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War in Here Transgender and Intersex People in Ny Prisons S Rivera 2007

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“It’s war in here”: A Report on the Treatment of Transgender and Intersex
People in New York State Men’s Prisons
First published in 2007 by
The Sylvia Rivera Law Project
322 8th Avenue, 3rd Floor
New York, NY 10001
www.srlp.org
The Sylvia Rivera Law Project (SRLP) works to guarantee that all people are free to selfdetermine their gender identity and expression, regardless of income or race, and without
facing harassment, discrimination, or violence.
SRLP is a 501c-3 nonprofit organization.
© Copyright 2007 SRLP. Some Rights Reserved.
SRLP encourages and grants permission to non-commerically reproduce and distribute this
report in whole or in part, and to further grants permission to use this work in whole or in
part in the creation of derivative works, provided credit is given author and publisher, and
such works are licensed under the same terms. (For more information, see the Creative Commons
Attribution-Noncommercial-Share Alike 3.0 License. <http://creativecommons.org/licenses/by-nc-sa/3.0/>
or send a letter to Creative Commons, 171 Second Street, Suite 300, San Francisco, California, 94105, USA.)

Contents

i
ii

Introduction 3
Scope & Methodology 5

iii

Background: Discrimination, Poverty, & Imprisonment 7

iv

Daily Realities: Conditions of Confinement for Transgender & Intersex People 15

v

Recommendations 32
Appendix A Frequently Asked Questions: Gender Identity & Expression 36
Appendix B Organizations 40
Appendix C Selected Bibliography 41
Appendix D Flow Charts 41
Notes 44
Acknowledgements 49

I
INTRODUCTION

Since opening in 2002, the Sylvia Rivera Law Project (SRLP) has provided free legal
services to over 700 intersex, transgender, and gender non-conforming people.* Our
clients are low-income people and people of color who face discrimination in the
areas of employment, housing, education, healthcare, and social services. Since our
founding, the attorneys and advocates at SRLP have consistently witnessed the disproportionate representation of our clients in the criminal justice system as a result
of police profiling, poverty, and the necessity of becoming involved in criminalized
activities to survive. We have also witnessed the exceptionally violent conditions
they face once imprisoned.
Unfortunately, very little information has been collected about transgender people and people with intersex conditions across the United States or their experiences
of confinement. A few key legal cases have highlighted the pervasive sexual violence1
or gender-related medical discrimination that they encounter while imprisoned.2
However, because corrections systems do not generally keep data regarding how
many people in the criminal justice system are transgender or intersex or the nature
of their experiences during imprisonment, a considerable gap exists with respect to
information about this group of people.
Forty percent of SRLP’s clients over the last four years have had criminal justice
issues in their cases, demonstrating the disproportionate role the system plays in our
communities. SRLP has served 106 clients who were imprisoned during the period

* See Appendix A, Frequently Asked Questions, on page 36 for explanations of language relating
to gender identity and expression, as well as transgender and intersex identities.

6 · “ i t ’ s wa r i n h e r e ”
over which we provided them with services. These clients overwhelmingly report experiencing assault, denial of urgently needed medical care, and placement in gender inappropriate facilities. While much of this discrimination is clearly illegal under
existing law, the lack of legal support available to imprisoned people results in most
being unable to enforce their rights.3
SRLP undertook this research to document the experiences of our clients in New
York State prisons. We recognize that while we do not have the capacity to collect
broad-scale empirical research about this population, we can share the wealth of
qualitative information we have obtained through advocacy on behalf of our imprisoned clients over the past three years. To create this report and to illustrate the
conditions of confinement that are commonly reported by our clients, the author
corresponded with and gathered detailed narratives from twelve SRLP clients who
are currently or were formerly imprisoned in various New York State men’s prisons.
In addition, the author interviewed a range of New York City–based advocates and
service providers who work with transgender communities. We hope that the information contained in this report is useful in assessing the issues facing members of
our community who are entangled in the criminal justice system, and in developing and implementing policies and practices to alleviate the violence and discrimination they face inside New York State correctional facilities.
Dean Spade
2006

II
SCOPE & METHODOLOGY

The main purpose of this report is to serve as a first step toward understanding the
treatment of transgender, gender non-conforming, and intersex people in New York
State men’s prisons. The report does not seek to convey one unifying, definitive
experience, or even to fully represent the experiences of the interviewees. Rather, its
central objectives are to describe some of the daily realities faced by a number of
SRLP’s clients; to outline some of the reasons why transgender people are disproportionately poor, homeless, and imprisoned; and to propose pragmatic recommendations to improve their treatment and decrease their overrepresentation in the
criminal justice system.
The research informing this report was conducted through in-person interviews
and written correspondence with currently and formerly imprisoned clients of
SRLP, as well as through supplementary interviews with a range of advocates in
New York City. In total, twelve current and former prisoners and ten advocates
working outside of prisons were interviewed for the report. In accordance with the
interviewees’ preferences, some names, along with all names and identifying
characteristics of specific correctional facilities and officers, have been changed.
The focus of this report is specifically on conditions of confinement in men’s
prisons because the vast majority of SRLP’s currently or formerly imprisoned
clients were housed in men’s facilities. Despite the focus on men’s prisons, it is critical to note that many transgender, gender non-conforming, and intersex people in
women’s prisons, as well as their advocates, have reported similarly harsh treatment
to that reported in men’s prisons. Some of these experiences are discussed towards

8 · “ i t ’ s wa r i n h e r e ”
the end of the Daily Realities section. Further research on the unique experiences
of gender non-conforming people in women’s prisons is urgently needed.*
There currently exists only minimal research on the experiences of transgender,
gender non-conforming, and intersex people in the criminal justice system or
on their paths to imprisonment.4 This report owes much of its analysis, findings,
and recommendations to this emergent research and to the range of dedicated
activists and advocates in New York City working to foreground the intersections
of gender identity discrimination, poverty, and criminalization. Most importantly,
this report emerges out of the insights and contributions of those imprisoned and
non-imprisoned people generous enough to share their experiences in our collective effort to raise public awareness about this urgent issue. It is our hope that this
report will help catalyze further research and policy change related to the treatment
of transgender, gender non-conforming, and intersex people in prison, and on the
myriad patterns of discrimination that result in their overrepresentation in the
criminal justice system.

* Correctional Association of New York’s Women in Prison Project has recently undertaken to expand the research tools it uses when visiting prisoners in women’s facilities to include questions
regarding harassment and violence based on gender identity or expression. The collection of this
type of data is essential to understanding these issues in the context of women’s facilities where
they often go unremarked. For further information, contact Tamar Kraft-Stolar, Project Director,
or Jaya Vasandani, Project Associate, or visit http://www.correctionalassociation.org.

III
BACKGROUND
Discrimination, Poverty, & Imprisonment

U.S. Imprisonment Rates Continue to Rise
As Prison Conditions Remain Brutal
As of June 30, 2005, there were over 2,186,230 people in U.S. prisons and jails—
1 in every 136 U.S. residents is imprisoned5—placing this country’s rate of imprisonment far ahead of any other in the world.6 Over the past three decades, the U.S.
prison system has undergone unprecedented growth in the rates of imprisonment,
facility construction, and federal funding. In 1980, there were a total of 1.8 million
adults under U.S. correctional supervision, including prisons, jails, detention centers, parole, and probation. At the end of 2004, that number had soared to almost
7 million—about 1 in every 31 adult residents—growing nearly 390% in 24 years.7
This surge in the prison population was largely a result of the “War on Drugs” declared by President Nixon and waged by each successive administration, as well as
“law and order,” “tough on crime” policies, which have allocated an unparalleled
amount of federal resources to national and local policing and imprisonment.8 The
past thirty years have also seen a massive growth in prison construction,9 the widespread privatization of the correctional system, and the dramatic expansion of federal and local prison funding—in 2001, the government spent $38.2 billion to maintain state correctional systems alone, representing an increase of 145% from the previous year.10 In 2003, the Bureau of Justice reported that the U.S. government spent
nearly $60.9 billion on corrections expenditures and employment, soaring over
423% since 1982.11
The growth of the U.S. prison system has had a severe and disproportionate effect on communities of color and low-income communities. African American peo-

10 · “ i t ’ s wa r i n h e r e ”
ple constitute 12.3% of the national population, compared to 43% of the U.S. prison
population. White people represent 69.3% of the national population, and 37% of
the imprisoned population. Latino/a people constitute 13% of the national population, compared to 19% of the prison population. Startlingly, almost 13% of
African American men between the ages of 25 and 29 are currently in U.S. prisons
or jails, compared to 3.7% of Latino men and 1.7% of white men in the same age
range.12 Although statistics on the rates of imprisonment in Native American communities are underreported, research has shown that Native Americans are disproportionately represented in the criminal justice system,* constituting the second
most imprisoned group per capita.13 Additionally, the number of people in federal
and state women’s prisons has grown from 12,279 in 1977 to 106,174 in 2005—an
increase of more than 760%.14 In New York State, the number of people in the state’s
women’s prisons increased by approximately 645% from 1973 to 2006. More than
71% of people in New York State women’s prisons are people of color: almost 48%
are African American, about 24% are Latina/o, and about 28% are white. 15
These national patterns are replicated in New York State, which as a state imprisons the fourth greatest number of people in the country (after Texas, California, and
Florida).16 As of June 2005, 482 out of every 100,000—about 92,769—New York residents were in the state’s prisons and jails.17 New York’s rate of incarceration is nearly
153% more than the national average. People of color are disproportionately represented in New York State prisons and jails. African Americans make up 15.9% of
the state’s general population, but represent 50.4% of the state’s imprisoned population. Together, African Americans and Latino/as make up about 91% of the
14,000 people in New York City jails.18
Reflecting national trends, people imprisoned in New York State are disproportionately from low-income backgrounds, lacking educational and economic opportunities. Ninety percent of people in New
Policing and law enforcement
York City jails do not have a high school
are disproportionately
equivalency, and between 50 and 70% of the
population reads English below a sixth grade
concentrated in low-income
level. More than 50% of people in New York
communities, communities of
State prisons do not have a high school
color, and poor urban areas
diploma. Additionally, between 60 and 70%
of prisoners in New York have a history of drug abuse.19 Nearly 60% of people in
women’s prisons nationally were not employed full-time prior to their imprisonment, and about 37% had incomes of less than $600 per month prior to arrest.20
Concurrent with the expansion of prison populations, funding, and construction, the U.S. has also intensified its use of policing and surveillance since the early
1980s.21 Policing and law enforcement are disproportionately concentrated in lowincome communities, communities of color, and poor urban areas, forcing these
communities to bear the brunt of increased police presence and “law and order”
* A 1999 Bureau of Justice Statistics report found that 4% of Native American adults were under
some form of correctional supervision, compared with 10% of African American adults and 2%
of white adults.

Transgender and Intersex People in New York State Men’s Prisons · 11

agendas. This practice has been consistent throughout the past few decades, but has
been exacerbated by the federal government’s “War on Drugs” and its current “War
on Terror,” which have driven the rates of arrest, detention, and deportation of people of color, homeless people, undocumented residents, and low-income people to
unparalleled heights.22 Intensified police brutality and profiling and the erosion of
many vital social services and public benefits have produced a national climate in
which people from racially and economically marginalized communities are more
likely than ever to be arrested and sent to prison. As discussed in the next section,
the increasing imprisonment of low-income people, people of color, and women has
occurred in conjunction with the disproportionate arrest and imprisonment of
transgender and gender non-conforming people, and has led to a particularly high
risk of imprisonment for people who live at the intersections of more than one of
these experiences.
In the current era of correctional expansion, we have also seen a simultaneous
intensification of human and civil rights abuses inside U.S. prisons, jails, and detention centers.23 Pervasive sexual assault—at the hands of both correctional officers
and other prisoners—has been documented as endemic and routine throughout
U.S. correctional facilities, particularly in women’s prisons.24 Egregious medical and
mental health neglect and mistreatment of prisoners are also extensively documented.25 Inadequate HIV and hepatitis C (HCV) prevention and treatment,
insufficient primary medical care and mental health treatment, among other violations of prisoners’ rights, are prevalent.26 The consistent use of isolation and solitary confinement as punitive measures and the resulting devastating psychological
impacts have also been documented.27 Racial segregation and pervasive racist harassment and abuse from correctional officials further compound the institutionalized discrimination within correctional facilities.28 The range of such human
rights violations in U.S. federal, state, and local custody inevitably produces a climate that can hardly be characterized as “rehabilitative.” It is in this already neglectful, abusive, and discriminatory environment that the experiences of transgender,
gender non-conforming, and intersex people in prison must be understood.

Due to Pervasive Discrimination and Targeting,
Transgender People are Disproportionately Poor
and Homeless
As a group, transgender and gender non-conforming people are disproportionately
poor, homeless, criminalized, and imprisoned.* Discrimination against transgender
people in housing, employment, healthcare, education, public benefits, and social
services is pervasive, pushing transgender people to the margins of the formal
economy. With few other options, many low-income and poor transgender people
engage in criminalized means of making a living, such as sex work. Transgender
* See Appendix D for two useful flow charts that illustrate the cycles of systemic poverty, homelessness, and imprisonment in transgender and gender non-conforming communities.

