An insider's guide to being transgender in prison

May 17, 2017 by Mia Harris, The Conversation
Credit: shutterstock.com

During the past 18 months, three openly transgender women have taken their own lives in custody in England: Vikki Thompson, Joanne Latham and Jenny Swift. Their deaths speak of the difficulties that transgender people face behind bars. The ongoing inquest into Thompson's death sheds some light onto those experiences.

In her new book, Transgender Behind Prison Walls, Sarah Baker has added her voice to this conversation. As a transgender woman serving time in a men's , Baker is all too aware of the lack of help, advice or information for transgender inmates or the staff responsible for their safety and well-being. Drawing upon her more than 25 years in custody, Baker seeks to help fill this gap. She has also spoken to me as part of my ongoing research into LGBT prisoners.

Baker's personal story of life behind bars is shared in the book's postscript. She describes in detail the discrimination, verbal, physical and sexual abuse that she has experienced since coming out as trans while in prison. Some of it makes for harrowing reading. Complaints she has made about her treatment have fallen on deaf ears. She alleges that she was blamed by an official for provoking attacks via her "lifestyle choice", and finds herself unable to prove discrimination "without a paper trail". The Ministry of Justice was contacted about these allegations by The Conversation but said it did not comment on specific cases.

In 2013, various newspapers wrongly reported that Baker had received gender confirmation surgery paid for by the NHS – sensationalist and transphobic coverage that Baker challenges in her book. Instead, she says that a gender identity clinic denied her both a diagnosis of and any treatment while she is in prison. Baker writes that she was told that she must first live in her affirmed gender for two years outside of prison and, since she is serving a life sentence, this could be a number of years and depends on when she gets parole.

Ministry of Justice guidance on the care of transgender prisoners states that: "The prison GP must refer all applications for gender reassignment surgery to a consultant specialising in gender dysphoria and will ordinarily accept advice from the consultant about whether gender reassignment surgery is considered appropriate in a particular case."

Having lived openly as a woman for five years in prison, Baker says in the book that in early 2017 she resorted to removing her own testicles with a razor in her prison cell. She explains that this "self-administered medical procedure" felt like her only option, given her longstanding and ongoing inability to access any treatment via official channels. In my own correspondence with her, Baker told me that she later went to hospital, and needed two operations.

Growing tolerance

Despite these distressing experiences, Baker is keen to emphasise that "most staff and prisoners have been kind", and that prisons have come a long way since she first arrived in 1985, when "there was no public interest in diversity and equality".

Baker is aware that transgender prisoners are a diverse group, and that her story cannot be taken as entirely representative. She emphasises, for example, that: "As a pre-op male-to-female transgender prisoner within the male prison system, I can only speak confidently about the environment that I live in." Yet she does contextualise her experiences, sharing excerpts of letters sent to her by three other prisoners. Transgender women Nicola and Deanne share similar experiences to Baker of being unable to access a diagnosis of gender dysphoria while in custody. Transgender man, Laura, received a diagnosis in the community but has not told prison staff about his gender identity, instead choosing to live as a woman while incarcerated in a women's prison.

Useful tips

Baker's book acts in part as a guide for transgender prisoners, with information such as how they can formally change their name. Baker also offers practical advice for transgender women in prison, with tips on clothing and footwear. Some of her advice might seem overly prescriptive or conservative. She counsels, for example, "in the interests of female etiquette and decorum, always cross your legs when sitting down", and "do not wear anything that draws negative attention from other prisoners". However, this is pragmatic guidance based on her experiences. As she explains: "Unfortunately, the clothes that we choose to wear will affect the way in which we are treated by others."

Baker also summarises and comments on the government's new legislation on transgender prisoners, which stipulates that prisons must recognise gender-fluid and non-binary inmates, and improves the procedures for making prison allocation decisions. Baker fears that security concerns will continue to trump claims to gender-affirming clothes and accessories, let alone housing in gender-appropriate prisons. She also predicts that prisoners will still struggle to receive diagnoses of gender dysphoria, let alone any necessary treatment, while in custody.

This is Baker's second book, and she has a third on the way. By introducing much-needed information about what it is like to be transgender behind bars, it helps us to understand why so many prisoners self-harm or take their own lives. On the publication of her first book in 2013, Baker received a "barrage of abuse" from the media and people on social media about her transition. I have corresponded with Baker through my research into the experiences of LGBT prisoners, and I sincerely hope that her new book will be received with the interest and respect that it most thoroughly deserves.

Explore further: Transgender patients not electing as much gender-affirming surgery as many believe, study finds

Related Stories

Transgender patients not electing as much gender-affirming surgery as many believe, study finds

May 4, 2017
Researchers from Boston Medical Center (BMC) have conducted the first study in the U.S. to determine the prevalence of gender affirming surgeries among a defined group of transgender patients, and found that most patients ...

Study of transgender preschoolers assesses preferences and identity

April 25, 2017
Gender may be the earliest identity and social category to emerge in development, research suggests, and acquiring knowledge about one's gender is considered a critical part of early childhood development. In one of the first ...

Is gender affirmative treatment effective for coexisting gender dysphoria and psychosis?

April 3, 2017
A new study demonstrates that gender dysphoria in individuals with coexisting psychotic disorders can be adequately diagnosed and safely treated with gender affirming psychological, endocrine, and surgical therapies. The ...

731 people get gender changes on NYC birth certificates

March 9, 2017
Health officials have changed the gender listed on 731 birth certificates since January 2015, with applicants ranging in age from 5 to 76 years old, officials said Thursday.

Are military physicians ready to treat transgender patients?

March 13, 2017
A small survey of military physicians found most did not receive any formal training on transgender care, most had not treated a patient with known gender dysphoria, and most had not received sufficient training to prescribe ...

New study highlights high rates of suicide and self-harm among transgender youth

August 31, 2016
In a new study, 30 percent of transgender youth report a history of at least one suicide attempt, and nearly 42 percent report a history of self-injury, such as cutting.

Recommended for you

Drug therapy from lethal bacteria could reduce kidney transplant rejection

August 3, 2017
An experimental treatment derived from a potentially deadly microorganism may provide lifesaving help for kidney transplant patients, according to an international study led by investigators at Cedars-Sinai.

Exploring the potential of human echolocation

June 25, 2017
People who are visually impaired will often use a cane to feel out their surroundings. With training and practice, people can learn to use the pitch, loudness and timbre of echoes from the cane or other sounds to navigate ...

Team eradicates hepatitis C in 10 patients following lifesaving transplants from infected donors

April 30, 2017
Ten patients at Penn Medicine have been cured of the Hepatitis C virus (HCV) following lifesaving kidney transplants from deceased donors who were infected with the disease. The findings point to new strategies for increasing ...

'bench to bedside to bench': Scientists call for closer basic-clinical collaborations

March 24, 2017
In the era of genome sequencing, it's time to update the old "bench-to-bedside" shorthand for how basic research discoveries inform clinical practice, researchers from The Jackson Laboratory (JAX), National Human Genome Research ...

The ethics of tracking athletes' biometric data

January 18, 2017
(Medical Xpress)—Whether it is a FitBit or a heart rate monitor, biometric technologies have become household devices. Professional sports leagues use some of the most technologically advanced biodata tracking systems to ...

Financial ties between researchers and drug industry linked to positive trial results

January 18, 2017
Financial ties between researchers and companies that make the drugs they are studying are independently associated with positive trial results, suggesting bias in the evidence base, concludes a study published by The BMJ ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.