Evaluation
Employees/contract staff will refer to the Employee Manual for the Identification, Treatment, and
Correctional Management of Transgender, Intersex, and Non-binary Individuals for detailed guidance
for transgender, intersex, and/or non-binary individuals. A Multidisciplinary Team (MDT) will convene
within 15 days if an individual discloses their transgender, intersex, and/or non-binary identity at any
time during incarceration and it has not been previously documented. Before the MDT meets, the
assigned case manager, a medical provider, and a mental health provider will meet with the individual
in a location where confidentiality can be maintained to discuss the housing review and protocols and
determine a recommendation based on the individual’s needs. The individual’s own views about
personal safety will be considered when making recommendations.
Diagnosis
A DOC policy specific to a diagnosis of Gender Dysphoria was not provided, though the term
is referenced in a protocol document, Guideline for Healthcare Support for Transgender
Individuals, as being determined by DSM-5 criteria.
Medicalization
Incarcerated transgender, intersex, and/or non-binary individuals will receive medical/mental health care per the Washington DOC Health Plan, Gender Dysphoria Protocol and GD-CRC, and Evaluation and Management of Hormonal Treatment of Gender Dysphoria/Transgender Identification Protocol.
In accordance with the WA DOC Health Plan, hormone replacement therapy (HRT) is designated as a Level 1 intervention while gender confirmation surgery (GCS) is designated as a Level 2 intervention and therefore subject to the demonstration of medically necessity of the intervention.
HRT may be prescribed by the Practitioner following an evaluation to determine transgender identification, informed consent has been obtained and no major medical contraindications exist. A diagnosis of Gender Dysphoria does not need to be present for HRT. Anyone who was prescribed HRT when they arrived to DOC will be continued without further review, unless there is an identified concern from their Practitioner.
Unless a person clearly does not meet medical necessity for surgical treatment of GD, they will be referred, upon their request, for a pre-surgical evaluation by an external GD Consultant if they meet specified criteria.
Requirements for Transfer to Women’s Facility
DOC Policy 310.150, Reception, Initial Classification, and Custody Facility Plan, indicates that males will be received at the Washington Corrections Center and females will be received at the Washington Corrections Center for Women. Initial reception and housing placement are determined based on the individual’s biological sex. However, the policy also permits exceptions to initial placement, and there have been occasions where an individual has been directly housed at a gender-affirming facility.
Once received into a DOC facility, the Incarcerated Individual may disclose that they are transgender or non-binary. The PREA Specialist will be notified of this disclosure. Within three business days of arrival, the Specialist will meet with the individual and offer the opportunity to voluntarily complete the Preference Request form (02-420). The individual will be told that the facility MDT will complete the Housing Protocol with them over the next 14 days to ensure safe housing and equitable access to programming and services. The individual will be housed according to their feeling of safety
pending the Housing Protocol completion.
In the event an Incarcerated Individual discloses to staff and the Department believes that an individual is not sincere in their gender identity and asserting it for an improper purpose, they will be referred to an external agency Gender-Affirming Mental Health Community Consultant, to evaluate the sincerity of the individual’s transgender identity.
In the event a transgender individual is transferred from gender-affirming housing at a jail to a non-gender-affirming DOC facility for reception, the Department will consider transferring the individual to a gender-affirming department facility within 15 days of transfer through the MDT process unless the individual requests in writing to complete their intake process at the non-gender-affirming facility or the HQ MDT Chair and Deputy Secretary agree to transfer sooner because clear and detailed information has been received that indicates the individual should be in the gender-affirming facility.
If notified promptly before the reception, consideration will be taken to receive the individual into a gender-affirming facility if transferring from a gender-affirming jail.
Limits based on type of crime committed?
DOC Policy 490.700 sets forth the procedure for the review of gender-affirming housing requests. Consistent with PREA standards, requests are reviewed on a case-by-case basis and consider the
Incarcerated Individual’s own views on safety. In addition, staff considers relevant security concerns such as their history of violent infractions, substantiated PREA claims, predatory behavior, and any other information which could affect the security of the gender-affirming facility.
Re-Evaluation required?
An individual identified as transgender, gender non-conforming, or intersex will have their housing reviewed, at minimum, every six months to ensure safe housing and access to programming.
Pronoun requirements?
All employees/contract staff/volunteers will address Incarcerated Individuals by the preferred pronoun in
DOC 02-420 Preferences Request or their last name per DOC 100.500 Non-Discrimination for Individuals policy. Refusal to use the individuals’ preferred pronouns is considered harassment and is a violation of policy.
Merging of “transgender” and intersex categories?
Yes.