12 · “ i t ’ s wa r i n h e r e ”
people also encounter pervasive violence and physical brutality at the hands of family members, community members, and police because of entrenched social stigma
and prejudice. Although incidences are vastly underreported because of antagonistic or fearful relationships with law enforcement officials, organizations such as the
New York City Gay and Lesbian Anti-Violence Project have found high rates of antitransgender physical and sexual assault and harassment.29 As a result of discrimination and violence, transgender people are often unable to access the minimal
safety nets that are supposed to provide for low-income and poor people—such as
shelters, foster care, Medicaid, and public entitlements. This lack of access forces
many transgender people to remain persistently homeless, marginally housed, unemployed, and without healthcare.30
For many transgender people, this social and economic marginalization begins
at a young age when they face rejection by their families and lose familial material
and emotional support. One advocate who works with LGBT youth describes the
frequency with which they choose or are forced to leave their homes: “Most of the
kids I work with leave home for a variety of reasons, but there’s almost always a connection between homophobia, transphobia, and the family. Often this is exacerbated
by poverty, and is combined with violence and harassment.”31 Because of a widespread lack of understanding of transgender identities, transgender youth report
particularly high rates of familial rejection. As one report on the treatment of LGBT
youth in out-of-home care settings notes, “A high proportion of LGBT youth who
end up in state care leave home or are ejected from their homes as a result of conflict
related to their sexual orientation or gender identity.”32 Many youth attempt to access the foster care system but face discrimination and harassment there and end up
marginally housed or homeless.* It is estimated that up to 40% of homeless youth
in New York City are lesbian, gay, bisexual, or transgender.33 Many LGBT youth run
away from hostile families and an unwelcoming foster care system, leading them to
engage in illegal or criminalized activities to survive, placing them at a higher risk
for arrest and entanglement in the criminal justice system.
Transgender youth also face discrimination at school, leading to difficulty continuing or completing their education.34 Transgender youth often encounter violence and harassment from fellow students, teachers, school administrators, and
school safety agents in their daily attempts to use gender-specific bathrooms, locker
rooms, and other sex-segregated facilities in schools. In 2005, a national survey of
LGBT students found that just over 64% of LGBT students reported feeling unsafe
at their school because of their sexual orientation specifically, and over 40% reported feeling unsafe because of how they expressed their gender. In addition to extensive rates of verbal harassment (just over 64%), the survey found that over a third
of students had experienced physical harassment at school on the basis of sexual orientation, and just over 26% on the basis of gender expression.35 More often than

* In 2002 a New York City circuit court judge recognized the widespread and illegal discrimination that transgender youth face in the foster care system, ruling in Jean Doe v. Bell that transgender youth cannot be forced to wear only clothing associated with the gender assigned to them at
birth. The court’s decision is available at http://www.srlp.org/documents/JeanDoe.pdf.

Transgender and Intersex People in New York State Men’s Prisons · 13

not, these incidences of verbal and physical harassment and assault went without
staff intervention or response. Another survey of the transgender community in
Washington D.C. found that over 40% of respondents reported not having finished
high school.36 Compounded by racism, poverty, and familial rejection, the pervasive
transphobia and homophobia found in schools produce a climate in which many
transgender youth find themselves unsafe and unable to complete educational programs.
These harsh realities compound the homelessness and lack of economic and educational opportunity for transgender youth. As one LGBT youth advocate noted,
For those who have access to a home in the first place, many youth are
being kicked out or running away because of violence. You also have youth
dropping out of school and ending up on the streets, or in the foster care
system, where they’re also being neglected or abused and where they are
being forcibly housed according to the biological sex they were born in,
not how they identify.37
In this context, it is not difficult to understand why so many transgender and gender non-conforming young people find themselves homeless, without the support
of families, communities, schools, or foster care, and entangled in the criminal justice system.
Although there is a significant lack of research documenting the poverty and
over-imprisonment of transgender adults, the research that has been conducted reveals high rates of discrimination, low income levels, and significant exposure to risk
factors related to imprisonment. Needs assessment surveys of the transgender
communities in San Francisco and Washington D.C. illustrate the ubiquitous discrimination and bias that many transgender and gender non-conforming people
encounter when trying to access basic healthcare, employment, and housing. A San
Francisco needs assessment surveying 155 transgender people found that half of the
respondents had experienced discrimination in employment, and that 64% made
less than $25,000 a year. Almost 20% did not have stable housing,38 and over 40%
lacked health insurance. Of the respondents who did have health insurance, very few
had insurance with coverage of treatment related to their transition. Of that small
group, most respondents had immense difficulty locating a competent doctor with
whom they felt comfortable to provide transition-related services.39 In Washington
D.C., nearly 30% of the respondents reported having no income at all, and another
32% reported earning $10,000 or less per year. Forty-two percent of the respondents
were unemployed, and 47% had no health insurance,40 more than three times higher
than the 15.2% national rate a year earlier.41 Thirty-two percent of the respondents
reported some form of discrimination in their attempts to access and maintain
housing, including outright rejection, denial of conditions available to other tenants, and harassment by a landlord or fellow tenant. As the vast majority—over
94%—of participants in the sample were people of color (70% of whom were
African American), this data makes apparent overlapping patterns of discrimination.
High rates of HIV/AIDS, sexually transmitted infections (STIs), hepatitis C
(HCV), depression, and mental illness, along with the lack of adequate medical

14 · “ i t ’ s wa r i n h e r e ”
treatment and transition-related care have been recognized as urgent health concerns for transgender and gender non-conforming people in the U.S.42 The transgender needs assessment in San Francisco found that 35% of MTF (Male-toFemale) respondents were HIV+. The findings of the D.C. assessment were close
behind, with 25% of respondents overall and 32% of MTF respondents reporting
that they were HIV+.43 This high rate of HIV is the result of a range of factors, including lack of prevention and harm reduction services, high rates of intravenous
drug use, and high-risk sexual activity.44 Although 52% of respondents had taken
hormones at some point in their lives, and 36% were currently taking some, only
34% of that group reported that a doctor monitored their blood levels while they
were taking hormones, and 58% reported acquiring the hormones from friends or
on the street, putting them at a greater risk for lower quality and inconsistent treatment, as well as heightened exposure to police criminalization. In these contexts,
hormone injection without sufficient medical supervision or sterilized materials can
also function as a vector for HIV transmission.
Lack of access to healthcare is a significant factor contributing to transgender
imprisonment. Service providers and others working directly with the community
often connect involvement in criminalized activity to efforts to access necessary and
appropriate medical care. A Los Angeles–based transgender advocate has witnessed
this pattern:
In my experience working with the trans community, I have seen many
transgender people become entangled in the criminal justice system
through activities they engage in to raise money for and access safe, adequate, and nondiscriminatory medical treatment related to their transition. It is easy to see the direct connection between discrimination in trans
healthcare and the over-incarceration of transgender people.45
Additionally, as one advocate who works with transgender communities in
California noted, the systemic criminalization of low-income women of color also
occurs at the level of over- and misdiagnosis: “Our communities are being labeled
as having schizoaffective disorder or borderIll-equipped to provide adequate
line personality disorder simply because
mental healthcare, correctional
they’re extremely traumatized from a lifetime of rejection and abuse, and use survival
facilities are increasingly
tactics that are also part of surviving as peobecoming depositories for
ple of color and being poor, which seems to
people with actual or perceived
clinicians as ‘manipulative’ and ‘pathologimental health concerns
cal.’”46 Ill-equipped to provide adequate mental healthcare, correctional facilities are increasingly becoming depositories for people with actual or perceived mental health concerns,47 a trend to which transgender
and gender non-conforming communities have been disproportionately subject.
These multiple types of discrimination result in transgender and gender nonconforming people becoming disproportionately poor, or homeless; unable to access healthcare, employment, or housing; and forced to endure persistent discrimination and violence within those institutions as well as in their homes and com-

Transgender and Intersex People in New York State Men’s Prisons · 15

munities. Because homeless shelters are sex-segregated and often riddled with
transphobia—forcibly housing residents according to their birth sex and not their
gender identity, thereby placing them at a high risk for violence and harassment48—
homeless transgender people are unable to access even the minimal support services available to non-transgender people who are marginally housed and without
income.49

Survival Crimes and Police Profiling Contribute to
Transgender Arrest and Imprisonment Rates
In the face of poverty and discrimination, many transgender people engage in criminalized activity such as sex work, drug sales, or theft, or become entangled in the
criminal justice system through other poverty-related arrests including loitering,
turnstile jumping, or sleeping outside.50 These activities, in combination with police profiling of transgender individuals as mentally unstable and violent, predisposed to involvement in sex work, inherently deceitful, or all of the above, place
transgender people—particularly low-income transgender women of color—at an
increased risk of contact with law enforcement.
Transgender people report
Such contact almost inevitably leads to violence
and abuse at the hands of police officers acting on
consistent police harassment,
individual and systemic transphobia. In a recent
brutality, and profiling
national report on anti-LGBT police violence,
Amnesty International found that anti-transgender police brutality occurs frequently throughout the country:
Transgender people, particularly low-income transgender people of color,
experience some of the most egregious cases of police brutality reported to
Amnesty International. AI’s findings suggest that police tend to target individuals who do not conform to gender stereotypes that govern ‘appropriate’ masculine and feminine behavior. Race plays an important factor in
determining the likelihood of an LGBT person being targeted for police
abuse, indicating that such abuses likely stem from racism as well as homophobia and transphobia. AI has also received reports of cruel, inhuman
and degrading treatment of LGBT individuals during arrest, searches and
detention in police precinct holding cells. AI heard reports of officers
searching transgender and gender variant individuals in order to determine their ‘true’ gender. AI also heard allegations of misconduct and abuse
of LGBT individuals in holding cells and detention centers, including the
inappropriate placement of LGBT individuals in situations which compromise their safety. In particular, transgender individuals are often placed in
holding cells according to their genitally determined sex, rather than their
gender identity or expression, placing them at greater risk of verbal, physical and sexual abuse at the hands of other detainees.51
One San Francisco-based survey found that police officers were the perpetrators of

16 · “ i t ’ s wa r i n h e r e ”
50% of incidents of transphobic and homophobic violence reported by transgender people.52 Transgender people report consistent police harassment, brutality, and
profiling, a trend many attribute to the stereotyping of transgender women as sex
workers53—regardless of their actual engagement in sex work—as well as transgender people’s inability to acquire identification that matches their gender expression.54 As one interviewee, a young transgender woman, describes:
My friends of trans experience get arrested like everyday. Sometimes they
get arrested for sex work even when they’re not working, the cops are like
‘She’s trans, let’s arrest her.’ Cops are looking for trannies. But when we
need help they’re not there, or when somebody is stalking us or somebody
is harassing us, they never there. They really don’t care and they don’t want
to hear it.55
In recent decades, changes in policing of neighborhoods that were traditional
meeting places for transgender community members—such as the West Village,
Chelsea Piers, and Meat Packing District in New York City—have contributed to increasing rates of arrest.56 One youth organizer describes the changes in the last
decade:
The fact that the ‘Quality of Life’ [QOL] policies were initially tested on
the 6th Precinct [New York City’s West Village] in the early 90s is not a coincidence. As one of the few remaining safe spaces for low-income queer
and trans youth of color and homeless people, the QOL policies specifically criminalized these communities to remove them from sight and to
maintain the ‘quality of life’ for the people who could afford to live in the
West Village. The policies continue today imposed all over New York City
and have been mimicked in many urban centers through out the United
States. These types of policies are directly connected to gentrification
projects that seek to displace and criminalize poor communities and
communities of color.57
It is through these patterns of systemic discrimination that transgender and gender
non-conforming people are criminalized and become over-represented in the
criminal justice system. Once arrested, they frequently receive severely inadequate
legal representation, and experience ignorance or prejudice on the part of their attorneys, prosecutors, and the courts, which can lead to disproportionately long sentences for minor offenses.58
The rampant discrimination that transgender people face in employment, social
services, and healthcare—as well as their consequent poverty, homelessness, and increased risk of contact with the police—results in their disproportionate arrest and
imprisonment. Much of the discrimination and violence experienced by transgender people outside of the criminal justice system are then replicated and amplified
inside of it. As one interviewee summarized, “We go from one world that hates us
to another one.”59

IV
DAILY REALITIES:
Conditions of Confinement
for Transgender & Intersex People

We’re seen as freaks or sick either mentally or physically or both. I know
this to be true from sitting back and simply living day to day the dangerous
life of a Puerto Rican pre-op transsexual locked up behind bars. I ask God
everyday ‘when’s this nightmare gonna be over.’ 60
I broke the law but I never did anything to deserve this . . . You live in fear
and you do what you do to survive.61
Many of the misunderstandings and biases about transgender people that fuel discrimination in the outside world are pervasive within the criminal justice system
and contribute to discriminatory treatment of transgender, gender non-conforming, and intersex people in prison. The discrimination and abuse that transgender,
gender non-conforming, and intersex people encounter in prison are centered on
issues of placement, access to medical care, access to showers, and clothing and appearance. Drawing on interviews with SRLP clients and their advocates, this section
describes how harassment and violence are promoted and facilitated in these contexts.

Placement
Interviewees consistently reported that placement within prisons was central to
their safety concerns. U.S. correctional facilities are sex-segregated, and house prisoners according to their birth-assigned sex and/or genitalia.62 Transgender women

18 · “ i t ’ s wa r i n h e r e ”
who live and identify as women but who were identified as male at birth are generally placed in men’s facilities. In men’s facilities, transgender women, gender nonconforming people, and intersex people are frequent and visible targets for discrimination and violence, and are subject to daily refusals by correctional officers and
other prisoners to recognize their gender identity.63
Two of the main types of housing in which a prisoner may be placed are general
population and protective custody. Protective custody units are reserved for people
who are at a higher risk of violence or harassment by other prisoners, those who are
receiving additional punishment, or those who are seen as more likely to commit
violent acts towards others. Individuals placed in protective custody can include
judges, politicians, people convicted of sex-related offenses, police officers, or people who might be targets of violence based on their gender expression or sexual
orientation. The level of safety that protective custody actually provides, however,
varies among facilities, sometimes providing a safe refuge from the violence of
other prisoners, while other times isolating prisoners, and thereby placing them
at a greater risk of violence at the hands of correctional officers.
One SRLP client, Jacquie, is currently seeking access to protective custody, hoping that such a placement would reduce her exposure to the violence and harassment she has experienced from other prisoners in the general population.
[Prison] is a horror show. It’s madness in here. Totally bizarre and crazy,
and you think ‘this can’t be real.’ But it’s everyday life. The best thing about
it is being locked up 23 hours a day, 7 days a week. Otherwise I would have
to survive in open population.64
Sunday, a former prisoner, echoes Jacquie’s sentiments, describing a specific instance
in which she was experiencing so much violence and abuse in general population
that protective custody seemed like the only alternative to death: “Can you imagine
what it must have been like for me to have requested that? But they wouldn’t even
do that for me.”65
However, other SRLP clients report that placement in protective custody is undesirable because it makes them more vulnerable to harassment and assault by correctional officers. Clients also cite the constraints it places on their relative mobility and access to vocational and recreational programs. Bianca, an SRLP client who
is currently imprisoned in general population and pursuing litigation in connection
with incidents in which she was raped by correctional officers, observes, “PC [protective custody] is even worse cause there are no cameras.”66 For Bianca, placement
in protective custody would mean less opportunity to document an ongoing pattern of abuse she experiences. Another interviewee reports, “I’ve spent 95% of my
time in PC where there are no programs,”67 highlighting the negative impacts of
denying educational, rehabilitative, and vocational programming to those housed
in protective custody units.
Vicki, who is currently in general population, is also critical of the isolation of
protective custody, explaining, “I need to be in general population. I need the freedom to move, if you can call it freedom.”68 Carrie Davis, the coordinator of the

Transgender and Intersex People in New York State Men’s Prisons · 19

Gender Identity Project at the New York City LGBT Center, echoes Vicki’s sentiments.
Many trans people I’ve worked with prefer to be in general population because finding their place in the prison culture, although it is an exploited
and vulnerable one, is preferable to the isolation of protective custody.69
Regardless of whether or not it provides some level of protection or safety, the detrimental physical and psychological impacts of isolation prove protective custody to
be a highly undesirable alternative to placement in general population.70 Our interviewees’ experiences reveal that as long as placement in prisons is sex-segregated and
based on genitalia and birth-assigned sex, and as long as isolation is the only alternative to living in general population, any placement for transgender, gender nonconforming, and intersex people in correctional facilities is dangerous and detrimental.

Harassment & Assault
Every person who was interviewed reported encountering some form of harassment
and/or assault during their imprisonment. The persistent physical, emotional, and
sexual abuse reported included verbal harassment, physical and sexual assault, humiliation, and rape.
PHYSICAL AND SEXUAL ABUSE

Because transgender, gender non-conforming, and intersex people in men’s prisons
are often highly visible, they become frequent targets for homophobic and transphobic violence and brutality.71 As one interviewee put it,“I’m 6'3"—I’m like a walking target.”72 Interviewees reported that much of this violence and brutality comes
at the hands of correctional officers and other prison employees. As Bianca notes,
this pervasive abuse is life-endangering: “My life is constantly threatened. I just want
to get out of here alive.”73 She describes repeated instances of rape and assault:
I’m not ashamed—it’s war in here. The administration is against us.
Something has to be done, and all they say is ‘Act like a man!’. . . [There is]
lots of harassment from other prisoners, but they’re sort of scared of me.
The correctional officers are the ones who are the most violent. They’re
the ones to be scared of. . . .
I’m raped on a daily basis, I’ve made complaint after complaint, but
no response. No success. I’m scared to push forward with my complaints
against officers for beating me up and raping me. I was in full restraints
when the correctional officers assaulted me. Then after they said I assaulted
them. All the officers say is ‘I didn’t do it.’ The Inspector General said
officers have a right to do that to me. That I’m just a man and shouldn’t be
dressing like this . . . .
When you get beat up real bad and they don’t want to take you out to
get checked out, they put you in the snake pit. They threw me in the snake

20 · “ i t ’ s wa r i n h e r e ”
pit for 6 months after beating me up. Six months! They’re animals.. . . I got
beat up by 12 officers. I’m only 123 lbs.74
After assaulting her, Bianca reported that the correctional officers tore up her mail
and repeatedly denied her urgent medical treatment. In a letter to the Office of
Mental Health, Bianca describes another incident in which a correctional officer assaulted her:
I had my face smashed into a wall by C.O. [name deleted], after asking him
politely to please don’t touch me, when he was pulling and tugging at my
sweater. I’m hurt, cause he’s not to put his hands on females, and that
being the case, why did he put his hands on me? ‘I am a woman’. . . Now
I’m having a nurvous breakdown, because my facial hair is growing, and I
was deprived a shower and razor, all cause a officer smashes a woman’s face
into a wall. That must make him a real man hitting a woman (me).75
For Bianca, this type of outright violence is accompanied by ongoing harassment,
discrimination, and humiliation:
At my last parole hearing they teased me, called me names. They shouldn’t
be able to do that at a parole hearing . . . One Corrections Officer gave me
women’s clothes, but then wrote me up the next day for attempted escape.
They took my wedding ring—they said ‘homos can’t get married’. . . They
make us feel like we’re the bad ones. . . .
Now there’s a new charge just for walking with trans people (or fags, as
they call us) for soliciting sex, they say. They think we’re all prostitutes. We
get blamed for everything.76
In addition to being verbally and physically harassed based on their gender identity,
interviewees reported being issued disciplinary infractions for suspected “homosexual activity” based on their perceived sexual orientation. Such infractions can damage their parole eligibility and lead to more serious punishments.
HUMILIATION

Harassment also takes the form of humiliation focused on gender identity and expression. For instance, Vicki, a transgender woman imprisoned in general population in a maximum security men’s facility in upstate New York, reports many of the
same types of harassment from correctional officers:
It’s the correctional officers that create trouble. They want me to be an outcast. . . One guard put liquid soap in my toilet so it would overflow with
bubbles. He hung my underwear all over the place as everyone was heading
to chow so that they would all see. It was horrifying and humiliating. Alls
I expected was to be left alone. One month after, I filed my complaint, no
response. It’s a lot of work to write someone up. Finally he was sent on
vacation. That’s it. But I’m still living with his friends . . . I feel like I’m
being held hostage.77

Transgender and Intersex People in New York State Men’s Prisons · 21

Vicki describes another incident in which a correctional officer took a love letter she
had received from another prisoner, photocopied it, and posted it throughout the
facility—the bulletin boards, the infirmary where she worked, and in the dining
hall—for correctional officers and prisoners to see.“Can you imagine being that humiliated? It’s a joke for both correctional officers and prisoners. For everyone.”78
Stefanie also describes humiliating incidences of harassment from correctional
officers:
One time I had 2 bras missing from my laundry, which I reported to the
CO’s. A Correctional Officer came on the loud speaker and announced it
to the entire prison. It was one of the most mortifying things that’s ever
happened. I couldn’t believe it.
There’s too much of a loophole for people to do whatever they want
with us . . . They’ll go out of their way to make your bid a living hell—
something needs to change. We need to better monitor what prison staff
do and how they conduct themselves.79
Lori, a transgender woman currently in the protective custody unit of a maximum
seurity men’s prison in upstate New York, describes the greater impact of this kind
of regular treatment:
It’s the little things, the things that are just a part of life here, but they add
up to hundreds of little things all geared toward making life miserable for
prisoners like me, but without risking discrimination complaints or other
types of complaints against correctional officers or other staff.80
Bea, a transgender woman imprisoned in the protective custody unit of a maximum
security men’s facility in upstate New York, reports that her cell’s water and power
have been shut off by correctional officers, she has been issued false tickets, and has
been assaulted by prisoners at the instigation of correctional officers. The correctional officers in her unit have also denied her access to paper and pens. Bea reports,
“Corrections allows all staff to abuse inmates, cheat inmates out of their privileges,
and write false tickets. And the good-old-boy club supports this throughout the
ranks.”81 Maverick, an intersex person who is currently imprisoned, also describes
the daily behavior of correctional officers: “They laugh at you, they call you names,
they collapse you emotionally.”82
SEARCHES

Unnecessary frisks and abusive strip searches are also commonly reported by
SRLP’s imprisoned clients. Vicki explains, “They use frisk as means of harassment,
with all their friends watching. After frisking me they say, ‘I need a cigarette now.’”83
Sunday, a transgender woman who has been imprisoned in numerous New York
prisons and jails, reports similar harassment:
One or two officers got out of line—friskings and strip searches 4-5 times
a day! Non-trans people don’t ever get searched unless they were suspected

22 · “ i t ’ s wa r i n h e r e ”
of something. If they want to they can just put you against a wall. And
everybody knows there’s a big difference between patting you down and
massaging you, feeling you up. But I couldn’t say anything cause I didn’t
want no trouble.84
People with intersex conditions also report experiencing regular unnecessary and
forceful strip searches. One transgender attorney in Oakland, CA, has noted that
correctional officers will often justify these excessive strip searches by the need to
“decipher” the ambiguous gender of people with intersex conditions:
People with intersex conditions who have not been surgically ‘normalized’
are seen as ‘freaks’ in the prison system, because their bodies defy easy categorization as ‘male’ or ‘female.’ People in prison with intersex conditions
have been put into punitive isolation for no other reason than because administrators did not know whether to place them in men’s or women’s
prisons. One client of mine who has an intersex condition was repeatedly
strip searched by custody staff for no other reason than to see her genitalia.
She did not identify as transgender, but the type of mistreatment, harassment, and stigmatization she experienced was similar to that experienced
by my transgender clients.85
Although non-transgender-identified people with intersex conditions and transgender-identified people experience distinct forms of discrimination in U.S. prisons and jails, it is clear that there are overlapping patterns of neglect and abuse. Both
groups report enduring consistent and humiliating strip searches at the hands of
correctional officers who target those with genitalia and identities that do not conform to conventional notions of gender and sex.
PUNISHMENT

A central aspect of the harassment reported by SRLP’s clients includes exaggerated
punishments. As Lori articulates,
When the average prisoner gets in trouble, they are given average punishments commensurate with the offense. When someone like myself gets in
trouble, it gets blown far out of proportion and usually results in the gay or
transgendered prisoner getting much harsher punishments than appropriate
for the offense or in comparison to other non-gay or non-transgendered
prisoners.86
Interviewees report being subjected to disproporTo compound the situation,
tionate isolation and solitary confinement where
correctional officers are almost
they experience regular physical and sexual assault,
harassment, and the denial of food and urgent
never reprimanded or even
medical services by correctional officers. At times,
reported for the majority of
the punishment is directly linked to gender identity
these violations
or expression (in addition to race, ethnicity, and
HIV status), whereas in other cases transgender prisoners are subject to disproportionate and therefore discriminatory punishment for common offenses. Lori served

Transgender and Intersex People in New York State Men’s Prisons · 23

a 30-day sentence of solitary confinement for possession of a bra.87 Bianca was
placed in solitary confinement for six months after she was assaulted by correctional
officers. She also received an additional sentence of two to four years because she
was caught in possession of a weapon that she was carrying to defend herself against
a group of prisoners who were continually assaulting her. To compound the situation, correctional officers are almost never reprimanded or even reported for the
majority of these violations because of the serious lack of formal accountability or
effective systems of recourse for imprisoned people.
LACK OF ACCOUNTABILITY

Such lack of accountability measures within prisons allows abuse of transgender
prisoners to proceed with impunity. As one interviewee, Bea, reports:
I’ve filed close to 100 grievances in the last 6 years. Most are met with retaliation and the system is so corrupt that evil guards are supported all the
way up to the central office level. In NYS, prison guards can do no wrong.88
Lori also describes the inadequacy of the correctional grievance procedure:
There was no retaliation [to my claims] per se, but the way in which NYS
DOCS [New York State Department of Corrections] prison staff and
officials manage to give misdirection, hide identities of responsible staff
members through conspiracies of silence and evasive propaganda, and
reinterpret complaint of prisoners into entirely different issues that they
refuse to address, there is often little need to retaliate because the inmate’s
problem is rarely even resolved.89
Glaysa has also emphasized the lack of institutional recourse for discrimination and
abuse:
The grievance procedure is suppose to be to help us, but a lot of the time
this grievance procedure is a joke because most of the time they rule
against us even though we have ligit grievances. I have filed several grievances on the improper medical care and the treatment of myself as a transgender. Most of the grievances were ignored and I was harassed and threatened for writing these grievances.90
One legal advocate for transgender prisoners emphasizes the thoroughly insufficient
nature of correctional grievance procedures:
When a transgender, intersex, or gender non-conforming person experiences rape or sexual assault and makes the courageous decision to do
something about it, the choices are often profoundly limited. One problem
is a lack of evidence. Correction officers typically refuse to allow inmates
access to medical care after a rape or assault or threaten retaliation if the
inmate insists on accessing medical care, so no medical records exist.
When inmates try to keep and hide physical evidence of an assault, such
as semen, correction officers can usually find it, destroy it, and retaliate

24 · “ i t ’ s wa r i n h e r e ”
against the inmate. Videotapes of incidents, when they exist, often mysteriously disappear or ‘fail to record.’ In one case, an assault against my client
was videotaped according to procedure, but no tape was produced during
discovery. . . . Another problem is a lack of legal service providers, agencies,
law offices, or other potential advocates who are able and willing to take
these kinds of cases.
An even more major obstacle, however, is retaliation against inmates
for speaking up. My clients have been punched, choked, thrown against
walls, threatened with murder, framed with contraband, described to other
inmates as an informant, and threatened with all of these acts in retaliation
for receiving a letter or a visit from me or my colleagues or for filing a
grievance. Understandably, many transgender, intersex, and gender nonconforming inmates falter in their determination to bring a lawsuit or
press their grievances in the face of these acts. As a legal service provider, it
is difficult to contact my clients when I know from them that correctional
officers are reading my letters and even claim to listen in on attorney-client
visits. It is also frustrating not to be able to contact someone I believe I can
help because she believes the officials’ threats that they will kill her if I do.91
ABUSE BY FELLOW PRISONERS

Although the majority of interviewees reported that the violence and abuse they encounter are at the hands of correctional officers, many interviewees also described
incidences of assault and harassment from other prisoners. Importantly, these incidences were never without either the implicit permission or active participation
of correctional officials. Stefanie articulates the forces underlying such abuse:
You have guys in here that for whatever there reasons were a threat to there
environment. Maybe cause they find a transsexual looks good so now they
question there own sexuality or manhood. You also have male prisoners
who come from strong religious backgrounds and are taught from early on
in there childhood to look at that as a repulsive thing and that this type of
lifestyle is sinful and wrong. But they have such a distorted, twisted, and
warped way of looking at things that they use there feelings of anger, bitterness, impotence, lust, denial, rage, bigotry, hatred, feeling power over
someone weaker, non-understanding, homophobia, and peer pressures to
inflict abuse and violence on transgenders.92
Stefanie also reports daily harassment in the form of consistent verbal humiliation:

* Gender Identity Disorder is recognized as an illness by the medical community. Diagnostic
criteria are promulgated by the American Psychiatric Association (APA) and the disease is listed
in the ICD-10. Treatment of GID with psychotherapy, hormonal treatments, and surgery (also
known as triadic therapy) is recognized as appropriate and standard care by both the APA in its
treatment text, “Treatments of Psychiatric Disorders.” Triadic therapy is also recognized as medically necessary and as the standard of care by the Harry Benjamin International Gender Dysphoria
Association, the largest professional organization of providers of care to transsexual patients.

