Gender-Affirming Surgical Care in Carceral Settings

Abstract:
Transgender and gender nonconforming (trans) individuals face disproportionate incarceration rates in the U.S., yet access to gender affirming surgical care in carceral settings remains limited despite clinical guidelines and legal protections under the Eighth Amendment. This perspective argues for the necessity of providing gender-affirming surgical care including preoperative evaluations, procedures, and postoperative management as part of standard medical practice in prisons and jails. The authors highlight the Federal Bureau of Prisons’ (BOP) guidance as a model and emphasize adherence to World Professional Association for Transgender Health (WPATH) standards. Key recommendations include training carceral staff, ensuring patient-centered care, aligning housing policies with safety protections under the Prison Rape Elimination Act (PREA), and leveraging Medicaid funding. The article underscores that denying such care violates constitutional rights and exacerbates health disparities for incarcerated trans populations.

Abstract:
Transgender and gender nonconforming (trans) individuals face disproportionate incarceration rates in the U.S., yet access to gender affirming surgical care in carceral settings remains limited despite clinical guidelines and legal protections under the Eighth Amendment. This perspective argues for the necessity of providing gender-affirming surgical care including preoperative evaluations, procedures, and postoperative management as part of standard medical practice in prisons and jails. The authors highlight the Federal Bureau of Prisons’ (BOP) guidance as a model and emphasize adherence to World Professional Association for Transgender Health (WPATH) standards. Key recommendations include training carceral staff, ensuring patient-centered care, aligning housing policies with safety protections under the Prison Rape Elimination Act (PREA), and leveraging Medicaid funding. The article underscores that denying such care violates constitutional rights and exacerbates health disparities for incarcerated trans populations.