victims if they disclosed the abuse. Prosecutors say he heightened their fear by boasting of fictional murders, using physical violence, and supplying them with drugs — including marijuana, crack, and methamphetamine — to coerce their silence.
The news report of his sentencing describes the intense trauma experienced by his victims.
“Wagoner would tell the children stories of all of the murders she committed and how she would dispose of the bodies in order to elevate the fear experienced by the children. In addition, the children thought this threat was legitimate due to the level of violence Wagoner displayed in the household, including slamming the children’s heads against the wall, whipping them with a belt, and beating their mother. She also provided them with marijuana, cocaine, crack, and meth as a bribe to keep them quiet,” the State brief explains (embedded below).
“From the date of her arrest in 2011 until around August 2016, Wagoner continued to identify as a man and made no claims as to a diagnosis of gender dysphoria. However, starting in August 2016, she started to communicate with her then-alleged fiancé that she was contemplating attempting to perform a self-surgery by cutting off her penis and genitals. It appears that the motivation for this was either to be released from prison or to be transferred to a women’s prison. In August 2016, she attempted self-surgery. Initially, she claimed that it was an accident. Later, she changed her story and claimed that she was attempting a gender-affirming surgery. On one other occasion, Wagoner re-injured her penis which required elevated medical attention at Mat-Su Regional Medical Center,” the State asserts.
After his purported efforts at self-surgery, Wagoner began to demand gender-affirming care in the form of everything from breast augmentation to voice alteration therapy, and finally testicle and penis removal and construction of a vagina, the State explains. The State Department of Corrections, beginning in 2017, tried to accommodate some of Wagoner’s demands, after diagnosis of his gender dysphoria by a third-party provider.
“These efforts, increasing in concert with Wagoner’s regular appointments with the facilities’ mental health staff, initially included medication, the provision of feminine hygiene products to Wagoner and ensuring the availability of certain cosmetics, feminine undergarments, and grooming devices through the commissary. During this time, Wagoner was often less than cooperative and declined to follow the recommended treatment plan,” the State explains.
Wagoner’s complains that despite multiple requests for treatment and five documented denials of HRT, the DOC refused to provide transgender-related care unless his condition became “life-threatening.”
Wagoner now seeks a preliminary and permanent injunction requiring the DOC to provide medical and mental health treatment in line with the World Professional Association for Transgender Health (WPATH) standards –guidelines that the Trump Administration has criticized as lacking scientific rigor.
The current case draws parallels to the 2019 Ninth Circuit decision in Edmo v. Corizon, Inc., which ruled that denying gender confirmation surgery to a transgender inmate violated the Eighth Amendment.
Last week, the Justice Department reversed actions taken under the Biden Administration regarding gender dysphoria claims by inmates who claimed a constitutional right to transgender surgeries provided by taxpayers.
The Justice Department’s Civil Rights Division, now headed by Assistant Attorney General Harmeet Dhillon, withdrew a prior statement of interest in Doe v. Fuller v. Georgia Department of Corrections and submitted a new statement of interest in Fuller v. Georgia Department of Corrections. The filings, in the US District Court for the Northern District of Georgia, address claims brought by inmates seeking taxpayer-funded, elective surgeries as treatment for gender dysphoria.
Details in that case are here:
