Policy Changes to Provide Access

Now that the history of our Commissioners Directive 800 policy has been explored in detail, it is necessary to discuss possible alternatives to this discriminating policy. Possible alternatives would include changing the wording of this policy. By simply modifying specific words within the policy you could completely change the implications affecting transgender individuals in the prison system. As we know there are very negative implications for transgender individuals with the current policy in place. Although, through fairly minimal word changes in the policy we could drastically improve incarcerated life for the Trans community.

The goal intended when we speak about alternative policy development is to break down the barriers for Trans individuals, when seeking access to health care within the prison system. First it is crucial for us all to understand what "access" means. "Getting in the door is the first step but access includes more, such as the quality of services, as well as the spirit in which the service is provided. Access is a commitment." http://www.the519.org/. Access for a Trans person in jail is about respect, and allowing the Trans person to have control over decisions regarding their own bodies.

Breaking down barriers to create this aforementioned access is our next step in eliminating discrimination from this prison policy. Barriers include having the jail’s "specialist" be in control of the Trans person, rather than having the Trans person’s doctor have input. Another barrier is the strict one-year requirement regarding the life test. Lastly, the jail’s "specialist’s" need to "recommend" surgery is a final barrier inhibiting Trans individuals from accessing healthcare, as well as having control over their own bodies.

Recommendations would include having incarcerated transgender individuals’ doctors able to have input into the lives of their patients. Doctors that have spent time with these Trans people, while they were in the community, would have a better idea of the "readiness" of their patients. Also, by making the time restrictions on the duration of life tests a bit less rigid, we could improve the quality of life for many incarcerated Trans people. Lastly, we should eliminate the need for the jail doctor to "recommend" surgery, as this is a monumental barrier for many Trans people trying to gain access to their health care needs.

Impacts of Case by Case Policy

It is a human right for transgendered people to be treated fairly and without discrimination, to have equal rights and opportunities and be recognized for their dignity and worth. Yet, all transgender people in prison are handled on a case by case basis where there is likelihood for personal interpretations of the policy to be projected by prison professionals that fluctuate from one case to the next.
Consistency in a structured environment such as prisons helps to create norms within that environment; consistent practices and principles normalize everyday conduct, attitudes and behaviours. Each transgendered person in prison, however, is scrutinized as an individual and treated separately from others often from a transphobic mindset. When each case is managed differently there is a lack of consistency both in the treatment and the outcomes. It causes confusion, perplexities and uncertainties about the norms pertaining to transgendered inmates. The variance in outcomes also makes it hard to distinguish the best way to go about solving the problem.
Prison professionals may use the inconsistencies as an escape route for their decisions and treatment towards a transgender inmate where they blame the system, not themselves for the discrimination. Other inmates may feed into the lack of consistency and see it as a doorway for justifying their transphobic ideals as well. A case by case framework may be detrimental to a transgender inmate in that they may internalize the negative ways in which they are treated, where their self-worth and self-esteem are diminished. They may also generate mistrusts towards prison professionals. Handling these issues case by case may also cause a divide between other transgender inmates whose experiences with the process are drastically dissimilar.
A universal law may not account for all the injustices faced by a transgender inmate, nevertheless, it may be a good place to start in order to establish a standard in which prison staff are held accountable for any mistreatments, and to abolish multiple interpretations of the policy in any given case. Assembling standards may assist in regulating and normalizing more positive perceptions about transgender inmates and help to protect them from harm.
For more information on human rights and sexual orientation, please visit: http://www.ohrc.on.ca/en/issues/sexual_orientation

Subjective Policy

On the surface, it appears as though this policy protects the transgendered inmate; however, when we dig deeper it becomes clear that this policy is very much subjective and open to interpretation. The policy is not uniform, and for that reason, allegations exclusive to transgender individuals are dealt with on a case by case basis. Furthermore, even if laws were uniform, transgender inmates face differential treatment which is associated with staff ideology.
Before 1918, the laws between provinces were dissimilar and in some cases, contrasting. This problem called for a conference with the intention of harmonizing the laws of the provinces and territories of Canada in 1918. This conference is now held annually in order to identify deficiencies, defects and gaps in existing law. The civil system which constitutes of lawyers, judges, analysts and law reformers meet to discuss possible areas in which provincial and territorial laws would benefit from harmonization. Uniform statutes are drafted by legislative counsel and effective immediately.
Critically speaking, the answer may not lie in trying to create a rigid, obstinate and objective legal system because human beings are multifaceted and complex. We are by nature subjective beings, and according to Niklas Luhmann, this awareness has allowed for the “personalization” of law to occur over time. This process takes into account environmental and individual factors and sees a need to move beyond this concept of a universal and uniform law. Niklas Luhmann’s concept is particularly useful to keep in mind as we enter a time when law and policy is being required to evolve to accommodate for lesbian, gay, bi-sexual and transgender individuals. The assimilation of transgender inmate’s into a prison setting which strictly accommodates toward heterosexual inmates and their values is no longer acceptable. What is needed is recognition of the diversity within institutions and the creation of policy with difference in mind.
Everything considered, it becomes open to discussion whether uniform law and policy are realities, as much as they may be aspirations.

