Autocastration in Ontario Federal Penitentiary Inmates

Conacher, G. Neil; Westwood, Gordon

doi:10.1192/bjp.150.4.565

Cited by 15 publications

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“…Autocastration, or surgical self-treatment (Brown, 2007), is a potentially lethal consequence of untreated severe GID in prison settings where cross-sex hormonal treatments are inaccessible. Although this rarely occurs in the community absent psychosis (Gossler et al, 2002;Haberman & Michael, 1979;Habermeyer, Kamps, & Kawohl, 2003;Pfafflin, 2007), Health Care Policies Addressing Transgender Inmates in Prison Systems / Brown, McDuffie 287 the authors have firsthand knowledge of completed autocastration and/or autopenectomy in six facilities in four states, and this behavior has been reported in incarcerated persons with GID in the literature (Conacher & Westwood, 1987). The term ''genital mutilation,'' often referred to in the literature for this behavior (Catalano, Morejon, Alberts, & Catalano, 1996;Martin & Gattaz, 1991;McGuire & Ahmed, 1998;Novello & Primavera, 1990), would not be accurate for patients who engage in surgical self-treatment to reduce testosterone levels in the absence of active psychosis.…”

Section: Discussionmentioning

confidence: 99%

Health Care Policies Addressing Transgender Inmates in Prison Systems in the United States

Brown

McDuffie

2009

Journal of Correctional Health Care

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Inmates with gender identity disorders (GID) pose special challenges to policy makers in U.S. prison systems. Transgender persons are likely overrepresented in prisons; a reasonable estimate is that at least 750 transgender prisoners were in custody in 2007. Using the Freedom of Information Act, requests were mailed to each state, the District of Columbia, and the Federal Bureau of Prisons in 2007. The requests were for copies of policies, directives, memos, or other documents concerning placement and health care access of transgender inmates. By April 2008, 46 responses were received; 6 states did not reply. Information was qualitatively analyzed and summarized. There was substantial disparity in transgender health care for inmates with GID or related conditions. Most systems allowed for diagnostic evaluations. There was wide variability in access to cross-sex hormones, with some allowing for continuation of treatment and others allowing for both continuation and de novo initiation of treatment. There was uniformity in denial of surgical treatments for GID.

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Section: Discussionmentioning

confidence: 99%

Health Care Policies Addressing Transgender Inmates in Prison Systems in the United States

Brown

McDuffie

2009

Journal of Correctional Health Care

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“…A particularly horrible complication of GID is attempted autocastration. Autocastration in prison settings is most often associated with a primary diagnosis of GID that is untreated or undertreated, with numerous examples of such behaviors occurring in corrections facilities in multiple countries (Blight, 2000; Brown, 2010; Conacher & Westwood, 1987; More, 1996). Five percent ( n = 6) of the inmates writings reviewed in this survey reported attempted or completed autocastration while incarcerated.…”

Section: Discussionmentioning

confidence: 99%

Qualitative Analysis of Transgender Inmates’ Correspondence

Brown

2014

Journal of Correctional Health Care

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Claims of inadequate health care and safety afforded to transgender inmates have become the subject of litigation. This article reviews 129 unsolicited letters from transgender inmates writing from 24 states and the Federal Bureau of Prisons to identify their concerns. Among the letters reviewed were reports from 10 inmates who had filed lawsuits naming departments of correction (DOCs) as defendants, claiming inadequate access to transgender health care. Five of these lawsuits have gone to trial. In all of those cases, the defendant settled the matter or was found liable as of the time of this report. Claims of inadequate care for transgendered patients that have sufficient merit to be fully litigated in U.S. courts appear likely to produce verdicts in favor of plaintiff inmates. The information gleaned from reviewing letters from transgendered inmates may alert staffs of DOCs to concerns worth addressing proactively to avoid the costs associated with transgender-related lawsuits.

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“…Lack of access to transgender health care in institutions has caused, or contributed to, serious negative health outcomes including depression, exacerbation of other mental illnesses, suicidal thinking and behavior, and autocastration and/or autopenectomy (Blacker and Wong, 1963;Brown, 2001Brown, , 2003Brown, , 2007Catalano, Morejon, Alberts, & Catalano, 1996;Conacher & Westwood, 1987;Haberman & Michael, 1979;McGuire, Ahmed, & Nazeer, 1998;Nakaya, 1996;Novello & Primavera, 1990;Springer, 1981). Indeed, the early work of Abraham on two of the earliest cases of SRS noted:…”

Section: Rationale For Revisionsmentioning

confidence: 95%

Recommended Revisions to the World Professional Association for Transgender Health'sStandards of CareSection on Medical Care for Incarcerated Persons with Gender Identity Disorder

Brown

2009

International Journal of Transgenderism

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Autocastration in Ontario Federal Penitentiary Inmates

Cited by 15 publications

References 0 publications

Health Care Policies Addressing Transgender Inmates in Prison Systems in the United States

Health Care Policies Addressing Transgender Inmates in Prison Systems in the United States

Qualitative Analysis of Transgender Inmates’ Correspondence

Recommended Revisions to the World Professional Association for Transgender Health'sStandards of CareSection on Medical Care for Incarcerated Persons with Gender Identity Disorder

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