Transgender and Intersex People in New York State Men’s Prisons · 25

I got a lot of slack from a lot of the CO’s there and faced a lot of prejudices
from inmates as well. They’d call me ‘lizard,’ faggot, homo, or to get me really upset, they’d call me by my boyname. ‘Lizard’ is a derogatory term directed at a lot of the transsexuals or ‘queens’ in prison. . . . Supposedly it’s
not the look to hang out with a ‘queen’ while in prison.”93
Bianca reports that she is subjected to so much harassment from other prisoners
that she has stopped attempting to go to meals. “I don’t go to breakfast, lunch, or
chow, so that I can stay out of people’s way. They come to me. I eat 5 or 6 pieces of
bread a day. I don’t go to meals—I can’t.”94
Glaysa, a transgender woman imprisoned in a maximum security men’s prison
in upstate New York, also reports persistent violence and harassment:
I have faced violence where I have been beaten and raped because of my
being a transgender with female breasts and feminine. I have been burned
out of a cell block & dorm because I wouldn’t give an inmate sex. I have
been slapped, punched, and even threatened because of my being a transgender that told another inmate ‘No’ when they told me they wanted sex
from me or my commissary buy. I have been harassed verbally and have
had others grab my female breasts and ass because they knew I was transgender and figured they can get away with such actions—which they do
most of the time due to the fact no one cares what happens to us transgenders inside. I’ve been subjected to all kinds of verbal harassment from ‘look
at that inmate scumbag transgender’ all the way to threats and sexual
harassment physically as well as verbally.95
Another aspect of the abuse that transgender, gender non-conforming, and intersex people in prison face is collaboration between correctional officers and other
prisoners to implement forced prostitution and coerced sexual engagement. Sunday
describes the realities of prison prostitution:
Lots of the girls were pushed into prostitution— they were pushed into
sexual things in order to get by. Some were just harassed, abused, spit on.
Different categories depending on how you looked. Some of us got picked
out as soon as we got there, even before we got classified—apparently
somebody who was doing life decided they took a liking to me. They
moved me in with him, I didn’t have a choice. But I also didn’t have the
violence like other girls, cause I was fucking one man. On the other hand,
I couldn’t stray—I couldn’t leave him—or he’d kill me. It wasn’t my choice,
it was told to me. They told me he’d take good care of me. The guards orchestrated all of this. These were the officers who were selling us off, not
the inmates. They said ‘You’re gonna be with him or in solitary.’96
Sunday’s description of the sexualized violence she experienced at the hands of both
correctional officers and other prisoners was echoed throughout the interviews. She
goes on to explain: “If you’re not fucking somebody, you’re gonna get fucked by
everybody.”97
In his testimony during a U.S. Department of Justice hearing on rape in prison,

26 · “ i t ’ s wa r i n h e r e ”
one legal advocate for transgender people in prison remarked on the widespread
practice of correctional officers forcing transgender people in prison into prostitution.
A common form of sexual abuse of transgender, intersex, and gender nonconforming people in prison is forced prostitution. In these systems, correction officers bring transgender women to the cell of male inmates and
lock them in for the male inmate to have sex with. The male inmate will
then pay the correction officer in some way, for example with cigarettes or
money. The correction officer sometimes gives a small cut to the woman
and brings her back to her cell.
The rape and sexual exploitation of transgender, intersex, and gender
non-conforming people in some facilities is very open. Sometimes all or
almost all the staff and officials in a particular facility know about the
abuse, but even those who do not participate in it maintain a rigid
conspiracy of silence.98
As one interviewee explains, “. . .you’re the lowest rung on the totem pole of prison
life. You have to pay somebody to protect you, but most people won’t be seen talking to you, or let you sit at their table, or touch their food.”99 This low position within
the prison hierarchy places transgender, intersex, and gender non-conforming
people in prison at increased risk of violence and abuse by other prisoners.100
Forced prostitution, sexual abuse,
Verbal harassment, physical abuse, and
and the practice of exchanging sex
sexual assault and coercion create an
for protection renders this population highly vulnerable to sexually
exceptionally dangerous climate for
transmitted infections (STIs), espetransgender, gender non-conforming,
cially HIV and hepatitis, which are
and intersex people in prison
widespread in U.S. correctional facilities.101 Verbal harassment, physical abuse, and sexual assault and coercion create an
exceptionally dangerous climate for transgender, gender non-conforming, and intersex people in prison. As Lori explains, these factors compound one another to
produce a climate in which abuse and discrimination is inevitable: “. . .for transsexual prisoners like me, it is very hard to stay out of the limelight, in a problem free
existence.”102

Denial of Medical Care
It is well documented that healthcare in U.S. prisons, jails, and detention centers is
severely inadequate in terms of both accessibility and quality.103 Following an extensive investigation of the recently privatized healthcare system in New York State prisons, a New York Times editorial emphasized the dilapidated state of correctional
medical care, asserting: “Prison inmates are literally the sickest people in our society.” The authors continue:

Transgender and Intersex People in New York State Men’s Prisons · 27

Shoddy care and the denial of care are unfortunately not unique to private
companies, which do not provide the majority of the health care that is
supplied to inmates. Many publicly run systems, which provide most of
the care for the nation’s inmates, are equally bad. The root problem is that
the country has tacitly decided to starve the prison system of medical care,
even though AIDS, tuberculosis and hepatitis are rampant behind bars,
and roughly one in six inmates suffers from a serious mental illness.104
Compounding a context in which the provision of general medical care is neglectful and inconsistent if not outright abusive, care related to mental health and sexually transmitted and preventable infections such as HIV/AIDS and hepatitis,
among other conditions, remains particularly insufficient.105
Exacerbating these barriers to adequate healthcare, transgender, gender nonconforming, and intersex people in prison receive additional forms of care-related
discrimination and neglect. Reports of the denial of basic care, discriminatory
providers, denial of hormones and other transition-related treatments, and high
rates of illness and STIs are common, and reveal serious health risks for transgender, gender non-conforming, and intersex people, as well as all people, in prison.
Despite the fact that medical experts agree that gender-related healthcare sought by
transgender and intersex people is medically necessary, non-experimental, safe, and
effective,106 these services are still routinely denied to imprisoned people. According
to one interviewee, “Medical services are poor for the average inmate. They see gender-related services as cosmetic, not essential to transition and to a healthy life.”107
Though not all transgender and intersex people undergo medical treatment related to their gender, those who do consider their treatment both medically necessary and a central aspect to their general well-being.* In order to obtain hormonal
therapy during imprisonment in New York State, transgender and gender nonconforming people must have been diagnosed with Gender Identity Disorder
(GID) prior to imprisonment and already be taking hormones pursuant to a prescription.108 Even for those who can overcome the administrative hurdles necessary
to be deemed entitled to gender-related care, such care is often inconsistent, featuring incorrect dosages of hormones and arbitrary termination of treatment. Denial
of gender-related medical care can result in serious medical and mental health conditions for prisoners, and can lead some to turn to hormones purchased from other
prisoners, self-surgeries, and other high-risk alternatives that often make transgender, gender non-conforming, and intersex people increasingly vulnerable to formal
disciplinary measures and unofficial punishment for having engaged in criminalized activity. Vicki, who was diagnosed with GID prior to her imprisonment, explains:
Hormones are sporadic. It’s a major chore to get refills. They took me off
Premarin [commonly prescribed hormone] for four months. You have no
idea the effect of that. I filed a grievance, wrote letters, finally won them
back after four months. Here I have to apply monthly, and they lie about
not having them. They’re trying to lower my dosage. They treat hormones
like they’re narcotics or something.109

28 · “ i t ’ s wa r i n h e r e ”
Dr. Nick Gorton, a transgender health expert, describes the severe health consequences that termination of treatment can have for transgender patients:
Numerous studies in the medical literature as well as the clinical experience of experts in the field demonstrate that denial of sexual reassignment
therapies not only cause patients significant anguish and suffering but that
it also results in significant morbidity and mortality. Untreated transsexual
patients have a suicidality of 20-30%, which is reduced to less than 1-2%
after treatment. Delay of treatment for transsexual patients not only exposes them to a longer duration of pain, suffering, and decreased social
functionality, but also unnecessarily places their lives at risk. The longer
the duration of suicidal feelings, the greater risk that a patient will be a
completer. Treated transsexual patients have a durable and sustained remission of their illness resulting in decreased psychiatric morbidity and
mortality as well as improvements in well-being, social and occupational
functioning, and interpersonal relationships.110
If a transgender person in prison does not meet the administrative requirements for
receipt of hormone treatment and is therefore
Many transgender people
denied treatment they may have been pursuoutside of prisons cannot access
ing outside of prison, the effects described by
Dr. Gorton are amplified. Bianca describes
healthcare due to poverty,
her situation: “I was diagnosed with GID indiscrimination, and other
side, and because of that they said I couldn’t
barriers. Upon entering prison,
get hormones. I was on bootleg hormones
even if they have been taking
from other girls in here. I got found out, got
hormones . . . many are unlikely
my hormones taken away, and got moved
111
to be able to produce a paper
from the block.” Bianca’s situation is not
unusual. Many transgender people outside of
trail that would entitle them to
prisons cannot access healthcare due to
continue treatment under New
poverty, discrimination, and other barriers.
York State’s current policy
Upon entering prison, even if they have been
taking hormones from an alternative source, many are unlikely to be able to produce
a paper trail that would entitle them to continue treatment under New York State’s
current policy.
Bea has faced many obstacles in her attempts to access hormones, and is completely unable to access Sex Reassignment Surgery (SRS). As she explains, this denial of care has resulted in significant trauma and emotional anguish: “I’ve told
Mental Health several times that I will not die with this on me, but they still do
nothing.”112 While in prison, Bea tried to perform surgery on herself three times
with personal items she had in her cell. The first time she was caught, placed in isolation for 60 days, and put in a disciplinary segregation unit for a week. The second
and third times she was taken to the hospital.113 Unable to access healthcare that
would support and affirm her gender identity, Bea has been driven to dangerous alternatives that demonstrate the urgency of her circumstances.

Transgender and Intersex People in New York State Men’s Prisons · 29
TRANSGENDER PEOPLE IN PRISON AT HIGH RISK FOR HIV/AIDS

HIV/AIDS in prison has reached endemic proportions,114 particularly for transgender, gender non-conforming, and intersex people, who often find themselves at a
higher risk for contracting HIV and for receiving inadequate and discriminatory
treatment. Sunday, who is HIV+ and an active member of an HIV+ homeless transgender advocacy group in New York City, describes the impacts of inappropriate
medical care for HIV/AIDS on transgender, gender non-conforming, and intersex
people in prisons:
Last time I was inside they told me they couldn’t give me my regimen that
I needed, because I’m HIV+ too. Even though they were in contact with
my doctor. They told me they didn’t have the meds I needed, so I chose not
to take anything. Thank god everything was OK, because I could have died.
You can’t play with HIV medication. I’m wondering how many girls go in
there non-resistant and come out resistant. And the psych meds are the
same way.115
HIV and AIDS are highly stigmatized in prison, and people who are HIV+ are consistently denied proper treatment and discriminated against based on their HIV status. Failure on the part of correctional administrators to promote harm reduction
strategies further compounds the problem. Sunday describes this difficult situation:
[T]hey don’t give you condoms because they say you’re two men and
you’re not allowed to have sex. What are you supposed to do? They know
it’s happening. You’re in bunks a foot from each other, and if you blow
someone up, they’ll cut you in the bathroom. Who you gonna tell? The
police? Most of the time you pray they’re cute and you do what you gotta
do. What do you expect? Men go in there for a long time, don’t have sex,
and then here we come? And you won’t give us condoms because you
don’t think we’re having sex. But what do you expect? It’s not a coincidence. There’s no information about HIV, no condoms, no classes. There’s
almost no testing. There’s nothing. And there are people getting raped
all the time.116
The high rates of rape, sexual coercion, and prostitution and the denial of condoms
and safer sex education put transgender, gender non-conforming, and intersex prisoners at a much higher risk for HIV infection than other prisoners. This high-risk
situation is then exacerbated by widespread failure on the part of correctional administrators to provide appropriate medical care for prisoners with HIV.