For more information on the Uniform Law Conference of Canada, please visit their website at http://www.ulcc.ca/en/home/

The "Specialist's" Impacts

Commissioner’s Directive 800 number 36 has been established as a very discriminatory policy. There are a plethora of ways that this policy impacts individuals, and it is crucial to pinpoint these impacts in order to understand the ways in which this policy is oppressive. One way that this policy affects the incarcerated transgender person is the requirement that one person, a psychologist, decides the fate of the individual. I intend to show that putting the outcome of someone’s life in the hands of another person, who could undoubtedly be transphobic, is very risky, and ultimately discriminating.
As transgender individuals are one of the most stigmatized and oppressed groups it is crucial that as a society we ensure that the medical treatment received by transgender individuals is not lined with discrimination. Although, health care providers, being human, often carry the same bigoted viewpoints that the rest of society does. One story that made headlines was when a Catholic hospital refused breast implants to a transgender woman. (http://www.catholicnewsagency.com/new.php?n=11383). The surgical coordinator was quoted as saying, "it is against god’s will". This type of discrimination is faced daily by people not within the jail system; I can only imagine the type of oppression that is occurring within the jail walls.
Transgender individuals have to go through multiple levels of personal contact before receiving actual sex-reassignment surgery. If these transgender individuals are subject to one transphobic individual throughout the process, there is a distinct possibility that they will not be able to receive proper treatment. There are many debates over the ethical nature of the Harry Benjamin standard of care we previously discussed. "Some members of the transgender community are very critical . . . of the Standards of Care and take issue with the perceived need for someone other than themselves to decide whether they are eligible for sex reassignment (Bockting, 2004).
By picking through the many aspects of the Commissioner’s Directive 800 we have noted that there are many areas of the policy that need improvement, as this policy has a direct impact on the life of all incarcerated transgender individuals. The very fact that someone other than the transgender individual has control over the life choices of the individuals marks the policy as problematic. Due to the fact that we live in a world that discriminates against the transgender community we must ensure that the transgender community, as well as the incarcerated transgender community, can access proper health care without facing barriers at every step of the process.

References
BOCKTING, W. (., ROBINSON, B. (., BENNER, A. (., & SCHELTEMA, K. (. (2004). Patient satisfaction with transgender health services. Journal of Sex & Marital Therapy, 30(4), 277.

What Makes a Specialist?

In the Commissioner’s Directive 800 policy number 36 it states that a recognized gender identity specialist has to confirm that the offender has satisfied the real life test for a minimum of one year prior to incarceration. It also states that the recognized gender identity specialist then has to recommend surgery happen during incarceration. When looking at this our questions are what qualification do you need to be recognized as a gender identity specialist? And who decides within the prison system which specialist to use with transgendered inmates?

In order to get a favourable recommendation for SRS two different specialists have to agree. One of the specialists must possess a Masters Degree in a clinical behavioural science. The other must hold a doctoral degree (e.g., Ph.D., Ed.D., D.Sc., D.S.W., Psy.D., or M.D.). The specialists should also demonstrate competence in psychotherapy, sex theory and therapy. If you look closely at the requirements as to what defines a specialist, it uses the words should and competence, this leaves a lot of room for recommendations being made by health professionals who are not necessarily proficient in transgendered issues and who are not experts on SRS surgery. Also leaving people’s fate in the hands of someone who is competent and not an expert doesn’t not sound promising. A lot of room is also left for discrimination, since being aware and up to date on transgender matters is only a recommendation and not a requirement.

The potential for discrimination is even higher when we are talking about a transgendered inmate for three main reasons. First of all, the prison is most likely not going to use the same specialist that has been treating the person during their RLE. This means that whoever is making the recommendation will not have been through the transition with the individual and will not be able to truly judge their motivation or success. Second of all since the prison is the one hiring the specialist and it is not required that the specialists are experts in the field of SRS, they are more likely to hire who is available and who will compile with their value system instead of the specialist would have the best interest of the prisoner in mind. This could very easily lead to a transgender inmate being stuck with a transphobic doctor deciding their fate. Thirdly since again the specialist is being hired by the correctional system, they very well may be being paid for their unfavourable recommendation, since it is much cheaper for prisons to pay a “specialist” than to pay for the expenses related to surgery, i.e. transportation and medical attention during recovery.

Therefore the fate of transgendered inmates is placed in the hands of whomever the prison sees fit: qualified or not, bought or not, open minded or not.....
http://www.genderpsychology.org/transsexual/hbsoc_1990.html

Discriminatory and Unfair Influence of Policy

As evidenced in the previous blog, the policies that are designed to protect the transgendered inmate are flawed, and this gravely influences and shapes the transgender inmate experience in the institution.

