Challenges Unique to Transgender Persons in US Correctional Settings: a Scoping Review

J Urban Health. 2023 Dec;100(6):1170-1189. doi: 10.1007/s11524-023-00794-z. Epub 2023 Oct 18.

Abstract

US correctional facilities operate under a binary interpretation of gender, which can yield inherent risks and conflicts for incarcerated transgender people. We conducted a scoping literature review on challenges unique to transgender individuals within US correctional settings. Online databases were searched to identify papers that addressed the challenges of incarcerated transgender adults age 18 + within US correctional institutions. A concurrent analysis of legal literature was reviewed with key policy recommendations extracted. A total of 33 papers (21 scientific studies and 12 legal analyses) met criteria for inclusion. Of the 21 scientific studies, the majority of papers (n = 14) focused on transgender women and most (n = 13) utilized qualitative methods. Emerging themes revealed challenges in key domains of violence, health, healthcare access, housing, and a pervasive culture of transphobia. Legal analyses supported policy changes such as implementing case-by-case housing classification systems, providing all forms of gender-affirming care, and safeguarding gender expression. Transgender persons face distinct obstacles while incarcerated in US correctional facilities and are in need of expanded protections. Working in tandem with efforts to decarcerate and reduce criminal legal involvement, widespread institutional policy change, such as redefining housing assignment policies, ensuring gender-affirming healthcare, and expanding transgender-specific competency trainings for correctional staff, is necessary.

Keywords: Correctional health policy; Incarceration; Transgender.

Publication types

  • Review
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Criminals*
  • Delivery of Health Care
  • Female
  • Gender Identity
  • Humans
  • Prisons
  • Transgender Persons*