Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2023 Feb;29(1):3-11.
doi: 10.1089/jchc.21.09.0094. Epub 2022 Nov 15.

Implementing Gender-Affirming Care in Correctional Settings: A Review of Key Barriers and Action Steps for Change

Matthew Murphy  1   2   3 , Brooke G Rogers  1   4 , Carl Streed Jr  5   6 , Jaclyn M W Hughto  7 , Asa Radix  8 , Drew Galipeau  1 , Siena Napoleon  1 , Ty Scott  1 , Madeline Noh  1 , Cassie Sutten Coats  3   7 , Leigh Hubbard  3 , Philip A Chan  1   3   7 , Amy Nunn  1   3   7 , Justin Berk  1   2
Affiliations
Review

Implementing Gender-Affirming Care in Correctional Settings: A Review of Key Barriers and Action Steps for Change

Matthew Murphy et al. J Correct Health Care. 2023 Feb.

Abstract

Transgender and gender-diverse (TGD) people are disproportionately impacted by incarceration, interpersonal violence, HIV and other sexually transmitted infections, substance use disorders, and suicidality. Little is known about successful approaches to improve health outcomes for TGD individuals impacted by incarceration. We review the barriers to providing gender-affirming clinical care in correctional systems in the United States, identify key knowledge gaps regarding the provision of gender-affirming care to incarcerated TGD populations, and highlight necessary steps to improve the health and safety of this highly vulnerable population. We also describe the components of a gender-affirming care model implemented in a state correctional facility, including support from correctional administrators, identifying a gender-affirming care provider, standardizing clinical care protocols, and adapting clinical services to TGD population needs. Similar models should be employed elsewhere to improve health outcomes for TGD populations during incarceration and on release.

Keywords: gender diverse; gender-affirming care; implementation; incarceration; transgender.

PubMed Disclaimer

Conflict of interest statement

Drs. Murphy and Rogers are supported by a Gilead Sciences grant, IN-US-276-5463. The other authors disclosed no conflicts of interest with respect to the research, authorship, or publication of this article.

References

    1. Baral, S. D., Poteat, T., Strömdahl, S., Wirtz, A. L., Guadamuz, T. E., & Beyrer, C. (2013). Worldwide burden of HIV in transgender women: A systematic review and meta-analysis. The Lancet Infectious Diseases, 13(3), 214–222. 10.1016/S1473-3099(12)70315-8 - DOI - PubMed
    1. Baral, S., Logie, C. H., Grosso, A., Wirtz, A. L., & Beyrer, C. (2013). Modified social ecological model: A tool to guide the assessment of the risks and risk contexts of HIV epidemics. BMC Public Health, 13(1), 482. 10.1186/1471-2458-13-482 - DOI - PMC - PubMed
    1. Bartholomaeus, C., & Riggs, D. W. (2017). Whole-of-school approaches to supporting transgender students, staff, and parents. International Journal of Transgenderism, 18(4), 361–366. 10.1080/15532739.2017.1355648 - DOI
    1. Binswanger, I. A., Stern, M. F., Deyo, R. A., Heagerty, P. J., Cheadle, A., Elmore, J. G., & Koepsell, T. D. (2007). Release from Prison—A high risk of death for former inmates. New England Journal of Medicine, 356(2), 157–165. 10.1056/NEJMsa064115 - DOI - PMC - PubMed
    1. Bockting, W. O., Miner, M. H., Swinburne Romine, R. E., Hamilton, A., & Coleman, E. (2013). Stigma, mental health, and resilience in an online sample of the US transgender population. American Journal of Public Health, 103(5), 943–951. 10.2105/AJPH.2013.301241 - DOI - PMC - PubMed

Publication types