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Soc Sci Med. 2017 Nov;193:80-89. doi: 10.1016/j.socscimed.2017.09.052. Epub 2017 Oct 5.

"What's the right thing to do?" Correctional healthcare providers' knowledge, attitudes and experiences caring for transgender inmates.

Author information

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).

KEYWORDS:

Corrections; Healthcare; Incarceration; Prisons and jails; Transgender

PMID:
29028559
PMCID:
PMC5695233
DOI:
10.1016/j.socscimed.2017.09.052
[Indexed for MEDLINE]
Free PMC Article

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