Exploring the health experiences of transgender individuals in a local jail

Lesbian, gay, bisexual, and transgender (LGBT) individuals face well-documented bias and discrimination both inside and outside of the correctional system. Individuals who identify as transgender, an umbrella term to describe persons whose gender identity and experiences do not conform to the sex assigned at birth, are particularly vulnerable. However, limited information is known about the relationship between jail environment and specific corre tional policies related to transgender individuals and health status. Therefore, the main aims of this study was to explore 1) how correctional policies related to transgender inmates are enacted and operationalized, and, 2) how correctional policies and the jail environment might affect the mental and physical health of transgender individuals. To address these aims, 15 interviews with transgender inmates were conducted. Our results indicate that transgender individuals are placed in a correctional facility based on their biological sex, but their physical location, within the larger facility, is on a separate floor that houses all "special populations" including anyone who identifies as LGBT and/or has a diagnosed mental illness. Additionally, participants relayed that medical professionals at the jail were willing to continue providing medication in support of transition, but only if the inmate could provide an official prescription for the medication in question. Participants also suggested that they often felt that the correctional policies in place and the jail environment itself could be detrimental to their health. Participants also indicated that residing on the "special populations" wing often resulted in stigma from other inmates and correctional officers. A majority of participants often indicated feeling discriminated against because of their transgender identity, and being sent to segregation frequently which had a negative effect on both physical and mental health status. In addition, although a majority of participants were mid-transition at the time of arrest, most reported that they were obtaining transition medication on the street, from an unofficial source such as a friend or family member. This meant that many participants were unable to gain access to relevant medications while incarcerated and were experiencing uncomfortable physical changes that often led to bouts of depression and anxiety. These findings suggest that correctional policies related to transgender individuals may have an unintended, negative affect on both mental and physical health, and, as such, alternative policies should be considered.