Evaluation
An incarcerated individual who self-identifies as transgender, gender diverse, or is diagnosed as intersex (either at Intake or a residential facility) shall be referred to Health Services and evaluated in accordance with Health Care Services Directive 2.17A, ”Health Service and Mental Health staff shall complete State Form 56492, “Transgender Evaluation” and forward a copy to the facility PREA Compliance Manager. The incarcerated individual shall be placed on the facility PREA Compliance Manager’s tracking mechanism for LGBTI individuals, and complete a new PREA Risk Screening.
Diagnosis
If a diagnosis of Gender Dysphoria is being considered or the patient is requesting accommodations or treatment for Gender Dysphoria, the patient shall be referred to a licensed psychologist and psychiatrist for further evaluation. Within ninety days (90) days of the referral, the psychologist and psychiatrist shall meet with the patient and complete their evaluation for presence of Gender Dysphoria. Once both evaluations have been completed, a Gender Dysphoria Review Committee including the evaluating psychologist and psychiatrist along with the Regional Director of Mental Health, Regional Director of Behavioral Health and Regional Director of Psychiatry will convene to review and discuss the evaluations completed for the patient and whether a GD diagnosis is present.
Medicalization
Patients diagnosed with Gender Dysphoria or intersex shall be enrolled on the mental health roster and in chronic care clinic to develop an Individualized Treatment Plan. Treatment options to alleviate symptoms of Gender Dysphoria, reduce comorbid mental health conditions, prevent suicidality, and improve overall quality of life may include:
A. Psychotherapy:
B. Hormonal Therapy:
C. Gender Affirmation Surgery (GAS): The Gender Dysphoria Review Committee shall follow WPATH Standards of Care and consider on a case-by-case basis.
Decisions regarding treatment must be approved by the Gender Dysphoria Review Committee.
Requirements for Transfer to Women’s Facility
The PREA Risk Manager shall schedule a meeting with the Transgender Review Committee and the incarcerated individual. Their recommendation will be reviewed by a Committee headed by the Director of the PREA. Their recommendation will be forwarded to the Deputy Commissioner of Operations for review and final decision. (*Note: Diagnosis of gender dysphoria is not a mandatory requirement or identified as a consideration factor by the Department when making housing recommendations/decisions on behalf of the incarcerated individual)
Limits based on type of crime committed?
Listed as a consideration factor during Committee Review, but procedures do not specify any limitations based on criminal history
Re-Evaluation required?
PREA Risk Screening placement and programming assessment recompleted every 6 months. Guidelines do not address whether the Committee’s will also complete a re-evaluation based upon that PREA reassessment.
Pronoun requirements?
Identified and confirmed during meeting with Transgender Review Committee following intake. Staff are encouraged to use preferred pronouns.
Merging of “transgender” and intersex categories?
Yes
