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Journal of Correctional Health Care
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Health Care Policies Addressing Transgender Inmates in Prison Systems in the United States

George R. Brown, MD

Mountain Home Veterans Affairs Medical Center, Mountain Home, Tennessee, george.brown{at}va.gov, From East Tennessee State University, Johnson City, Tennessee

Everett McDuffie, MD

From East Tennessee State University, Johnson City, Tennessee

Inmates with gender identity disorders (GID) pose special challenges to policy makers in U.S. prison systems. Transgender persons are likely overrepresented in prisons; a reasonable estimate is that at least 750 transgender prisoners were in custody in 2007. Using the Freedom of Information Act, requests were mailed to each state, the District of Columbia, and the Federal Bureau of Prisons in 2007. The requests were for copies of policies, directives, memos, or other documents concerning placement and health care access of transgender inmates. By April 2008, 46 responses were received; 6 states did not reply. Information was qualitatively analyzed and summarized. There was substantial disparity in transgender health care for inmates with GID or related conditions. Most systems allowed for diagnostic evaluations. There was wide variability in access to cross-sex hormones, with some allowing for continuation of treatment and others allowing for both continuation and de novo initiation of treatment. There was uniformity in denial of surgical treatments for GID.

Key Words: prison inmates • transgender • health care policies • prison health care

This version was published on October 1, 2009

Journal of Correctional Health Care, Vol. 15, No. 4, 280-291 (2009)
DOI: 10.1177/1078345809340423
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