Showers and Lack of Privacy
SRLP’s imprisoned transgender, gender non-conforming, and intersex clients report
that accessing shower facilities safely is extremely difficult. Because most facilities
have group showers, transgender, gender non-conforming, and intersex people fear

30 · “ i t ’ s wa r i n h e r e ”
showering because of the unwanted sexual attention they receive from other prisoners and correctional officers. SRLP’s clients and advocates have had little success
in their efforts to obtain permission to shower privately. Bea explains, “I asked for
a medical permit to take private showers but individual correctional officers
continue to try to force me into group showers. They constantly try to force me to
take showers with men and if I refuse they won’t give me one.”117 Bianca recalls,
“Somebody ran up on me in the shower and the officer just sat there and laughed.”118
Lori continues:
It is really uncomfortable taking a shower in a room with several other
men, at least some of which are incarcerated for some type of sex crime,
and every one of them has his eyes all over your body. I could get rich by
charging men to see my body in here, but would rather be poor and do
without the uncomfortable sensation of being watched so intensely.119
Sunday echoes Lori’s sentiments:
And the showers were the worst. They are one big open area with shower
heads. If you get in there with titties, or with any other work done, it becomes a masturbation-athon. The officers are right next to you, they can
see everything. How I survived is sticking with the girls. Or you find somebody big and you become the typical jailhouse punk.120
Another client of SRLP reports similar harassment in the shower setting:
I have trouble showering safely because that’s when others come in the
bathroom and always try to see me naked, ask me for sex, or try to take sex
from me even though I’m unwilling to do anything sexual with them.121
An attorney at SRLP describes one particularly disturbing experience in advocating
for access to private showers for two clients at a New York State prison, which clearly
illustrates correctional officers’ indifference to the abuse that accompanies this basic
daily function for transgender, gender non-conforming, and intersex people in
prison:
I have two clients in the same facility. I heard from one, a trans woman,
that she was not being allowed to shower alone, and was afraid to shower
in the group shower because she has breasts and other feminine characteristics and already gets a lot of sexual attention. She feared assault in a
group shower, but was being denied private showering so she wasn’t showering at all. My other client, a person with an intersex condition, was being
allowed to shower alone, so I reached out to the superintendent to ask that
the trans client receive the same treatment. It seemed clear that both of
these clients were vulnerable to assault in group showers. The superintendent told me ‘Our policy is to prevent pregnancy.’ He was making it clear
that he was not concerned about rape, only about making sure that the
intersex client did not become pregnant.122

Transgender and Intersex People in New York State Men’s Prisons · 31

As this incident demonstrates, for many transgender, gender non-conforming, and
intersex people in New York State prisons, showering is a particularly dangerous aspect of imprisonment because group showering facilities make them exceptionally
vulnerable to sexual harassment and assault.

Appearance Regulations and the Denial of Gender
Expression
The denial of access to gender-appropriate clothing, make-up, and other items associated with gender expression, as well as punishment for possessing such items,
are other concerns that SRLP’s imprisoned clients frequently raise. As one client reports, “Anything feminine—if it says ‘ladies’ on it—you’re not getting them.”123 Lori
describes one instance of punishment for possessing feminine clothing:
I am currently serving a 30 day keeplock [disciplinary segregation] for
possession of brassieres which were not authorized. Unless I develop breast
tissue, I will never get authorization for bras. And I will only develop breast
tissue after receiving hormonal therapy, which the state has continuously
denied me.124
Jacquie also raises the problem of restricted access to feminine clothing in the facility where she is imprisoned, explaining, “You can have a bra but you can’t have
panties. You’re only allowed a sports bra, but no make-up.”125
Many transgender women also report having their hair forcibly cut upon entrance to men’s prisons. Stefanie describes this traumatizing experience:
It was the most devastating day of my life when they made me cut my hair
when I was transferred to [facility removed]. It took me so long to grow it.
It was like taking an arm. I wish they would not have done that. They don’t
do that to female inmates. I have to keep my fingernails trimmed, like they
are weapons or something.126
Interviewees in men’s prisons reported that wearing longer hair and nails are often
some of the only outlets available to them to express their gender.
During a hearing before the U.S. Department of Justice on conditions of
confinement for transgender and intersex prisoners, one advocate spoke about the
damaging effects of restrictive policies around gendered clothing and expression:
Too many jails and prisons limit the ability of prisoners to dress or groom
in a way that is comfortable for them . . . many transgender women housed
in men’s facilities are denied access to bras and are forced to keep their hair
at a stereotypically male length. Transgender men in women’s facilities
often find that they have to keep their face shaven despite the fact that they
are not provided with proper grooming supplies . . . some women’s institutions require male inmates to wear garb that is similar to a dress.

32 · “ i t ’ s wa r i n h e r e ”
This form of harassment is the kind of on-going indignity that can lead
to more significant issues down the line . . . health problems can result from
women being denied bras or men being forced to shave without the proper
tools. And the lack of bras has facilitated, in a number of cases, sexual
harassment.127
In a letter to the Office of Mental Health in her facility, Bianca also describes the destructive impacts of having her gender expression regulated:
I style my long hair in a feminine manner, and I’m getting picked on and
called names, and everybody is laughing at me. These are coming from the
correctional officers. . . .
I get so depressed, and I hide under my covers and start crying, cause
this isn’t fair, ‘why me,’ I’ve been a respectful person. I do not deserve this. I
try to stay strong, and keep in mind, that soon, I will be 100% woman the
way I was ment to be, but as each day go by, I hurt, and hurt, and hurt. I
need weekly psychological counseling, cause I am to depressed to feel good
about myself, and consintrate. And I’m asking for help. I do not want to
hurt myself no more, but I need weekly counseling in private, so I can prevent any suicidal thoughts or attempts. . . .
I refuse to come out of my cell until I be able to shower and shave. If I
continue to be deprived of shower and shaving, I will start with a letter to
Albany Mental Health Department, followed by a hunger strike.128
Multiple interviewees described the traumatic consequences of having their appearance and gender expression monitored and curtailed by policies such as those described above. These regulations create an environment in which transgender, gender non-conforming, and intersex people are more likely to suffer from depression,
anxiety, and a range of other mental health conditions.

Women’s Prisons
As is the case in men’s prisons, authorities in women’s prisons target transgender,
gender non-conforming, and intersex people in those facilities with verbal harassment, humiliation, excessive strip searches,
The excessively harsh treatment
and isolation, and refuse to recognize their
gender identities.
that male-identified and masculineA transgender attorney who works with
appearing transgender and
transgender and intersex people in California’s
gender non-conforming people
women’s prisons has noted the discriminatory
frequently report at the hands of
and abusive treatment that transgender and
law enforcement carries over into
gender non-conforming people encounter in
those facilities.
their experiences in custody
Trans men and gender variant people—many of whom identify as butches,
studs, and aggressives—receive particularly forceful treatment and neglect

Transgender and Intersex People in New York State Men’s Prisons · 33

by correctional officers. They are faced with homophobic and transphobic
harassment from guards who call them ‘it’ and write them up for hugging
another prisoner because they assume they are violating rules against ‘homosexual contact.’ They are almost completely denied hormones and transition-related care, and they are subjected to excessive, humiliating, and
voyeuristic strip searches. These types of harassment are particularly pervasive for trans and gender variant people of color—especially black and
Latino people—who are also targeted by correctional officers because of
their race.129
One transgender man imprisoned in a women’s correctional facility in California
articulates the imposition of clothing requirements as part of the constant harassment he experiences: “At one point I was being made to wear a dress, despite the fact
that no one else in the prison was forced to. It was just to humiliate me.” He also describes an incident in which another transgender man in his facility was stripsearched publicly by correctional officers so they could “tell his gender.”130 Another
person imprisoned in the same facility who identifies as an aggressive femme lesbian, describes repeated incidents in which male correctional officers harassed
transgender and gender non-conforming prisoners, questioning why they “think
they’re men:” “Butch and aggressive women get messed with the most. They’re the
ones who get written up, harassed. They do this to isolate and quarantine people—
it’s all motivated by hate.”131
The excessively harsh treatment that male-identified and masculine-appearing
transgender and gender non-conforming people—particularly people of color—
frequently report at the hands of law enforcement carries over into their experiences
in custody.132 During a police raid of a predominately LGBT people of color political event in New York City, a Filipino transgender activist reported that two police
officers “grabbed and pushed him down on the trunk of the car, kicked his legs
apart, and repeatedly hit his head against the trunk, then handcuffed him.”133 After
he was taken into custody, at the NYPD’s 77th Precinct in Brooklyn, one of the arresting officers verbally targeted him because of his non-conforming gender expression, allegedly saying, “I know what you are. I know your kind. I just want you to
know you’re never going to have a family like me, kids like me, a dog like me. And
know that whatever you strap on between your legs will never be as real or as big as
mine. You’re going to end up like the rest of your kind, without a job, homeless, and
shooting up drugs.” Because officers were unclear how to handle his search or placement, he was subsequently left handcuffed to a pole during questioning and ultimately detained in the female section of the jail. Throughout his detention, the
officers insisted on using female pronouns when referring to him.134 As his experience illustrates, the forms of harassment, humiliation, and abuse that are common
in women’s prisons, jails, and detention centers are compounded when correctional
officers and law enforcement target people for non-conforming gender identities
and expressions, as well as for their racial identities and political views.

V
RECOMMENDATIONS

As extensive research has shown, the criminal justice system continues to devastate
those communities who are subject to the most intense forms of marginalization
and criminalization—communities of color, transgender communities, and poor
communities. Because of this reality, SRLP recognizes the urgent need for a fundamental shift away from our culture’s over-reliance on imprisonment and policing,
as solutions to poverty, violence, drug use, and other social and economic problems.
As such, we support strategies that help communities to attain the resources they
need to combat poverty and discrimination, and to avoid contact with law enforcement. However, we also recognize the need for immediate relief from the lifeendangering violence and abuse that transgender, gender non-conforming, and
intersex people, as well as all people, face inside the criminal justice system. These
recommendations articulate immediate changes that can be made to alleviate
some of these conditions.

1

Adopt measures that will reduce the criminalization
and imprisonment of transgender, intersex, and gender
non-conforming people in recognition of the extreme
danger this population faces while imprisoned.

Ensure access to safe and gender identity-appropriate housing, employment,
healthcare, social services, and education for transgender, intersex, and gender
non-conforming people. Such access is essential to mitigating the high rates of

Transgender and Intersex People in New York State Men’s Prisons · 35

homelessness, poverty, illness, and unemployment resulting from transphobic discrimination that leads to survival crimes and the disproportionate rates of arrest
and imprisonment of transgender and gender non-conforming people.
Expand funding for and use of community-based gender identity-appropriate alternatives to imprisonment, including drug treatment programs.
Improve re-entry services, providing access to programs upon release from imprisonment that can effectively meet the needs of transgender, intersex, and gender
non-conforming people, such as employment support, drug treatment, and trauma

counseling to help transgender prisoners heal from the violence they experience inside prisons. Such programs will help to decrease parole violations and recidivism
among formerly imprisoned transgender people. Most importantly, no person
leaving prison or jail should be mandated against their will to participate in a program in which they will be forced to live as a different gender identity than their
own, or in which they are likely to be mistreated on the basis of their gender identity, gender expression, or intersex conditions.
Eliminate the profiling and false arrest of transgender, intersex, and gender nonconforming people, as well as people of color, low-income people, and homeless

people. This can be achieved through strategies such as producing and implementing clear policing policies relating to gender identity issues, ongoing training at all
levels of law enforcement, and developing oversight and accountability structures
to monitor police conduct and ensure compliance with behavior guidelines and
policies.

2

Make concrete changes to correctional policies to
improve the safety and treatment of transgender,
intersex, and gender non-conforming people in prison,
as well as all people in prison.

Place transgender, intersex, and gender non-conforming people based on their
own assessment of where they will be most safe and least vulnerable to violence
and harassment while fully respecting their gender identity. Upon entry to a cor-

rectional facility, officials should place transgender and intersex people according
to where individuals determine they will be able to achieve a maximum level of
safety and respect for their gender identity. Possible placements include women’s
facilities, men’s facilities, general population, protective custody, and/or single
bunk cells. Officials should not automatically place transgender people according
to their birth-assigned sex, but allow them to determine the most appropriate placement based on their safety concerns and gender identity. Provide for immediate
changes in placement should an individual’s assessment of their safety change.

36 · “ i t ’ s wa r i n h e r e ”
Develop clear written policies about the treatment of transgender, intersex, and
gender non-conforming prisoners, providing guidelines for appropriately address-

ing safety concerns, prohibiting discrimination, verbal harassment, and inappropriate and abusive searches, and providing for effective enforcement. These policies
should make clear that verbal harassment (such as using homophobic or transphobic epithets), sexual harassment, or using a name or pronoun other than that which
a person prefers are unacceptable. These policies should also ensure that transgender, intersex, and gender non-conforming people in prison have access to private
showers upon request for safety reasons.
Provide in-depth, regular, and mandatory training to all civilian and correctional
staff and contractors who interact with people in prison by appropriately qualified

outside trainers to increase awareness of issues specific to transgender, intersex, and
gender non-conforming people, including appropriate ways to interact with this
population. This training should also be provided to all other parties involved in the
criminal justice system in an official capacity, including police officers, judges, attorneys, prosecutors, parole and probation officers, and inspectors general and their
staff.