The policy we have chosen questions what it means to have equal access to emergency health care in Canada. More specifically, minorities receive poorer health care and as a result, have poorer health outcomes. This is certainly true for the transgender inmate as they are less likely to receive certain surgical procedures. The question is not do disparities in health care exist for the transgender inmate but the challenge is in developing and implementing certain strategies to eliminate them. This needs to happen from the bottom up, as it is evident in the prison system that these discriminatory policies could be said to encourage and maintain indifference.

The psychological state of the transgender individual is in constant turmoil. Often, the transgendered individual is at a point where they are trying to establish a personal sense of identity. This is extremely difficult to accomplish in an institutional setting because you’re working with a system that fails to recognize you as an individual. This is evident as transgender inmates are prohibited from receiving their surgery and from obtaining necessary hormones to maintain their transition. They may experience permanent side effects from being unable to transition such as anxiety and suicidal tendencies. Depression is the leading mental health concern among the transgendered population. For more information on how depression specifically affects the transgendered person, visit: http://www.firelily.com/gender/gianna/depression.html
As we can see, it appears that the very notion of transgender is a psychological and medication problem. As a result, health care providers initially pathologize the transgender condition and in doing so place their mental illness as a secondary concern.

When transgender inmate is living with individuals they do not identify with, this creates an uncomfortable and dangerous situation. These inmates are neither sympathetic, now sensitive to their situation and may not agree to how they have chosen to live their life. Experiences often include sexual assault, brutality, threats and harassments. This may not only be coming from fellow inmates, but staff working in the institution also.

Transgender Policy: Discriminatory and Unfair

The laws which are created with the intention of “protecting” the transgender inmate are discriminatory, biased and unfair. Policy makers have inadvertently created a system which results in the production, maintenance and preservation of the ill treatment of the transgender individual. Moreover, it does this to such a large extent that it questions the intentions of policy makers to create a fair system to begin with. It is my intention to critically examine this law, in order to identify the various inadequacies that support its framework.
What I found to be chief contradictions and areas of discrimination were within the institutions obligation to deliver suitable health care to the transgender inmate. This policy specifically claims that all inmates have the right to health care and that staff members have an obligation to bring attention those inmates who appear to be ill in any way. Furthermore, emergency health care is a priority. In reality, we generally see this as applying to acute problems only. The distress transgender inmate’s faces are long lasting and constant. Inmate health care is flawed and will not support the transition of the transgender inmate regardless of the severity of distress. Inmates are unable to receive sex reassignment surgery and they are only granted hormone treatments if they request it, and make arrangements for the hormone to be sent to the hospital via a third party.
In some cases, the transgendered individual has lengthy sentences and although an inmate’s health care is subject to these considerations we do not see the process of transitioning as being a top priority. As a result, the denial or cession of a progressing transition causes exceptionally harmful psychological states.

Moreover, the transgender inmate faces further barriers when it comes to living arrangements. They are required to be placed in the institution based on their biological genitalia. This is unfair as you cannot create a uniform policy because the transgendered individual can be at a range of places on the transitioning continuum. For example, if they have partly transitioned, they may still have their biological gender; however, may look, speak and resemble the opposite gender due to extensive hormone use. It is dangerous to place these individuals with fellow inmates with whom they do not identify or classify as there same gender. To comprehend the unique problems faced by a transgender individual when entering this environment, please read the story of Kalani Key, a women’s story of survival in a male prison.
http://www.alternet.org/rights/69173/

The Real Impacts of Real Life Experiece

The RLE is a discriminatory process but what is even more oppressing are the impacts it has on the lives of the people forced to endure it. One of the biggest impacts felt by transgendered people during this time frame is that employment can become difficult. Because the person is not legally the gender in which they are living lots of employers do not understand the situation and therefore won’t hire transgendered people during their RLE, or they fire them because of it.
Transitioning is already a very stressful time for a transgendered person, the RLE adds further debilitating stress by focusing the person’s mind on the test instead of on living their lives. If the “patient” does not prosper during their year in RLE it is not contributed to this stress but to the fact that they must not really be a transgendered person or that they don’t want the surgery bad enough. During the RLE the person must appear eager enough for surgery or it can be further delayed, this add an extreme amount of pressure to the individual going through such a huge change.
Something as simple as going to the toilet in public becomes a huge ordeal for a person in RLE. According to the test you must act fully in your desired gender, but having not had SRS causes obvious difficulties.
The RLE is also when transgendered people are the most vulnerable to discrimination, harassment and violence (http://www.genderadvocates.org/reports/supp98a.pdf). So for some passing the test becomes a matter of life and death.

