Christopher Daley, spokesman for the Transgender Law Center, said surgery "is not appropriate in every case" of GID, but questions Michaud's assessment because, while a mental health official, he is not an expert in the narrow field of gender disorders.
"Whether or not it is elective surgery ... that is up to the doctors. It's a very specialized field," Daley told ABC News. His organization has put out an extensive policy draft on how law enforcement should handle gender variant inmates.
Policies on how to deal with transgender inmates vary from state to state and from prison to prison. As of now, Wisconsin is the only state that has a law specifically prohibiting the state from paying for such treatment, the Inmate Sex Change Prevention Act.
The law prohibits the use of "state funds or resources or federal funds to provide or facilitate that provision of hormonal therapy or sexual reassignment surgery ... of a prisoner."
There have been similar acts proposed elsewhere but none that have passed and the ACLU is currently fighting the Wisconsin law.
As for Kosilek, her fate will be decided in federal court where Judge Mark Wolf, the same judge who ruled in her favor in 2002, will preside.
If granted the surgery, Kosilek's future prison housing remains uncertain but experts in transgendered law tell ABC News that prisoners are almost always housed based exclusively on genitalia.
The lawsuit will surely remind many people of the 1993 death of Cheryl Kosilek, but Michelle Kosilek claims in court that being trapped in a male body is like dying.
"The greatest loss is the dying I do inside a little bit every day," Kosilek has said.
Advocates such as Minter and Daley, however, hope that people unfamiliar with GID will not judge transsexual people based on the convicted killer.
"It is difficult to be her spokesperson," Shannon Minter said, "She is not typical of transgendered prisoners or transgendered people."