3

Improve and enhance grievance procedures and
accountability measures to address assault,
discrimination, and abuse when it does occur.

Improve methods for prisoners to quickly and easily make confidential complaints
of abuse, discrimination, or harassment to an independent agency. This agency

should be adequately trained and have unrestricted access to the correctional facility and the necessary authority and resources to conduct thorough, sensitive, and
prompt investigations, including affirmative investigations.
Eliminate statutory and practical obstacles to prisoners seeking legal redress for
harms they suffer while imprisoned. This should include repeal of the Prison

Litigation Reform Act and the Son of Sam laws, which place unfair limitations on
the ability of prisoners to seek such redress. Additionally, prisoners should be ensured meaningful access to law libraries and free legal assistance resources for prisoners should be increased.
Create a strong statutory presumption against prisons, jails, detention facilities,
and their officials if they fail to produce evidence related to a prisoner’s lawsuit

(e.g. video records, medical records, grievance claims).

Transgender and Intersex People in New York State Men’s Prisons · 37

4

Ensure access to adequate and nondiscriminatory
medical and mental healthcare, vocational and
educational programming, recreational activities,
and gender-appropriate clothing.

Provide consistent and adequate access to medical care to all prisoners, including
hormonal therapy and transition-related services, even if a prisoner cannot ade-

quately document that s/he was receiving hormonal therapy prior to imprisonment.
The ability to transition and express their gender identity is central to the psychological and physical health of many transgender people. If they have not accessed
transgender-related healthcare prior to imprisonment, they should be provided
with access to a clinician who can help them begin this process, and provided with
the subsequent treatment to facilitate their transition.
Improve access to basic medical and mental healthcare without discrimination or
harassment. Guarantee basic medical and mental healthcare that is free from dis-

crimination, harassment, and abuse.
Provide access to educational, vocational, and rehabilitative programming, recreational activities, and employment without discrimination or harassment.
Ensure access to gender-appropriate clothing. Allow transgender prisoners access

to clothing and related items that they feel are compatible with their gender identity and expression, and with which they feel most comfortable. For transgender
women, this may include bras, skirts, blouses, and feminine underwear. In addition,
officials should lift prohibitions on long hair and nails, as they are often essential aspects of the gender expression of transgender people.
Ensure that appropriate medical and mental health services are available to survivors of rape, sexual abuse, assault, or harassment.
Ensure that condoms are readily accessible to prisoners. This is a critical measure
because of the extremely high rates of transmission of HIV and other STIs in prison.

38 · “ i t ’ s wa r i n h e r e ”

Appendix A Frequently Asked Questions:
Gender Identity & Expression134
The following are a series of questions that are frequently asked as people attempt
to better understand gender identity and expression and the experiences of transgender, gender non-conforming, and intersex people. These questions, their answers, and the terms used are constantly evolving, deeply personal, and vary greatly
across cultural and age lines. The following is only one set of answers, and does not
represent the full range of answers or experiences that exist among transgender, gender non-conforming, and intersex people.
1. What is “transgender”?

Transgender is a term used to describe people whose way of understanding their
own gender, or whose way of expressing their gender (clothing, hairstyle, etc.), is different from what society expects based on what gender they were identified with
when they were born. This term includes a wide range of people with different experiences—those who change from one gender to another as well as those who
sometimes express different gender characteristics, or whose gender expression is
not clearly definable as masculine or feminine.
2. What do the terms “transgender woman” and “transgender man” mean?
Who do I use them for?

When speaking about transgender people, always refer to their current gender. A
transgender man is someone who is a man now, even though he was identified as
female at birth. A transgender woman is a someone who is a woman now, even
though she was identified as male at birth.
3. What is “transition”?

Transition refers to the process that some transgender people go through in changing from one gender to another. This process can include beginning to go by a new
first name, using a new pronoun (“she” instead of “he” or “he” instead of “she”), and
making changes in appearance.
4. What is “intersex”?

People with intersex conditions have bodies that are not easily classifiable as “male”
or “female” according to current Western medical standards governing what “male”
and “female” bodies are supposed to look like. There are a variety of intersex conditions. For example, some people have chromosomes that are not XX or XY but are
XXY or some other set of shapes. Similarly, many people have masculine or feminine hormones in their bodies in balances that are not considered the norm for female or male bodies. The most commonly discussed intersex experience is that of
people who are born with what some doctors call “ambiguous genitalia,” meaning
genitalia that do not look the way doctors think male or female genitalia should
look. Too often, parents of children with this intersex condition are pressured to
make a rushed decision to have the child undergo surgery to make the child’s gen-

Transgender and Intersex People in New York State Men’s Prisons · 39

itals conform more closely to the medical standard for their assigned sex.135 These
procedures are often performed without giving parents sufficient information
about intersex conditions and what options exist, and can sometimes result is the
loss of sexual or reproductive function.136
Intersex activist organizations are working to educate doctors, parents, and medical students so that children with intersex conditions will be allowed to determine
what procedures they may or may not want for their bodies after they have fully developed. The Intersex Society of North America website, <http://www.isna.org>, is
a great source of information. Many people are surprised to learn how high the rates
of intersex conditions are: one in 2,000 babies have intersex conditions, and five or
six babies a day in the U.S. are subjected to related surgery.137 Despite these large
numbers, the experiences of people with intersex conditions remain marked by
stigma and secrecy.
5. With all these new terms emerging all the time, what
am I supposed to call people?

Transgender communities, like other communities facing discrimination, have
used different words to refer to themselves over time. Some words are acceptable to
use if you are part of the transgender community but can sound offensive if someone outside the community uses them. All communities fighting discrimination develop new terms over time to refer to themselves and their experiences. For example, years ago people commonly referred to “homosexual rights,” whereas now people often say “gay and lesbian rights.” All of these communities continually revise the
language they use to self-identify—language that more accurately describes their experiences—in an effort to move away from outdated, offensive, and inaccurate
terms. Transgender communities are the same, and different members of the community will use different words to describe themselves. It would be impossible to
create a glossary that included every potential word a person might use, especially
since these terms are still emerging. For that reason, the best way to use this glossary is as a general guide. First and foremost, always refer to people in the way that
they prefer.
6. What should I call a transgender person?

Transgender people should always be called by the name they currently prefer, even
if their legal or medical records still use their old name. They should also always be
called by the pronoun they currently use. Transgender women should be called
“she/her” and transgender men should be called “he/him.”
7. Do all transgender people have surgery?
What is transgender healthcare like?

Misconceptions about transgender healthcare are pervasive. Perhaps the single most
erroneous misconception is that transgender healthcare consists of a single “sexchange operation.” In fact, there are several different kinds of treatment that people seeking sex reassignment pursue, including psychotherapy, hormone therapy
treatment, voice surgery, voice training, Adam’s apple reduction, facial surgery, chest

40 · “ i t ’ s wa r i n h e r e ”
or breast surgeries, and a range of genital surgeries. Medical professionals, in conjunction with their patients, determine what treatment is medically appropriate for
each person, taking into account pre-existing medical conditions, mental health status, and lived gender experience.
Although a common medical treatment that transgender people undergo is hormone therapy, there are many people who prefer to use hairstyle, clothing style, and
other non-medical interventions to express their gender identity.
There is no medical rationale for linking legal recognition of a person’s new gender to genital reconstructive surgery or any other specific treatment that may not
be desirable, medically appropriate, or possible for all people. For example, the most
common sex reassignment surgery for transgender men is chest surgery. In contrast,
fewer than 3% of male-identified transgender people undergo any reconstructive
genital surgery, due to the severe limitations and medical risks associated with this
surgery at this time.138
8. Are transgender people gay?

Although they are often confused in our culture, gender identity and sexual orientation are different parts of a person’s identity. Sexual orientation is about who you
are sexually or romantically attracted to, whether you are lesbian, gay, straight, bisexual, etc. Gender identity is about how you understand your own gender: whether
you understand yourself to be male, female, or something else, and how you express
that.
• Every individual has a sex assigned to them at birth, a gender identity,
and a sexual orientation.
• Being transgender does not mean that you are gay and being gay does
not mean that you are transgender.
• Gender is about who we believe ourselves to be; sexual orientation is
about who we are attracted to.
• Just like non-transgender people, transgender people can be gay, lesbian,
straight, bisexual, or anything else.
• Assuming a transgender person’s sexual orientation, or asking them
detailed personal questions about it, is never appropriate.

9. Are there certain words I should avoid saying
that might offend someone?

Some terms are used often by the media, but are actually offensive or inappropriate to use when talking about transgender people. Here are some ways to avoid potentially offending a transgender person:
• Avoid the term “transvestite.” This term is used often by the media to
refer to anyone who is transgender. It is not a very commonly used term
in transgender communities in North America, and can sound very offensive when used to describe someone who does not identify that way.
“Transgender” is a better general term to use. Most importantly, refer to
the person as they refer to themselves.

Transgender and Intersex People in New York State Men’s Prisons · 41

• Always refer to a person’s current gender. A person who was identified
at birth as male but sees herself as a woman now is a woman or a transgender woman. A person who was identified at birth as female but sees
himself as male now is a man or a transgender man.
• Avoid the terms “pre-op” and “post-op.” These terms suggest that every
transgender person is on the road to some kind of surgery when, in reality, individual decisions about whether to have any medical procedure
vary from person to person. These terms can also often be used as a
judgment, indicating that some transgender people are more “real” than
others. Referring to people in terms of what medical procedures they
have undergone is inappropriate and could potentially reveal private
information about them. These terms should not be used to refer to
clients or co-workers.

42 · “ i t ’ s wa r i n h e r e ”

Appendix B Organizations
The following is a list of organizations in New York City and across the United States
working on issues related to criminalization, poverty, and imprisonment in transgender and intersex communities.
American Friends Service Committee
1501 Cherry Street
Philadelphia, PA 19102
(215) 241-7125
http://www.afsc.org/lgbt/fighting-violence.htm

Peter Cicchino Youth Project
c/o Urban Justice Center

666 Broadway, 10th Floor
New York, NY 10012
(646) 602-5600
http://www.urbanjustice.org

Amnesty International, OUTfront!
5 Penn Plaza
New York, NY 10001
(212) 807-8400
http://www.amnestyusa.org/outfront/

Stop Prisoner Rape
3325 Wilshire Boulevard, Suite 340
Los Angeles, CA 90010
(213) 384-1400
http://www.spr.org

Correctional Association of New York
135 E. 15th Street
New York, NY 10003
(212) 254-5700
http://www.correctionalassociation.org

Sylvia Rivera Law Project
322 8th Avenue, 3rd Floor
New York, NY 10001
(212) 337-8550
http://www.srlp.org

Critical Resistance
1904 Franklin StreetSuite 504
Oakland, CA 94612
(510) 444-0484
http://www.criticalresistance.org

Transgender, Gender Variant, and
Intersex Justice Project (TGIJP)
1095 Market Street, Suite 308
San Francisco, CA 94103
(415) 252-1444
http://www.tgijp.org

FIERCE!
437 W. 16th Street, Lower Level
New York, NY 10011
(646) 336-6789
http://www.fiercenyc.org
Housing Works
57 Willoughby Street
Brooklyn, NY 11201
(347) 473-7400
http://www.housingworks.org
LockedOut
c/o Prison Book Project
P.O. Box 396
Amherst, MA 01004
NYC Gay & Lesbian Anti-Violence
Project
240 W. 35th Street, Suite 200
New York, NY 10001
(212) 714-1184
http://www.avp.org

Transgender/Gender Variant in Prison
(TIP) Committee
1095 Market Street, Suite 308
San Francisco, CA 94103
(415) 252-1444
http://www.tgijp.org/tip
Transgender in Prison Journal
c/o Gender Identity Center of Colorado

1401 Saulsbury, Suite G9
Lakewood, CO 80214
http://www.gicofcolo.org
Transgender Law Center
870 Market Street, Room 823
San Francisco, CA 94102
(415) 865-0176
http://www.transgenderlawcenter.org
TransJustice c/o Audre Lorde Project
85 South Oxford Street
Brooklyn, NY 11217
(718) 596-0342
http://www.alp.org