The Real Life Experience

The real life experience (RLE) is a major part of the Standard of Care that transgendered inmates must pass in order to receive SRS while imprisoned. RLE is a process where transgendered people have to live in their preferred gender for a year in order to demonstrate that they can function in that gender role. The RLE is a discriminatory and oppressive imposition placed on transgendered people, instead of focusing on helping them cope with being who they are, the RLE is all about testing whether they can be who society wants them to be.
Social, legal and employment systems frequently support the false conceptualized pathway set up by the SOC, meaning that a person can’t legally change their names or gender without surgery. This makes it near impossible for transgendered people to have a successful social change of gender during the RLE. In essence they must live in the gender they identify with but are not given any of the rights associated with this.
The most discriminatory part of the RLE is that permission is needed to have a medical surgery by a therapist. The question should not be whether the individual has successfully completed the RLE but whether he or she is able to give informed consent for the surgery. Like in most surgeries if the patient is well informed and has a surgeon who is willing to perform the surgery, it should be allowed, especially since SRS’ are usually paid for by the individual.
Though it is definitely not the same, an example to illustrate my point is doctors don’t go around telling women who want breast enlargements that they must walk around wearing padded bras for a year before they are allowed surgery. Transgendered people do not want surgery for aesthetic reasons, they want to be able properly live as the gender they identify with, and shouldn’t have to jump through society imposed hoops to do so.

http://wiki.susans.org/index.php/Real_life_experience

Policy Impacting the Individual

It is easy to graze the surface, in a theoretical manner, about how Commissioner’s Directive 800 number 36 is discriminatory to transgendered individuals, but to really understand the effects of these policies it is necessary to grasp the impacts on the individual. As I have previously shown, transphobia, immigration status and language are all barriers to the healthcare system for transgendered individuals. I will go on to exemplify the specific impacts that these roadblocks have on the individuals in the transgender community, and portray the way in which we limit healthcare in an systematic manner.
Transphobic doctors have been known to refuse treatment to transgendered individuals. This refusal often leaves transgendered people with very few options if they would like to start on their road to sex reassignment. This lack of accessible healthcare may lead some transgendered folks to seek access to hormones on the street. The danger in terms of dosage and access to clean needles is tremendous. This phenomenon, of refusal of health care, is putting an entire community at risk.
Another way that transphobia is manifested in doctors is when they use their position of power to diagnose the transgendered individual as "ill" and try to "treat" the person. Not only is this unethical, but also, labeling this person as "ill" can make the transgendered person feel that there is something wrong with their feelings. This can in turn make the transgendered person focus on their "illness" rather than on their sex reassignment plans. Oftentimes non-Canadian transgendered people flee to Canada in search of a liberal society that will assist them on their sex reassignment journey. With no status, and often little money, our oppressive society often leaves these transgendered individuals with little way to make money outside of the sex work industry. Not only are these surgeries very costly, but also if this person were emigrating from non-English speaking country, expensive translators would be necessary.
Here we have been able to personalize the myriad ways in which Commissioners directive 800 number 36 directly impacts the lives of the people in the transgender community. Society systematically limits access to healthcare, and then writes and imposes these policies as if they are somehow attainable to the folks they purport to serve. The policy investigated would be blameless if we were serving a population of all upper class white Canadian men. Although, as shown this is not the case. Canadian society limits access to healthcare to certain marginalized groups, and as a result we can not apply policy to heterogeneous populations as if they were not so.

For information on transgender health needs please visit-

http://www.transgendercare.com/

Inherant Discrimination Within Policy

The Commissioner’s Directive 800 policy number 36, a policy which speaks to the rights of transgender individuals in the Canadian jail system, is inherently discriminatory. The wording of this particular policy assumes a level playing field within our society, although the field, in actuality, is quite bumpy. The Policy uses words like "gender identity specialist", as if this type of specialist is readily accessible to the transgender community. I will show how transphobia, immigration status and language are all aspects of that bumpy playing field that result in the unavailability of healthcare. This lack of access to healthcare provides the necessary evidence in order to render this policy 36 discriminatory.
Transphobia is a major barrier in terms of accessing healthcare for the transgender individual. Often there are encounters with transphobic doctors who will refuse treatment outright to the transgender individual. Another way transphobia is manifested within the medical field is when doctors try to "cure" the transgendered person. Transgendered people are sometimes viewed as "ill" by transphobic doctors and then the doctor attempts to treat the "illness", rather than initiate steps towards sexual reassignment.
Immigration status is also a major problem when trying to access healthcare. Even if the transgendered individual were lucky enough to see a doctor who was willing to provide treatment, the lack of a healthcard would make the cost of these treatments and procedures tremendous. Furthermore, if this individual were emigrating from a non-English speaking country, there would be further costs endured in order to hire a translator to convey their needs to the doctor.
This policy requires an individual to gain access to the Canadian Healthcare system. But, as you can see this access is often very restricted for the transgendered individual. It is obvious that the nature of this policy is discriminating to transgendered individuals; the very individuals that it should seek to protect. The life test is the next term that is imposed on the transgender individual. Imposed by the same oppressive policy writers that create these discriminatory barriers to healthcare.

