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On December 16, 2014, in Kosilek v. Spencer, the U.S. Court of Appeals for the First Circuit held that refusing to provide a transgender prisoner sex reassignment surgery did not violate the Eighth Amendment. The court reasoned that the prisoner’s claim did not amount to an Eighth Amendment violation because she received adequate treatment for gender dysphoria and prison officials were not deliberately indifferent to her medical needs. This Comment argues that the First Circuit erred by ignoring medical consensus and relying on an outlier medical opinion when determining that sex reassignment surgery was not constitutionally required. Further, the majority’s decision will have the unforeseen consequence of preventing other prisoners in the First Circuit from successfully bringing an Eighth Amendment claim for sex reassignment surgery in the future.