The care and management of transgender prisoners

Last December the Ministry of Justice announced a review into the care and management of transgender prisoners. A year later and finally the review has been published, accompanied by Prison Service Instruction 17/2016 The Care and Management of Transgender Offenders which must be fully implemented by 1st January 2017. Here we summarise some key points and changes.

There is a greater emphasis on early identification so that decisions can be made and support put in place as soon as possible. The PSI states that ‘arrangements must be in place to determine the legal gender of all offenders at the first point of contact’. Staff should not ask to see a Gender Recognition Certificate but can request to see your birth certificate. You should also have the opportunity to express the gender you identify with at the earliest opportunity and have that respected in the way you are communicated with and treated.

The PSI introduces multi-agency ‘Transgender Case Boards’ to make decisions about location and to review the care and management of transgender prisoners whilst in custody.  An ‘Initial Local Transgender Case Board’ should take place either during pre-sentence report or within 3 working days of reception in custody. As well as your legal gender the board should consider the strength of evidence of living in the gender you identify with and all known risk factors to determine your location within the estate. Where location decisions are agreed which are not in accordance with your legal gender, this must be signed off by the Deputy Director of Custody or the chair of the Complex Case Board.  Prior to these decisions initial location will be in accordance with legal gender.

The initial board should also form a local agreement for the initial care and management plan. Following this ‘Local Transgender Review Boards’ will provide an opportunity to review these plans, and address concerns that you might have. Centrally managed ‘Complex Case Boards’ can also be referred to for cases which present a significant level of complexity. The PSI states that ‘the offender must be provided with an opportunity to participate in and/or make their views known to all Transgender Case Boards’.

Searching arrangements should be discussed and included in agreements. Your view of searching procedures should be sought at the earliest opportunity and a voluntary agreement put in place to how this should be done. If you have applied for or have obtained legal recognition of the gender with which you identify you must be searched in accordance with this unless alternative arrangements are agreed. It is important to note that searches must in not be conducted to determine gender.

The PSI is clear that ‘all transgender prisoners covered in this policy must be allowed to express their gender identity and including dressing in clothes suited to the gender with which they identify in line with relevant dress codes and subject to any requirement to wear prison issue clothing.’ In reference to names it states ‘transgender prisoners must be allowed to adopt a gender appropriate or gender-neutral name and be addressed by others consistent with the gender they identify with.’

Annex A of the PSI gives more details on supporting people to live in the gender they identify with. It advises that the prison should obtain from an equivalent opposite gender prison a set of guidelines for what clothing and personal care products are allowed. Items to assist with presentation in the gender you identify with such as sophisticated prostheses or padded bras may only be prohibited if they present a security risk which cannot be reasonably mitigated.  The prison must be able to provide a detailed and reasonable justification for applying any restrictions, which cannot include IEP levels. In terms of makeup, items which are vital to presenting in the gender identified with, such as foundation to cover facial hair, may not be restricted. However, other make up may be restricted in line with the IEP framework.

Regarding access to relevant healthcare, prisons must make sure that those who have been diagnosed with gender dysphoria have access to the same quality of care that they would expect to receive from the NHS if they had not been sent to prison. The PSI further states that ‘if medical treatment for gender dysphoria is commenced before reception into prison, and the prisoner applies for it to be continued, it should be continued until the prisoner’s gender specialist has been consulted on the appropriate way to manage the prisoner’s treatment unless the doctor working in the prison has reasonable clinical grounds for not doing so.’

The PSI also seeks to educate staff in a variety of terms that might be used in relations to transgender issues. Further training and guidance for staff are also intended as well as access to specialist advice such as though Regional Lead Psychologist and Transgender Complex Case Boards. A NOMS transgender Advisory panel is also to be established to develop and review relevant policy and concerns.

For more detailed information or if you would like us to send you a copy of the new PSI please contact us. Unlike the previous instruction, PSI 17/2016 covers aspects of management in the community as well, particularly in relation to Approved Premises which may also be useful to you.

You can contact the Prison Reform Trust’s advice team at FREEPOST ND6125 London EC1B 1PN. Our free information line is open Monday, Tuesday and Thursday 3.30-5.30. The number is 0808 802 0060 and does not need to be put on your pin.