For more on systemic discrimination please visit- http://www.queensu.ca/humanrights/tap/3discrimination.htm

Impact of Gaps and Assumptions in SRS Policy for Transgender Inmates

The overall impact of Correction Services Canada SRS policy is that many transgendered inmates who are in desperation for the surgery do not receive it. The difficulties and restrictions in accessing SRS behind prison walls also render the transgendered inmate powerless. They are controlled under an institution that has policies with loopholes so many of those who want the surgery fall through the cracks.
There are huge implications for pre-operative transgendered individuals who are waiting for the surgery, or do not qualify (likely because they are blocked by at least one of the existing barriers in the policy) in that they are obliged to settle with hormone therapy for the time being. This is problematic because despite their transition to being feminine or masculine, they are held in male and female institutions respectively. For example, a male to female transgendered inmate may be stuck in limbo before surgery in a male prison where they are commonly abused, assaulted, harassed and/or exploited.
It is crucial to also interpret where the underlying tones in the policy come from. There are societal ideologies around heterosexuality and gender. Being heterosexual is viewed as the norm and anything that drifts from this is deemed as deviant. In our society, a person’s external appearance is assumed to match their gender identity. Because the transgendered community does not fit into either category, they are stigmatized and pushed margins of society where they are at a disadvantage. In a book called, “Transgender Rights” the authors state the following, “at the core of the law’s power over trans women and men is its ability to pronounce individuals legally female or male regardless of their gender identity or expression”, they also go on to say that there is paradigm enforced, especially by the courts, where “trans women and men have no place” (Currah P, Juang R.M., Minter S, pg 46, from http://books.google.ca/books?id=FUwOKayHVwcC ) . The policy reflects the general non-acceptance for transgendered people in society. Furthermore, since institutions like prisons hold so much power, they are responsible for reproducing incorrect assumptions and do not recognize transgender inmates as full and equal participants in society (http://www.ccsd.ca/subsites/inclusion/bp/as.htm).
The overall impact of the combination of prison policy restrictions and ideologies sends a message across the board – that transgendered people are not the norm. Themes regarding social responses and belief about transgendered inmates are based on exclusion. They are excluded from personal and physical security and from non-discriminatory prison policy, where they are further excluded from adequate health care services.
For further information, please see: Transgender Rights by Paisley Currah, Richard M. Juang, Shannon Minter, Published by U of Minnesota Press, 2006 ISBN 0816643121, 9780816643127 368 pages or visit http://www.upress.umn.edu/Books/C/currah_transgender.html or http://bookd.google.ca/book?id=FUwOKayHVscC
Please also visit: http://www.xpressions.org/

A Critical Analysis of Sex Reassignment Surgery (SRS) Policy for Transgender Inmates

Merely having policies in prisons that address transgendered people in general is not satisfactory. Anti-oppressive theoretical framework suggests that social relationships manifest in ways that give dominant groups power through systematically reducing, controlling, manipulating or immobilizing subordinate groups (http://aosw.socialwork.dal.ca/theory.html). The current Sex Reassignment Surgery policy in correctional facilities can be dismantled to evaluate institutional injustices against transgendered inmates in this context.
Current Correction Services Canada policy is based on the premise that changing a person’s sex IS APPROPRIATE AND NECESSARY when recommended by a gender identity specialist to ATTEND TO the NEEDS of a transgendered individual. CSC acknowledges the need for SRS – they made a policy that adheres specifically to it, yet the policy is set up so there is LIMITED ACCESS to the means. Denying or making access difficult for subordinate groups is a form of systemic oppression.
The policies are layered in a way that one policy impacts another. They overlap so the transgendered inmate moves through the legislation facing constant roadblocks. Let’s critically examine how the policies around gender identity disorder are interwoven:
1) Subsection 33 (initiate or continue hormones), Subsection 34 (pre-operative placement), Subsection 35 (placement/ program decisions accommodate needs including safety and privacy) and Subsection 36 (SRS) are all limited to subsection 32 (label and continuity of healthcare).
Further, within the above:
2) Subsection 36 is limited in itself because a)need real life test that is not available behind bars, b) it’s ‘considered’, and c) it MAY then be ‘recommended’.
3) Subsection 34 (pre-operative placement) and Subsection 35 (placement/program decisions accommodate needs including safety and privacy) are limited to the occurrence of subsection 36 (SRS), which may not occur because subsection 36 (SRS) is limited to itself and #1.
And finally,
4) Being placed in a facility that adheres to the gender in which a transgendered inmate associates with (which would be the opposite of subsection 34, or post-operative placement) is contingent upon subsection 36 (SRS) – which may not occur based on all the above mentioned limitations. http://www.csc-scc.gc.ca/text/plcy/cdshtm/800-cde-eng.shtml#_gender
The legislation makes SRS nearly unattainable, and consequently makes proper placement unattainable. This process is a cycle of exclusion and confusion for the transgendered inmate. It is accomplished through control and a process that makes the transgendered inmate immobile; thus it is discriminatory.