Transgender and Intersex People in New York State Men’s Prisons · 43

Appendix C Selected Bibliography
All Too Familiar: Sexual Abuse of Women in U.S. State Prisons. Human Rights Watch. December
1996. <http://hrw.org/reports/1996/Us1.htm>.
Daley, Chris, Elly Kugler and Jo Hirschman. Walking While Transgender: Law Enforcement
Harassment of San Francisco’s Transgender/Transsexual Community. Ella Baker Center for
Human Rights and TransAction. 2000.
Joslin, Courtney. Fact Sheet: Rights of Transgender Prisoners. National Center for Lesbian Rights.
July 2006. <http://www.nclrights.org/publications/tgprisoners.htm>.
Justice for All? A Report on Lesbian, Gay, Bisexual, and Transgendered Youth in the New York
Juvenile Justice System. Urban Justice Center. 2001. <http://www.urbanjustice.org/pdf/publications/lesbianandgay/justiceforallreport.pdf>.
Lee, Alexander L. Gendered Punishment: Strategies to Protect Transgender, Gender Variant &
Intersex People in America’s Prisons. JD thesis, U of California, Berkeley. 2003.
<http://www.srlp.org/documents/alex_lees_paper2.pdf>.
Minter, Shannon, and Christopher Daley. Trans Realities: A Legal Needs Assessment of San
Francisco’s Transgender Communities. National Center for Lesbian Rights and Transgender
Law Center. 2003. <http://www.nclrights.org/publications/pubs/transrealities0803.pdf>.
Mottet, Lisa and John Ohle. Transitioning Our Shelters: A Guide to Making Homeless Shelters
Safe for Transgender People.” National Coalition for the Homeless and National Gay and
Lesbian Task Force Policy Institute. 2003.
<http://www.thetaskforce.org/downloads/TransHomeless.pdf>.
Mariner, Joanne. No Escape: Male Rape in U.S. Prisons. Human Rights Watch. 2001.
‘Not part of my sentence’: Violations of the Human Rights of Women in Custody. Amnesty
International USA. 1999. <http://web.amnesty.org/library/Index/engAMR510011999>.
Peek, Christine. “Breaking Out of the Prison Hierarchy: Transgender Prisoners, Rape, and the
Eighth Amendment.” Santa Clara Law Review. 44. (2004): 1211-1248.
Rosenblum, Darren. “‘Trapped’ in Sing Sing: Transgendered Prisoners Caught in the Gender
Binarism.” Michigan Journal of Gender & Law. 6. (2000): 1211-1248.
Spade, Dean. “Compliance is Gendered: Transgender Survival and Social Welfare.” In
Transgender Rights. Eds. Paisley Currah, Shannon Minter, and Richard Juang. Minneapolis:
University of Minnesota Press, 2006.
Still in Danger: The Ongoing Threat of Sexual Violence Against Transgender Prisoners. Stop
Prisoner Rape. 2005. <http://www.spr.org/pdf/stillindanger.pdf>.
Stonewalled: Police Abuse and Misconduct Against Lesbian, Gay, Bisexual and Transgender People
in U.S. Amnesty International USA. September 2005. <http://www.amnestyusa.org/outfront/stonewalled/>.
Whitlock, Katherine. Corrupting Justice: A Primer for LGBT Communities on Racism, Violence,
Human Degradation & the Prison Industrial Complex. American Friends Service
Committee. 2005. <http://www.afsc.org/lgbt/documents/corrupting-justice.pdf>.
Xavier, Jessica. The Washington Transgender Needs Assessment Survey. Gender Education and
Advocacy. 2000. <http://www.glaa.org/archive/2000/tgneedsassessment1112.shtml>.

Appendix D Flow Charts
The following charts illustrate the cycles of systemic poverty, homelessness, and imprisonment in transgender and gender non-conforming communities.

Temporary housing
inaccessible often rejected
from gender-segregated
shelters or experience harassment and abuse at shelters

homeless or
at risk for
homelessness

barriers
to
education

Kicked out of home because of abuse
from parents and foster parents; trans
youth are not allowed to express their
gender identity in gender-segregated
group homes

Permanent housing
inaccessible due to
housing discrimination
in private housing
market; low-income
housing options are
often gender-segregated,
and trans people are
rejected for placement

Can’t apply for school
or access higher
education due to lack
of I.D. or because their
I.D. doesn’t match the
name or gender they
live as

Drop out due to harassment, violence
and/or discrimination at school

inadequate
or no
health care

low income
or
no income

Discrimination in
hiring and workplace
because few laws
prohibit employment
discrimination on the
basis of gender
identity; it’s hard to
find trans-aware legal
assistance

Bias, discrimination and ignorance
in medicine: inappropriate and
harmful treatment, including
institutionalization and damaging,
incompetent medical procedures

Transgender and gender non-conforming people are much more likely to be
poor or homeless than the average person. This diagram shows how various
factors combine into an interlocking system that keep many trans and gender
non-conforming people in situations that are vulnerable and unequal.

POVERTY & HOMELESSNESS

SYSTEMS OF INEQUALITY:

Trans-specific physical and
mental health care needs are
often not provided or covered
even if insured; shortage of
knowledgeable health care
professionals who can provide
trans-specific care

No access to health care:
trans people are often
denied all treatment or
are afraid to seek care due
to past mistreatment

Persistent and severe medical
problems: transphobic violence
leads to increased mental health
and medical problems.

Can’t apply for jobs or
access good employment due to lack of I.D.
or because their I.D.
doesn’t match the name
or gender they live as

Unequal access to benefits
because benefit applications
require I.D. which may show an
incorrect name or gender; if cut
off from welfare illegally, it’s hard
to find trans-aware legal assistance

Gender-segregated arrest procedures (searches, holding cells, policies and
procedures, etc.) do not accommodate trans people. Low-income transpeople are especially targeted due to lack of access to health care that
would help them “pass” as non-trans people, as well as surgical procedures,
and are commonly misclassified by arresting officers as “male” or “female”
based on their appearance or whether they’ve had genital surgery.

False arrests for lack of
proper identity documents
(by INS, police, etc.)

Trans women are often falsely arrested
for soliciting just for being transgender

criminalization
of
trans people

Denied access to hormones and other trans-specific health care
while incarcerated. Forced to change gendered characteristics
of appearance in prison (made to cut hair, give up prosthetics,
clothing). This results in mental anguish and increased exposure
to harassment and violence because appearance may conform
even less to gender identity.

Isolated and/or subjected to increased sexual
violence, harassment, and abuse at the hands
of prisoners and corrections facility staff.

Low-income trans people are exposed to
arrest, police harassment, incarceration and
violence far more than the average person

criminalization
of poor
and homeless
people

False arrests for using
the “wrong” bathroom

This diagram illustrates how overpolicing and profiling of low income people and of
trans and gender non-conforming people intersect, producing a far higher risk than
average of imprisonment, police harassment, and violence for low income trans people.

Trans people suffer additional gender-related harms
while in custody of the criminal justice system

Charged with “Quality of Life”
crimes like sleeping outside,
turnstile jumping, loitering,
etc. due to lack of resources
(housing, money)

Charged with survival crimes (sex
work, drugs, theft, etc.) due to lack
of access to gainful employment or
education

Subject to profiling and harassment;
excessive police presence in poor communities; increased exposure to police

CRIMINAL JUSTICE

SYSTEMS OF INEQUALITY:

46 · “ i t ’ s wa r i n h e r e ”

Notes
1

See, e.g., Farmer v. Brennan, 511 U.S. 825 (1994) (finding that prison officials are not liable for
violence inflicted on a transsexual prisoner by other prisoners unless they have actual subjective
knowledge that the transsexual prisoner is at risk and deliberately fail to act on that knowledge.
See also Lucrecia v. Samples, 1995 U.S. Dist. LEXIS 15607 (Oct. 16, 1995) (finding no Eighth
Amendment violation where prison officials transferred male-to-female transsexual prisoner,
who had developed breasts and had her testicles surgically removed, from female prison to male
prison, where she was subjected to constant verbal, physical, and sexual harassment and assault
by other prisoners and by prison guards). But see Powell v. Schriver, 175 F.3d 107 (2nd Cir. 1999)
(holding that qualified immunity did not protect prison official from claim that the disclosure of
the inmate’s transsexual status constituted deliberate indifference to a substantial risk of serious
harm, in violation of the 8th Amendment).
2 See Kosilek v. Maloney, 221 F. Supp. 2d 156 (D. Mass. 2002) (holding plaintiff ’s transgender
healthcare was a serious medical need and prison officials were required to provide treatment as
prescribed by a physician with experience in treating gender identity disorder; the court further
held this treatment could include hormone therapy or gender reassignment surgery); De’Lonta v.
Angelone, 330 F.3d 630 (4th Cir. 2003) (holding termination of a transgender prisoner’s hormone treatment which led her attempts to mutilate herself, could constitute deliberate indifference). See also Allard v. Gomez, 2001 WL 638413 at **1 (9th Cir. 2001) (holding that whether a
transgender prisoner who was denied hormone therapy on a case-by-case basis or a blanket rule
either of which was deliberate indifference was a triable question of fact); Wolfe v. Horn, 130 F.
Supp. 2d 648 (D. Pa. 2001); Phillips v. Michigan Department of Corrections, 731 F. Supp. 792
(W.D. Mich. 1990).
3 See, e.g., Powell v. Schriver, 175 F.3d 107 (2 nd Cir. 1999) (holding that qualified immunity did not
protect prison official from claim that the disclosure of the inmate’s transsexual status constituted deliberate indifference to a substantial risk of serious harm, in violation of the 8 th
Amendment); Kosilek v. Maloney, 221 F. Supp. 2d 156 (D. Mass. 2002) (holding plaintiff ’s transgender healthcare was a serious medical need and prison officials were required to provide treatment as prescribed by a physician with experience in treating gender identity disorder; the court
further held this treatment could include hormone therapy or gender reassignment surgery);
De’Lonta v. Angelone, 330 F.3d 630 (4th Cir. 2003) (holding termination of a transgender prisoner’s hormone treatment which led her attempts to mutilate herself, could constitute deliberate
indifference). See also Allard v. Gomez, 2001 WL 638413 at **1 (9th Cir. 2001) (holding that
whether a transgender prisoner who was denied hormone therapy on a case-by-case basis or a
blanket rule, either of which was deliberate indifference, was a triable question of fact); Joslin,
Courtney. “Fact Sheet: Rights of Transgender Prisoners.” National Center for Lesbian Rights. July
2006. 4 December 2006 <http://www.nclrights.org/publications/tgprisoners.htm>.
4 In particular, Alexander Lee’s 2003 article, “Gendered Punishment: Strategies to Protect
Transgender, Gender Variant & Intersex People in America’s Prisons” (hereinafter Gendered
Punishment) and the Urban Justice Center’s 2001 report, Justice for All? A Report on Lesbian, Gay,
Bisexual, and Transgendered Youth in the New York Juvenile Justice System (hereinafter Justice for
All?).
5 Beck, Allen J. and Paige M. Harrison. Prison and Jail Inmates at Midyear 2005. United States
Department of Justice. Bureau of Justice Statistics. Washington, D.C.: GPO, May 2006.
Hereinafter, Prisons and Jail Inmates at Midyear 2005. The Bureau of Justice Statistics does not
consistently gather statistics specific to Native, Asian, Pacific Islander, and Arab Americans, or
transgender people in prison. These statistics should be understood in the context of these gaps
and limitations.
6 Walmsley, Roy. World Prison Population List (sixth edition). 2005. 4 December 2006
<http://www.kcl.ac.uk/depsta/rel/icps/world-prison-population-list-2005.pdf>.
7 United States Department of Justice. Bureau of Justice Statistics. Corrections Statistics. 2005. 4
December 2006 <http://www.ojp.usdoj.gov/bjs/correct.htm>.
8 Mauer, Marc. Race to Incarcerate. New York: New Press, 2001.
9 Lawrence, Sarah and Jeremy Travis. The New Landscape of Imprisonment: Mapping America’s
Prison Expansion. New York: Urban Institute Justice Policy Center, 2004.
10 United States Department of Justice. Bureau of Justice Statistics. State Prison Expenditures, 2001.

Transgender and Intersex People in New York State Men’s Prisons · 47
Washington, D.C.: GPO, June 2004.
11 United States Department of Justice. Bureau of Justice Statistics. Justice Expenditure and
Employment in the United States, 2003. Washington, D.C.: GPO, April 2006.
12 Prisons and Jail Inmates at Midyear 2005, 11.
13 Greenfeld, Lawrence A. and Steven K. Smith. American Indians and Crime. Office of Justice Programs. December 2004. 4 December 2006 <http://www.ojp.usdoj.gov/bjs/pub/pdf/aic02.pdf>.
For an in-depth analysis of the impact of incarceration and criminalization on Native American
communities, see Ross, Luana. Inventing the Savage: The Social Construction of Native American
Criminality. Austin, TX: University of Texas Press, 1998.
14 Prisons and Jail Inmates at Midyear 2005.
15 Women in Prison Fact Sheet. Correctional Association of New York. March 2006. Hereinafter,
Women in Prison Fact Sheet.
16 Prisons and Jail Inmates at Midyear 2005.
17 Prisons and Jail Inmates at Midyear 2005.
18 Prisoner Profile. Correctional Association of New York. March 2006. Hereinafter, Prisoner Profile.
19 Prisoner Profile.
20 Women in Prison Fact Sheet.
21 Parenti, Christian. Lockdown America. New York: Verso, 2000. Hereinafter, Lockdown America.
22 Lockdown America. See the Center for Juvenile and Criminal Justice’s 2000 report, Poor
Prescriptions: The Costs of Imprisoning Drug Offenders in the United States. Center on Juvenile
and Criminal Justice. 4 December 2006 <http://www.cjcj.org/pubs/poor/pp.html>. See also
Caught in the Net: The Impact of Drug Policies on Women and Families. American Civil Liberties
Union, Break the Chains, and the Brennan Center for Justice. 2005. 4 December 2006
<http://www.aclu.org/drugpolicy/gen/23513pub20050315.html>.
23 For a comprehensive investigation of the various forms of abuse and violence that people in U.S.
prisons encounter on a regular basis see Gibbons, John J. and Nicholas de B. Katzenbach.
Confronting Confinement: A Report of the Commission on Safety and Abuse in America’s Prisons.
Vera Institute. June 2006. 4 December 2006
<http://www.prisoncommission.org/pdfs/Confronting_Confinement.pdf>.
24 See Abuse of Women in Custody: Sexual Misconduct and the Shackling of Pregnant Women.
Amnesty International. 2006. 4 December 2006
<http://www.amnestyusa.org/women/custody/abuseincustody.html>. No Escape: Male Rape in
U.S. Prisons. Human Rights Watch. 2001. 4 December 2006
<http://www.hrw.org/reports/2001/prison/>. All Too Familiar: Sexual Abuse of Women in U.S.
State Prisons. Human Rights Watch. December 1996. 4 December 2006 <http://hrw.org/reports/1996/Us1.htm>.
25 Healthcare in New York State Prisons: A Report of Findings and Recommendations by the Prison
Visiting Committee of Correctional Association of New York. Correctional Association of New
York. February 2000. 4 December 2006 <http://www.correctionalassociation.org/PVP/publications/healthcare_report.pdf>. See also, ACE Program of the Bedford Hills Correctional Facility.
Breaking the Walls of Silence: AIDS and Women in a New York State Maximum-Security Prison.
Woodstock, NY: Overlook Press, 1998: 23-26.
26 Ill-Equipped: U.S. Prisons and Offenders with Mental Illness. Human Rights Watch. 2003. 4
December 2006 <http://www.hrw.org/reports/2003/usa1003/>. Hereinafter, Ill-Equipped.
27 Davis, Angela Y., and Cassandra Shaylor. “A Question of Control.” San Francisco Chronicle. 9
April 2000: 1. Out of Sight: Super-Maximum Security Confinement in the United States. Human
Rights Watch. February 2000. 4 December 2006 < http://www.hrw.org/reports/2000/supermax/>.
28 Editorial Desk. “Racial Segregation in Prison.” The New York Times. 14 November 2004: 10.
29 Anti-Lesbian, Gay, Bisexual, and Transgender Violence in 2005. The National Coalition of AntiViolence Programs and the New York Gay and Lesbian Anti-Violence Project. 26 April 2006. 4
December 2006
<http://www.ncavp.org/common/document_files/Reports/2004NationalHV%20Report.pdf>.
30 Mottet, Lisa and John Ohle. Transitioning Our Shelters: A Guide to Making Homeless Shelters Safe
for Transgender People. The National Coalition for the Homeless and the National Gay and
Lesbian Task Force Policy Institute. 2003. 4 December 2006 <http://www.thetaskforce.org/downloads/TransHomeless.pdf>. Hereinafter, Transitioning Our Shelters.
31 Mukarji-Connolly, Anya. Personal Interview. 29 June 2004.

