Prisons vs LGBTQ
In Orange Is The New Black (season 1, episode 3), a character said this in regards to a transgender individual's need for care, "if he wanted to keep his girlish figure, he should’ve stayed out of jail.” This episode received widespread acclaim from critics and was one of the most eye-opening episodes of the entire series. It began to delve into Sophia’s (the inmate) past and showed her struggles within the prison. The episode displayed repeated abuse and extensive time in isolation for her "protection."
But that is just a show...right? Medical care for LGBTQ people in correctional facilities is not much different than for straight or cisgender inmates. Right?
Sadly, it is a true example of reality for LGBTQ and, in particular, trans women of color. So, why are we unable to do better?
Well, better is a relative term. Treatment and equality have slightly improved for the LGBTQ community in my lifetime; however, it has a long way to go. Today, I will focus on the LGBTQ community and the corrections system. I will also cover our current impact and how we can elevate and change the landscape for tomorrow.
There is a staggering number of youths in the corrections/juvenile justice system. While 4-6% of the system's general population (gen-pop) are under 18, 20% of that number are LGBTQ(1). Gender Nonconforming Youth (GNCT) are 3x more likely to be removed from their home and are 5x more likely to be placed in a group or foster home(2). Breaking it down by birth sex, LGBTQ women are 4x more likely to be arrested. Even more surprising – there is no data available for Trans Individual arrest rates; however, studies have shown 1 in 5 experienced police harassment or worse. Of that percentage, 38% are trans individuals of color(3). There are an estimated 3,200 trans individuals in United States prisons, 1827 in local jails, and 4890 in State Prisons(4).
Once they get incarcerated, transgender individuals face high rates of harassment and physical and sexual assault. Also, they are commonly denied routine healthcare(5).
Most prisons in the United States assign correctional housing according to a person's birth sex. That can cause increased stress and anxiety and potentially exacerbate diagnosed and undiagnosed mental health disorders.
Protections for LGBTQ individuals are generally covered under the Eighth Amendment, as it prohibits deliberate indifference to the medical needs of inmates. However, the amendment does not address the intricacies of care for transgender individuals, such as hormone therapy or the continuance of the gender reassignment process. There are no specific laws that protect or keep this process intact. In addition, trans individuals must be seen by a psychiatrist after intake is complete. That can take days, if not weeks, and they must be formally diagnosed with Gender Identity Disorder (GID) or Gender Dysphoria. However, appeal to GID is a double-edged sword. While it allows access to hormone therapy, it describes transgender individuals as somehow sick or infirm. This description is contradictory to the LGBTQ conceptualization of itself (6).
Furthermore, the PREA – or Prison Rape Elimination Act of 2003 – is another form of protection for all inmates. Although, it became major for LGBTQ inmates. It enables them to blow the whistle on guard abuse or other inmate abuse. Staff abuse of LGBTQ inmates is estimated at 5.4% versus 1.2% of straight inmates, and abuse by another inmate is estimated at 12.2% for LGBTQ versus 2.1% for straight inmates(7). The downside of PREA is that there have been higher levels of solitary confinement as a solution, with 85% of all inmates reporting they had been segregated(8). While segregation can be helpful, it should be temporarily. It should only get used when there are no other feasible alternatives, not as a blanket policy(9).
There is so much to uncover, reflect, and take action on within the LGBTQ community – more so for affected inmates. So, how can anyone change such a broken system?
It is important to remember that many of these protections came along because people like you and like me - who believe in equality for every single person – stood up and spoke up. It is vital to identify allies, including those who have gotten incarcerated, to speak on the lack of access to health care and mental health care. We must stand up for those who have been abused, neglected, and tortured while incarcerated. There is still so much to do: Policies to review, Protocols to rewrite, and People to rebuild.
It is not impossible. We can reform the system. All we need is your help.
Resources: (1-8)
https://www.prisonpolicy.org/blog/2021/03/02/lgbtq/
https://digitalcommons.wcl.american.edu/cgi/viewcontent.cgi?article=1679&context=jgspl
https://www.transequality.org/sites/default/files/docs/resources/NTDS_Report.pdf
https://transequality.org/sites/default/files/docs/resources/TransgenderPeopleBehindBars.pdf
https://pubmed.ncbi.nlm.nih.gov/25330561/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5227944/pdf/AJPH.2016.303576.pdf