For more information, please visit http://www.nsrap.ca/

How policy affects the lives of transgendered individuals

Organizations try to protect transgender individuals by creating non-discrimination laws and policy which state that no one should not be treated unfairly or harassed because they are transgender. Most organizations have anti-discrimination policy; however only few specifically include transgender individuals. When they are included, policies follow a similar composition:You are considered transgender if:o You want to live as a member of your preferred gendero You are in the process of changing over to your preferred gendero You live as a member of your preferred gendero You have lived as a member of your preferred gender in the past oro You are intersexual and live as a member of your preferred gendero You do not need to be taking hormones, nor be planning or have had sex reassignment surgery.Anti-discrimination policy applies to all social locations at all times; however, the onus is on the victim to make a complaint and report it to the authorities. If their complaint is valid, legal authorities will investigate your compliant. A private settlement will try to be reached and if that is not possible, your case will go to tribunal court. On paper, this looks like an objective policy that could protect and shelter transgender individuals from prejudice, discrimination and inequity. However, when we de-construct such policy we see various discrepancies begin to emerge.Terminology such as, “preferred gender” and “valid complaint” are ambiguous and can be interpreted in many different ways. Furthermore, the onus is on the victim to make the complaint, which further accentuates the vulnerability of the transgender individual and draws attention to the superiority and dominance of law enforcement officers. Furthermore, settling the dispute through a private settlement highlights the taboo nature of the transgender experience.When we consider anti-discrimination policy within institutions like jails and prisons, the transgendered inmate is faced with further barriers towards equality. Although specific institutions may have policies in place to protect the well being of the transgender individual, many staff do not follow the ideology that the policy sets out. Staff may not approve of how the transgender individual has chosen to live their life and because they are in a powerful position, they very well may support and be part of the ill treatment of the powerless transgender inmate. For example, instances have occurred where staff have been reported physically, sexually, verbally and emotionally abusing transgender inmates. All too often, transgender inmates have to remain silent if only to keep on good behavior to hopefully be granted early parole.It’s evident that the very policies and procedures being created to help the transgender population are far from perfect, filled with oppressive undertones and are not always adhered to or applied equally.For more information on transgender law and policies, including anti-discrimination laws please visit: http://www.transgenderlaw.org/resources/index.htm

Systems and Responsibilities: No Universal Policy for Transgendered Inmates

Since there is no universal policy with respect to transgendered people in prisons and they are handled on a case by case basis there is a lot of room for poor treatment and inadequate services for them while incarcerated. Discrimination against transgendered inmates occurs at the federal level and trickles down into the institutional framework. In both cases, transgendered inmates do not have access to the same resources as the mainstream prison population, and this is certainly problematic in terms of their human rights.

Take, for example at the federal level, the idea that Corrections Canada has recognized the need for suitable, gender specific interventions. Policies were changed to address the particular needs of women, and the Prison for Women (P4W) was closed down because it was criticized heavily for its lack of suitable programs. Incarcerated women currently receive programming directly intended for women in conflict with the law (http://www.csc-scc.gc.ca/text/releases/00-07-06_e.shtml); likewise, male programming targets male offenders. The way in which transgendered offenders are placed however, means that programming is limited to the institution they are placed in, which, by nature does not address the needs of the gender they associate themselves with and contradicts Corrections Canada’s intention to provide specified services. It is important to note that the change in policies for female offenders holds both the institution and the staff members responsible for meeting the criteria as set out in the policies.

No universal policy also means that, at the institutional level, prison staff members are not held accountable for any injustices towards transgendered people. Front-line prison employees are responsible for the detailed transmission of information about daily occurrences in the facility, often referred to as ‘shift change’. In this framework, when passing on information about an inmate who is transgendered, pertinent information may not be passed on because it may not seem important. This practice may also become a breeding ground for inappropriate dialogue regarding the transgendered individual. Further, given that correctional facilities exist in both the private and public realms, treatment towards transgendered inmates may differ from facility to facility, or even from shift to shift. Inconsistencies in attitudes and beliefs manifest and negatively impact the environment as a whole. In these instances, the transgendered individual may be treated fairly during the day shift, and poorly during the afternoon shift sending conflicting and often traumatizing messages not only to the inmate, but to other inmates and other employees.

When considering the existing policies around SRS, operating on a case by case basis means that anyone who wants the surgery has to be held under a microscope. Relaying of information in this sense may come in the form of logging daily routines, behaviours and activities between front-line staff, prison officials and the gender identity specialist. Therefore, any decisions with respect to SRS may be hindered by factors that the transgendered inmate has no control over.

The Policy

Though there have been advancements in policies for incarcerated transgendered inmates, we believe that their human rights continue to be violated. The policy we have chosen to examine is the current 2008 policy for transgendered inmates looking to have SRS (http://www.cscscc.gc.ca/text/plcy/cdshtm/800-cde-eng.shtml). The Commissioner’s Directives 800-36 a. states that SRS will only be granted to a prisoner if a recognized specialist has stated that they have passed the real life test, as described in the Harry Benjamin Standards of Care, for a least a year before imprisonment.

