Transgender Health Care
Our facility occasionally receives an inmate who is at some stage of gender reassignment. We would like to develop policies and procedures for managing their medical needs related to this process. Do the NCCHC standards offer any guidance?
Implicit guidance is found in three standards: Medical Autonomy (J-A-03, P-A-03), Patients With Special Health Needs (J-G-02, P-G-02) and Continuity of Care During Incarceration (J-E-12, P-E-12). However, you may find it helpful to consult NCCHC’s recent position statement on Transgender Health Care in Correctional Settings. Below are relevant excerpts from two recommendations in the Health Management section.
- The management of medical (e.g., medically necessary hormone treatment) and surgical (e.g., genital reconstruction) transgender issues should follow accepted standards1 developed by professionals with expertise in transgender health. Determination of treatment necessary for transgender patients should be on a case-by-case basis. Ideally, correctional health staff should be trained in transgender health care issues. Alternatively, they should have access to other professionals with expertise in transgender health care to help determine appropriate management and provide training in transgender issues.
- Diagnosed transgender patients who received hormone therapy prior to incarceration should have that therapy continued without interruption pending evaluation by a specialist, absent urgent medical reasons to the contrary. Transgender inmates who have not received hormone therapy prior to incarceration should be evaluated by a health care provider qualified in the area of transgender health to determine their treatment needs. When determined to be medically necessary…hormone therapy should be initiated and sex reassignment surgery considered on a case-by-case basis. Regular laboratory monitoring should be conducted according to community medical standards.
— From CorrectCare Volume 24, Issue 2, Spring 2010