Health-Related Experiences, Needs, and Challenges of Transgender People in Prisons: A Systematic Review

• Published date: 01 December 2023
• DOI: http://doi.org/10.1177/00328855231208015
• Author: Snehasish Tripathy,Sapna Negi,Elakeya Udhaya,Mirza Adil Beig,Dilip Kumar
• Date: 01 December 2023
• Subject Matter: Articles

Health-Related

Experiences, Needs,

and Challenges of

Transgender People

in Prisons: A

Systematic Review

Snehasish Tripathy

1

, Sapna Negi

2

,

Elakeya Udhaya

3

, Mirza Adil Beig

4

,

and Dilip Kumar

3

Abstract

Despite transgender people being a vulnerable group, many jurisdictions lack

an appropriate prison policy for transgender prisoners. We examined f‌ive

databases for studies published in English between 2010 and December

2022. After screening, a total of 18 articles were included for review, high-

lighting four signif‌icant issues: (1) incorrect housing classif‌ication; (2) barriers

to gender-aff‌irming commodities; (3) healthcare services; and (4) gender-

based violence and discrimination against transgender inmates by other

inmates and prison off‌icials. The study recommends appointing an interdis-

ciplinary transgender committee in prisons and enhancing gender sensitivity

among corrections off‌icials to meet the transgender inmates’needs.

Keywords

prisoner health, transgender inmates, discrimination, gender identity

1

Dr. D. Y. Patil Dental College & Hospital, Pune, India

2

Indian Law Society - Centre for Mental Health, Law, & Policy, Pune, India

3

Prasanna School of Public Health, Manipal, India

4

Dehradun Institute of Technology, Dehradun, India

Corresponding Author:

Sapna Negi, Indian Law Society - Centre for Mental Health, Law, & Policy, Pune, Maharashtra

411004, India.

Email: sapnanegi512@gamil.com

Article

The Prison Journal

2023, Vol. 103(6) 812–836

© 2023 SAGE Publications

Article reuse guidelines:

sagepub.com/journals-permissions

DOI: 10.1177/00328855231208015

journals.sagepub.com/home/tpj

Introduction

Transgender is an umbrella term for persons whose gender identity, gender

expression, or behavior does not conform to that typically associated with

the sex to which they were assigned at birth. Gender identity refers to a

person’s internal sense of being male, female, queer, nonbinary; gender

expression refers to how a person communicates gender identity to others

through behavior, clothing, hairstyles, voice, or body characteristics

(American Psychological Association, n.d.). The Global Gender Identity

Report states that over 2% of the respondents from 27 countries identif‌ied

themselves as transgender. Around 3% of the population in Germany and

Sweden are transgender (Statista, 2023). Another recent 2022 report shows

that more than 1.6 million adults (aged 18 and older) and young people

(aged 13–17) identify themselves as transgender in the US alone, and one

in f‌ive people who identify themselves as transgender are aged 13–17

(Jody et al., 2022). Similarly, a systematic analysis of papers from 2009 to

2019 indicated that Transgender population ranged from 0.5% to 4.5% of

the adult population. However, there is a lack of good quality empirical evi-

dence and data (like from census) quantifying the true proportion of the trans-

population (Zhang et al., 2020).

Due to this population underestimation, transgender people, or gender-

diverse people worldwide usually have less access to health care than the

general population. However, access to healthcare services is even more

daunting for those transgender people who are imprisoned due to various

issues, including stigma, discrimination, and legal barriers. Additional to

the health challenges (Reisner et al., 2016), transgender prisoners also face

discrimination and physical, sexual, and psychological assault in prison envi-

ronments, perpetrated by prison off‌icials, staff, or other inmates (Alfonsín

et al., 2020; Lamble & College, 2012). Additionally, they lack proper

access to gender-specif‌ic medical care and counseling centered on their

gender identity or sexual orientation, including access to care for reproductive

health, access to hormone therapy, and treatment options for gender transition

(Van Hout et al., 2020). Because of the anxiety brought on by this alienation,

TGD individuals are more at risk of physical ailments like HIV infection as

well as psychological disorders including suicide risk, drug abuse, and the

likelihood of drug overdose (Global Prison Trends 2021, n.d.). As a result,

the World Health Organization, the United Nations Off‌ice of Drugs and

Crime, and the National Standard to Prevent, Detect and Responds to

Prison Rape: Final Rules in the United States of America identif‌ied these

transgender (LGBT) prisoners as “vulnerable”(Gatherer et al., 2014).

Unfortunately, the information about the LGBTQ population remains

Tripathy et al. 813