The Harry Benjamin Standards of Care (http://wpath.org/Documents2/socv6.pdf) are clinical guidelines intended to provide directions for people with gender dysphoria. The guideline mentioned in the policy is that of the real life experience. When a specialist assess whether an offender has passed the real life test they review the person’s abilities in the new gender role in 6 areas:

To maintain employment

To function as a student

To function in community based volunteer activity

To undertake a combination of 1-3

To acquire a new legal name

To provide proof that other people besides the therapist know that the inmate functions in the new gender role

If and only if the patient demonstrates stability in these 6 areas can surgery be recommended by the specialist. There is an ongoing debate outside prison walls as to whether the SOC is a fair assessment. One of the main arguments against seems to be the undefined and ambiguous interpretation of what stability means. This becomes highlighted even more when a transgendered person is incarcerated because that can be seen as instability in the eyes of society, but is not necessarily relevant to the person’s gender transitioning. The policy also mentions that the prisoner has to have been living up to SOC standards as the new gender for at least a year before incarceration. Meaning anyone who is at an earlier stage of their transition is not going to be eligible for SRS at anytime while imprisoned.

Part b of The Commissioner’s Directives 800-36, states that not only does the prisoner have to pass the real life test and be living by SOC standards for a year, but the recognized gender identity specialist (chosen by the institution) must recommend that the surgery be allowed during incarceration. So even after satisfying the SOC, the specialist can still deny the prisoner their right to SRS for whatever reason they see fit.

Though it is defiantly an improvement to have a standard policy for transgendered inmates and SRS, 800-36 is too vague and open to interpretation by prison officials, leaving plenty of room for the continual oppression of transgendered prisoners.

The Evolution of Prison Policy

The introduction of Canadian policy regarding the medical treatment of transgendered individuals occurred in 1982. I will illustrate the progress, although fairly minimal, that Canada has made since that 1982 implementation. In 1982 Correctional Service of Canada implemented a policy that stated that each inmate would be treated on an individual basis. No treatments were initiated while incarcerated. Continued hormone treatment would be provided if it "appeared" that the inmate would pursue SRS upon their release. Lastly, the policy DID NOT allow for any sex reassignment surgeries. This 1982 policy was fairly restrictive; although the policy allowing for occasional acceptance of hormone treatment was a step in the right direction.

In 1987 there was another revision of policy. This new policy remained firm on the position of no sexual reassignment surgeries. The alteration within the policy stipulated that inmates were allowed to be administered hormones, but the hormone treatments will cease nine months prior to release. This policy marked an increased oppression among transgendered individuals in the prison system.

Again this policy was altered, in 1993, to allow for hormone treatments throughout the entirety of incarceration. An interesting alteration of the policy was the new allowance for "sexual reconstructive surgery", although there was still no authorization for sexual reassignment surgery. Finally in 1995 sexual reassignment surgeries were permitted to take place, although, only with the explicit permission of the Regional Deputy Commissioner as well as the Commissioner of CSC. 1997 marked a negative shift in this policy, when the policy stated that there would be no consideration for sex reassigment surgery during the time of incarceration. http://www.chrt-tcdp.gc.ca/search/view_html.asp?doid=264&lg=_e&isruling=0

The current policy regarding sexual reassignment surgery among Canadian transgendered inmates states that there will be some allowances for the surgery. Although this is a progressive move towards decreasing oppression among transgendered inmates, there is still substantial work to be done in improving these life-altering policies. Restrictions regarding real life tests, and there required completion before incarceration, limits access to sexual reassignment surgery. For many inmates, due to these restrictions, SRS will never be approved; these policies are ultimately discriminating towards these members of the incarcerated transgendered community.

Our lens through an anti-oppressive framework

We will be exploring the transgender experience from within an anti-oppressive framework. This is a broad paradigm that seeks to combat all forms of discrimination through the ways in which they are practiced. It is a way of conceptualizing oppression that gives us a brief inkling as to why some people believe the way they do. It is the basis for challenging inequality by fully identifying what drives people to hold prejudices. It reminds us that society enforces a lot of our beliefs and this way of thinking can help us to understand how something can become a norm and asks how we can best go about explaining, and challenging oppression.Under the anti-oppressive framework, we see discrimination toward the transgender individual on three levels. On a personal level, they face prejudice, harassment and are often the targets of violent hate crimes. For example, “transgender individuals living in America today have a one in 12 chance of being murdered. In contrast, the average person has about a one in 18,000 chance of being murdered”. (http://www.hrc.org/issues/1508.htm)On a structural level, the media perpetuates the view of transgenders as being unequal and inferior in today’s society. For example, in the movie, “Boys Don’t Cry”, 21-year-old Brandon Teena was raped and later killed by two friends after they discovered he was biologically female. Subsequently, the sheriff who referred to Teena as an “it,” did not allow his deputies to arrest the two men. (http://www.youtube.com/watch?v=aOarssJWHhI)What happens is that on a global level, we end up pathologizing the transgender individual and normalizing the idea that they are a less then.We believe that discrimination on a personal and structural level towards transgendered individuals is particularly prominent in a penitentiary setting. The treatment they receive from fellow inmates and staff strongly conflict with their rights as human beings under the constitution. The fundamental point about equality and human rights is that ultimately, it doesn't matter who you are, or how big or small the group you belong to is, your rights have to be protected, and you should be treated equally. This is something that unfortunately needs to be de-constructed under an anti-oppressive framework because somehow the shift has been made to normalize the unequal treatment of smaller, minority groups such as transgender individuals. What we as members of society do not realize is that the problems of inequality in society are very much issues for the entire country and thus will take the effort of all of its citizen’s to transform our thinking and bring about effective change.

