Getting Hormones and Surgery for Transgender Prisoners

[xchrom]

http://www.theatlantic.com/health/archive/2013/08/getting-hormones-and-surgery-for-transgender-prisoners/278998/

Yesterday, one day after the whistleblower formerly known as Pfc. Bradley Manning was sentenced to 35 years in prison for leaking thousands of classified documents, Manning announced that she has embraced her true gender identity and would like to live out the rest of her sentence—and the rest of her life—as Chelsea Manning, a woman. So how does the criminal justice system care for the health and well-being of transgender prisoners?

Access to transition-related healthcare services, such as hormone therapy and sex reassignment surgery, has been a major concern for transgender prisoners and advocates. Before 2010, it was the policy of the U.S. Bureau of Prisons to provide hormones at whatever level was maintained prior to the incarceration. After a 2010 lawsuit, however, the bureau reformed those regulations to include transgender women who did not begin hormone therapy until after their incarceration—and today, for the most part, transgender prisoners are able to access necessary hormone therapy. When Pfc. Manning mentioned in her statement that she would like to begin hormone therapy “as soon as possible,” the Army quickly released a statement saying that it “does not provide hormone therapy or sex-reassignment surgery for gender identity disorder.”

“It seems odd that the Army would make a determination on Manning’s healthcare needs before they’ve even had an assessment,” says Masen Davis, the Executive Director of the Transgender Law Center. “Manning has the right to access necessary medical care while she is in prison, which may include estrogen. That should be determined by a doctor and the patient, not by bias.”

Although transgender inmates are not currently able to receive sex reassignment surgery while incarcerated, in 2012 a U.S. District Judge ordered Massachusetts prison officials to provide sex reassignment surgery to Michelle Kosilek, a transgender woman serving life in prison for murder, on the basis that the surgery would meet Kosilek’s “serious medical need.” The Massachusetts Department of Correction is currently appealing the decision, but according to Jennifer Levi, Director of the Transgender Rights Project for the Gay and Lesbian Advocates and Defenders (GLAD), the decision opens the door to the possibility that transgender inmates might be able to access sex reassignment surgery.

[MADem]

1. It does not "seem odd" at all--the Army's policy has always been to not recognize the issue.

No shooting the messenger, now. In fact, I will be very pissed indeed if I get hot-breathed responses that mistake the imparting of factual information for "advocacy." The Army has never, ever, provided hormone therapy or sex reassignment surgery. If they do so in this case, they will be breaking new ground.

Manning will be inprocessed as "Bradley, male" to any military prison--either an Army one, or a joint one. He will be given "consideration" by the guards (e.g. perhaps allowed to shower separately, and the guards will take extra care to make sure he's OK, maybe have a talk with the prison leaders to keep an eye out, e.g.), and he'll be placed in an environment where he can live safely. He won't be isolated, and the odds are good his fellow prisoners will not fuck with him--military prisons are, by and large, surprisingly drama-free, and the prisoners do a fair job of disciplining themselves.

The military simply does not recognize any need to treat gender identity issues. Will that change with Manning? Hard to know. I am simply advising all here that this is not "treated" beyond psychological intervention (therapist) and perhaps some mood altering/anti-anxiety type drugs.

If he is transferred to a civilian prison, he has a better chance of getting therapy, but the living environment in some facilities is FAR less safe.

So....it's kind of a coin toss. Wait until parole, and live in a secure environment, or take a chance in a federal prison system, and hope that access to surgery is possible (not a sure thing, in any event).