Friday, October 24, 2008

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.....


  1. In your posting, you said that "the prison is most likely not going to use the same specialist that has been treating the person during their RLE."

    Why is this? What justification is there for finding a different specialist who has not been involved with the client - of course it is unfair to the client, but it also seems (from a capitalist perspective) like a waste of valuable resources..
    any thoughts?

  2. Lindsay, I agree with you- it is crazy to switch the specialist once the individual is incarcerated. Although, the jail would most likely be hiring a specialist, because then the specialist, under the control of the jail, is less likely to approve surgery, which would save the jail money. What do you think??