Ideologies and Transgendered Inmates

An ideology can be seen as “a comprehensive vision, or as in a set of ideas proposed by the dominant class of a society to all members of that society” (http://en.wikipedia.org/wiki/Ideology). Ideologies surrounding gender identity are revealed through institutions. They relay information about what is perceived as ‘normal’. Dominant ideologies, which are ideologies held by people in power, permeate into institutions such as prisons. Dominant ideologies that support categories of either male or female create inequalities for transgendered inmates and have a large influence on how they are treated in prison. They are often subject to inadequate practices and poor staff attitudes; this can be said to perpetuate the oppression of transgendered inmates.

Transphobia is evident in prisons. Transgendered inmates are often harassed, abused and treated unfairly due to the social stigma placed on them. Some prisons place transgendered inmates in protective custody (PC) or segregation to help ensure their safety. Although this practice is an attempt to assist the transgendered inmate population, it is to their detriment. Transgendered inmates placed in PC are often housed with sex offenders – a place where they are vulnerable to sexual violence and exploitation ( http://prisonjustice.ca/).

Segregated transgendered inmates are faced with either spending potentially harmful time isolated from others, or placed back into the general prison public where they are targets for physical and/or sexual assaults. While segregated, offenders receive little to no programming and minimal interaction with both staff and inmates – programming and interaction that they are entitled to, especially since they are not in segregation for disciplinary reasons. Since segregation is frequently used as a disciplinary measure, the transgendered inmate may, by the very way in which they are supposed to be protected by the institution, internalize their segregation as a punishment, repressing them further. Also, the act of segregating transgendered inmates only feeds into the perceptions around transgendered people as a marginalized group by separating them and housing them in less than adequate conditions.

Transgendered inmates not only face discrimination in terms of how or where they spend their time while incarcerated; they also are discriminated against on a daily basis. They are subject to sexism by both inmates and prison guards whom all carry with them the idea that trans people are less than, or not as deserving as, they are. As Barbara Findlay, a lawyer who acts on behalf of the transgendered community states, like other oppressed groups, transgendered people are at a higher risk of criminal behaviour than others for reasons that are attributed to their transgendered status (http://www.barbarafindlay.com/articles/45.pdf). Thus, it is imperative to consider how prison perceptions have a negative impact on the journey towards gender identity.
For further information about ideologies and transgender inequality, see: http://www.greenleft.org.au/1999/363/18687

Synthia Kavanagh Human Rights Case

Discrimination is nothing new for transgendered inmates. The injustice starts as soon as they are taken into custody. The debate as to where to place transgendered people often leads to them being placed with those of the sex that they don’t identify with or in solitary confinement for their own protection. This is especially an issue when the prisoner is pre-operative. There have been many cases of transgendered prisoners fighting this human rights violation.
One of the most publicized cases in Canada is the Synthia Kavanagh Human Rights Case (http://www.chrt-tcdp.gc.ca/). Synthia Kavanagh was born a man but has been living as a woman since the age of 13. She legally changed her name from Ricky at the age of 19. When Synthia was arrested in 1989, she had already begun the process of her transition. When sentenced to life imprisonment for murder, Synthia was taking hormone therapy in preparation for sex reassignment surgery. The judge on her case recommended that she be placed in a female prison; nevertheless Corrections Canada put her in a male institution, and restricted her hormone dosage which started to reverse the physical changes she had already endured. She was repeatedly denied her request for SRS. Distraught Synthia attempted to cut off her penis, and spent years in segregation after being harassed, taunted and sexually assaulted in the general population (http://www.prisonjustice.ca/).
Kavanagh filed a complaint with human rights arguing that the Canadian government had an obligation to provide her with adequate medical care, including sex reassignment surgery. As well she filed for the right to be placed in a female prison. She was successful in both her claims. The Canadian Human Rights Tribunal agreed that the current policy of housing male to female transgendered prisoners among the male population was discriminatory. They required Corrections Canada to start assessing transgendered inmates and their housing needs individually with an expert doctor in the treatment of gender dysphoria (http://dawn.thot.net/Synthia_Kavanagh.html). Synthia won the right to her SRS and was moved to a female institution.
Though this case was a big leap forward for the rights of transgendered inmates, its ruling is not without flaw. A case by case policy leaves each individual at the mercy of the judge, doctor and prison officials they encounter. This perpetuated the ongoing violation of their human rights.
For more examples of transgendered experiences in prison see:
http://www.sfgate.com/cgi-bin/article.cgi?f=/n/a/2007/07/20/state/n165230D88.DTL
http://www.the519.org/programs/trans/resourses/TPIP-Trans_people_in_the_prison_system.pdf
Prisoner of Gender by Kathy Johnson
http://cruelandunusualfilm.com/