Texas inmate threatens to commit self-castration or suicide if gender reassignment surgery is not provided. Does declining to provide the procedure inflict cruel and unusual punishment? Fifth Circuit: There’s legitimate medical debate about the efficacy of gender reassignment, so withholding it isn’t cruel, and no state in the country routinely provides it, so withholding it isn’t unusual either. Dissent (sidestepping linguistic debate by using no gendered pronouns): The question isn’t whether there’s debate in general, but whether there’s debate as to this inmate; the case should be remanded for more fact-finding.