Kirsty A Clark1, Jaclyn M White Hughto2, John E Pachankis3. 1. UCLA Fielding School of Public Health, Los Angeles, CA, USA. Electronic address: kclark13@ucla.edu. 2. Yale School of Public Health, New Haven, CT, USA; Fenway Institute, Boston, MA, USA. 3. Yale School of Public Health, New Haven, CT, USA.
Abstract
RATIONAL: Incarcerated transgender individuals may need to access physical and mental health services to meet their general and gender-affirming (e.g., hormones, surgery) medical needs while incarcerated. OBJECTIVE: This study sought to examine correctional healthcare providers' knowledge of, attitudes toward, and experiences providing care to transgender inmates. METHOD: In 2016, 20 correctional healthcare providers (e.g., physicians, social workers, psychologists, mental health counselors) from New England participated in in-depth, semi-structured interviews examining their experiences caring for transgender inmates. The interview guide drew on healthcare-related interviews with recently incarcerated transgender women and key informant interviews with correctional healthcare providers and administrators. Data were analyzed using a modified grounded theory framework and thematic analysis. RESULTS: Findings revealed that transgender inmates do not consistently receive adequate or gender-affirming care while incarcerated. Factors at the structural level (i.e., lack of training, restrictive healthcare policies, limited budget, and an unsupportive prison culture); interpersonal level (i.e., custody staff bias); and individual level (i.e., lack of transgender cultural and clinical competence) impede correctional healthcare providers' ability to provide gender-affirming care to transgender patients. These factors result in negative health consequences for incarcerated transgender patients. CONCLUSIONS: Results call for transgender-specific healthcare policy changes and the implementation of transgender competency trainings for both correctional healthcare providers and custody staff (e.g., officers, lieutenants, wardens).
RATIONAL: Incarcerated transgender individuals may need to access physical and mental health services to meet their general and gender-affirming (e.g., hormones, surgery) medical needs while incarcerated. OBJECTIVE: This study sought to examine correctional healthcare providers' knowledge of, attitudes toward, and experiences providing care to transgender inmates. METHOD: In 2016, 20 correctional healthcare providers (e.g., physicians, social workers, psychologists, mental health counselors) from New England participated in in-depth, semi-structured interviews examining their experiences caring for transgender inmates. The interview guide drew on healthcare-related interviews with recently incarcerated transgender women and key informant interviews with correctional healthcare providers and administrators. Data were analyzed using a modified grounded theory framework and thematic analysis. RESULTS: Findings revealed that transgender inmates do not consistently receive adequate or gender-affirming care while incarcerated. Factors at the structural level (i.e., lack of training, restrictive healthcare policies, limited budget, and an unsupportive prison culture); interpersonal level (i.e., custody staff bias); and individual level (i.e., lack of transgender cultural and clinical competence) impede correctional healthcare providers' ability to provide gender-affirming care to transgender patients. These factors result in negative health consequences for incarcerated transgender patients. CONCLUSIONS: Results call for transgender-specific healthcare policy changes and the implementation of transgender competency trainings for both correctional healthcare providers and custody staff (e.g., officers, lieutenants, wardens).
Authors: Ronald C Kessler; Patricia Berglund; Olga Demler; Robert Jin; Kathleen R Merikangas; Ellen E Walters Journal: Arch Gen Psychiatry Date: 2005-06
Authors: Jaclyn M White Hughto; Kirsty A Clark; Frederick L Altice; Sari L Reisner; Trace S Kershaw; John E Pachankis Journal: Soc Sci Med Date: 2017-10-30 Impact factor: 4.634
Authors: Erin C Wilson; Robert Garofalo; Robert D Harris; Amy Herrick; Miguel Martinez; Jaime Martinez; Marvin Belzer Journal: AIDS Behav Date: 2009-02-06
Authors: Jaclyn M White Hughto; Sari L Reisner; Trace S Kershaw; Fredrick L Altice; Katie B Biello; Matthew J Mimiaga; Robert Garofalo; Lisa M Kuhns; John E Pachankis Journal: J Public Health (Oxf) Date: 2019-03-01 Impact factor: 2.341
Authors: Jaclyn M White Hughto; Kirsty A Clark; Frederick L Altice; Sari L Reisner; Trace S Kershaw; John E Pachankis Journal: Soc Sci Med Date: 2017-10-30 Impact factor: 4.634
Authors: E Coleman; A E Radix; W P Bouman; G R Brown; A L C de Vries; M B Deutsch; R Ettner; L Fraser; M Goodman; J Green; A B Hancock; T W Johnson; D H Karasic; G A Knudson; S F Leibowitz; H F L Meyer-Bahlburg; S J Monstrey; J Motmans; L Nahata; T O Nieder; S L Reisner; C Richards; L S Schechter; V Tangpricha; A C Tishelman; M A A Van Trotsenburg; S Winter; K Ducheny; N J Adams; T M Adrián; L R Allen; D Azul; H Bagga; K Başar; D S Bathory; J J Belinky; D R Berg; J U Berli; R O Bluebond-Langner; M-B Bouman; M L Bowers; P J Brassard; J Byrne; L Capitán; C J Cargill; J M Carswell; S C Chang; G Chelvakumar; T Corneil; K B Dalke; G De Cuypere; E de Vries; M Den Heijer; A H Devor; C Dhejne; A D'Marco; E K Edmiston; L Edwards-Leeper; R Ehrbar; D Ehrensaft; J Eisfeld; E Elaut; L Erickson-Schroth; J L Feldman; A D Fisher; M M Garcia; L Gijs; S E Green; B P Hall; T L D Hardy; M S Irwig; L A Jacobs; A C Janssen; K Johnson; D T Klink; B P C Kreukels; L E Kuper; E J Kvach; M A Malouf; R Massey; T Mazur; C McLachlan; S D Morrison; S W Mosser; P M Neira; U Nygren; J M Oates; J Obedin-Maliver; G Pagkalos; J Patton; N Phanuphak; K Rachlin; T Reed; G N Rider; J Ristori; S Robbins-Cherry; S A Roberts; K A Rodriguez-Wallberg; S M Rosenthal; K Sabir; J D Safer; A I Scheim; L J Seal; T J Sehoole; K Spencer; C St Amand; T D Steensma; J F Strang; G B Taylor; K Tilleman; G G T'Sjoen; L N Vala; N M Van Mello; J F Veale; J A Vencill; B Vincent; L M Wesp; M A West; J Arcelus Journal: Int J Transgend Health Date: 2022-09-06