48 · “ i t ’ s wa r i n h e r e ”
32 Marksamer, Jody, Caitlin Ryan, and Shannan Wilber. Serving LGBT Youth in Out-of-Home Care:
CWLA Best Practice Guidelines. Child Welfare League of America. 2006. 4 December 2006
<http://www.nclrights.org/publications/pubs/bestpracticeslgbtyouth.pdf>.
33 Justice for All?
34 Hatred in the Hallways: Violence and Discrimination Against Lesbian, Gay, Bisexual, and
Transgender Students in U.S. Schools. Human Rights Watch. 2001. 4 December 2006
<http://www.hrw.org/reports/2001/uslgbt/toc.htm>.
35 Kosciw, J. G. 2005 National School Climate Survey: The Experiences of Lesbian, Gay, Bisexual, and
Transgender Students in Our Nation’s Schools. Gay, Lesbian and Straight Education Network.
2004. 4 December 2006 <http://www.glsen.org/binary-data/GLSEN_ATTACHMENTS/file/3003.PDF>.
36 Xavier, Jessica M. The Washington Transgender Needs Assessment Survey. Gender Education and
Advocacy. 2000. 6 December 2006 <http://www.gender.org/resources/dge/gea01011.pdf>.
Hereinafter, D.C. Needs Assessment.
37 Fenner, Bran. Personal Interview. 21 June 2004.
38 Minter, Shannon, and Christopher Daley. Trans Realities: A Legal Needs Assessment of San
Francisco’s Transgender Communities. Transgender Law Center. 2003. 4 December 2006 <
http://www.transgenderlawcenter.org/tranny/pdfs/Trans%20Realities%20Final%20Final.pdf>.
Hereinafter, Trans Realities.
39 Trans Realities.
40 D.C. Needs Assessment.
41 Mills, Robert. Health Insurance Coverage in the United States: 2002. United States Census Bureau.
Current Population Reports P60-223. Washington, D.C.: GPO, 2003.
42 National Coalition for LGBT Health. Overview of U.S. Trans Health Priorities. National Center
for Transgender Equality. August 2004. 4 December 2006
<http://www.nctequality.org/HealthPriorities.pdf>.
43 Trans Realities. D.C. Needs Assessment.
44 United States Department of Health and Human Services. Centers for Disease Control and
Prevention. HIV/AIDS Surveillance Report. 2004. 3 November 2006.
<http://www.cdc.gov/hiv/stats/hasrlink.htm>.
45 Marksamer, Jody. Personal Interview. 20 July 2005.
46 Lee, Alexander. Letter on file with author. 15 March 2006.
47 Mental Health in the House of Corrections: A Study of Mental Healthcare in New York State
Prisons. Correctional Association of New York, 2004. 4 December 2006 <http://www.correctionalassociation.org/PVP/publications/Mental-Health.pdf>. Ill-Equipped.
48 Transitioning Our Shelters. Otis, Ginger Adams. “No Shelter for Transsexuals: Case of
Preoperative Woman Raped at Men’s Homeless Facility Exemplifies City’s Dilemma.” Village
Voice. 8 June 2001.
49 Transitioning Our Shelters.
50 Gendered Punishment.
51 Stonewalled: Police Abuse and Misconduct Against Lesbian, Gay, Bisexual and Transgender People
in the U.S. Amnesty International. 2005. 4 December 2006
<http://web.amnesty.org/library/index/ENGAMR511222005>.
52 Trans Realities.
53 Walking While Transgender: Law Enforcement Harassment of San Francisco’s Transgender/Transsexual Community. Ella Baker Center for Human Rights. 2000. Hereinafter,
Walking While Transgender.
54 Spade, Dean. Personal Interview. 22 June 2004.
55 Devani. Personal Interview. 28 June 2004.
56 Rosado, Justin Antoin. “Corroding Our Quality of Life.” In That’s Revolting! Queer Strategies for
Resisting Assimilation. Ed. Matt Bernstein Sycamore. New York: Soft Skull Press, 2004: 287-302.
Goldstein, Richard. “Street Hassle: New Skool Versus Old School in Greenwich Village.” Village
Voice. 24 April 2002.
57 Mananzala, Rickke. Personal Interview. 15 June 2004.
58 Spade, Dean. “Compliance is Gendered: Transgender Survival and Social Welfare.” In
Transgender Rights. Eds. Paisley Currah, Shannon Minter, Richard Juang, Minneapolis:
University of Minnesota Press, 2006.
59 Sunday. Personal Interview. 30 August 2004.

Transgender and Intersex People in New York State Men’s Prisons · 49
60 Stefanie. Letter, on file with author. 12 August 2004.
61 Jacquie. Personal Interview. 9 July 2004.
62 Rosenblum, Darren. “‘Trapped’ in Sing Sing: Transgendered Prisoners Caught in the Gender
Binarism.” Michigan Journal of Gender & Law. 6 (2000): 522-526.
63 Peek, Christine. “Breaking Out of the Prison Hierarchy: Transgender Prisoners, Rape, and the
Eighth Amendment.” Santa Clara Law Review. 44 (2004): 1211-1248.
64 Jacquie. Personal Interview. 9 July 2004.
65 Sunday. Personal Interview. 30 August 2004.
66 Bianca. Personal Interview. 23 July 2004.
67 Bea. Letter, on file with author. June 2005.
68 Vicki. Personal Interview. 23 July 2004.
69 Davis, Carrie. Personal Interview. 2 July 2004.
70 Haney, Craig. “Mental Health Issues in Long-Term Solitary and ‘Supermax’ Confinement.” Crime
& Delinquency. 49.1 (2003): 130.
71 See Stop Prisoner Rape and Still In Danger:The Ongoing Threat of Sexual Violence against
Transgender Prisoners. Stop Prisoner Rape. 2005. 4 December 2006
<http://www.spr.org/pdf/stillindanger.pdf>.
72 Vicki. Personal Interview. 23 July 2004.
73 Bianca. Personal Interview. 23 July 2004.
74 Bianca. Personal Interview. 23 July 2004.
75 Bianca. Letter to NYS Department of Corrections, Department of Mental Health. 30 June 2003.
76 Bianca. Personal Interview. 23 July 2004.
77 Vicki. Personal Interview. 23 July 2004.
78 Stefanie. Letter, on file with author. 12 August 2004.
79 Stefanie. Letter, on file with author. 12 August 2004.
80 Lori. Letter, on file with author. 9 August 2004.
81 Bea. Letter, on file with author. July 2005.
82 Maverick. Personal Interview. 10 July 2004.
83 Vicki. Personal Interview. 23 July 2004.
84 Sunday. Personal Interview. 30 August 2004.
85 Lee, Alexander. Personal interview. 30 August 2006.
86 Lori. Letter, on file with author. 9 August 2004.
87 Lori. Letter, on file with author. 9 August 2004.
88 Bea. Letter, on file with author. June 2005.
89 Lori. Letter, on file with author. 25 July 2005.
90 Glaysa. Letter, on file with author. 27 July 2005.
91 Arkles, Gabriel. Prison Rape Elimination Act testimony, on file with author. 15 August 2005.
92 Stefanie. Letter, on file with author. 12 August 2004.
93 Stefanie. Letter, on file with author. 12 August 2004.
94 Bianca. Personal Interview. 23 July 2004.
95 Glaysa. Letter, on file with author. 1 August 2004.
96 Sunday. Personal Interview. 30 August 2004.
97 Sunday. Personal Interview. 30 August 2004.
98 Arkles, Gabriel. Prison Rape Elimination Act testimony, on file with author. 15 August 2005.
99 Jacquie. Personal Interview. 9 July 2004.
100 See Peek, Christine. “Breaking Out of the Prison Hierarchy: Transgender Prisoners, Rape, and
the Eighth Amendment.” Santa Clara Law Review. 44 (2004): 1211-1248..
101 Maruschak, Laura M. “HIV in Prisons and Jails, 2002.” Bureau of Justice Statistics Bulletin.
Washington, D.C.: U.S. Department of Justice, Office of Justice Programs. December 2004.
102 Lori. Letter, on file with author. 9 August 2004.
103 Healthcare in New York State Prisons: A Report of Findings and Recommendations by the Prison
Visiting Committee of Correctional Association of New York. Correctional Association of New
York. February 2000. 4 December 2006 <http://www.correctionalassociation.org/PVP/publications/healthcare_report.pdf>.
104 Editorial Desk. “Death Behind Bars.” The New York Times. 10 March 2005: 26.
105 Health in the House of Corrections: A Study of Mental Healthcare in New York State Prisons.
Correctional Association of New York. June 2004. 4 December 2006 <http://www.correctionalassociation.org/PVP/publications/Mental-Health.pdf>. Ill-Equipped. United States Department of

50 · “ i t ’ s wa r i n h e r e ”
Health and Human Service. Centers for Disease Control and Prevention. Prevention and Control
of Infections with Hepatitis Viruses in Correctional Settings. January 2003. 4 December 2006
<http://www.cdc.gov/mmwr/PDF/rr/rr5201.pdf>.
106 Smith, Yolanda Louise Susanne. “Sex Reassignment: Outcomes and Predictors of Treatment for
Adolescent and Adult Transsexuals.” Psychological Medicine. 35 (2005): 89-99. Michel, A, et al.
“The Transsexual: What About the Future?” European Psychiatry. 17 (2002): 353-362.
107 Jacquie. Personal Interview. 9 July 2004.
108 Brooks v. Berg, 270 F. Supp. 2d 302, 312 (N.D.N.Y. 2003).
109 Vicki. Personal Interview. 23 July 2004.
110 Gorton, R. Nicholas. Personal Interview. 14 July 2005.
111 Bianca. Personal Interview. 23 July 2004.
112 Bea. Notes from case file. 20 August 2003.
113 Bea. Notes from case file. 20 August 2003.
114 Polych, Carol and Don Sabo. “Sentence—Death by Lethal Infection: IV-Drug Use and Infectious
Disease Transmission in North American Prisons.” In Prison Masculinities, eds. Don Sabo, Terry
A. Kupers, Willie London. Philadelphia: Temple University Press, 2001. 174-180.
115 Sunday. Personal Interview. 30 August 2004.
116 Sunday. Personal Interview. 30 August 2004.
117 Bea. Notes from case file. 20 August 2003.
118 Bianca. Personal Interview. 23 July 2004.
119 Lori. Letter, on file with author. 9 August 2004.
120 Sunday. Personal Interview. 30 August 2004.
121 Glaysa. Letter, on file with author. 3 August 2004.
122 Spade, Dean. Personal Interview. 22 June 2004.
123 Jacquie. Personal Interview. 9 July 2004.
124 Lori. Letter, on file with author. 9 August 2004.
125 Jacquie. Personal Interview. 9 July 2004.
126 Stefanie. Personal Interview. 10 July 2004.
127 Daley, Christopher. Prison Rape Elimination Act testimony, on file with author. 14 August 2005
128 Bianca. Letter to NYS Department of Corrections, Department of Mental Health. 22 June 2003.
129 Lee, Alexander. Personal Interview. 18 July 2005.
130 Joey. Personal Interview. 29 July 2005.
131 Beverly. Personal Interview. 29 July 2005.
132 See Amnesty International’s September 2005 report, Stonewalled: Police Abuse and Misconduct
Against Lesbian, Gay, Bisexual and Transgender People in the U.S. for extensive documentation of
the systematic police violence against gender non-conforming people of color.
133 NYPD: Concerns over Reported Use of Excessive Force and Ill Treatment of Transgender Activist.
Amnesty International USA. 21 July 2004. 4 December 2006
<http://action.web.ca/home/lgbt/alerts.shtml?x=61013>.
134 NYPD: Excessive Force.
135 These Frequently Asked Questions and Answers are adapted from text written by Paisley Currah
(Transgender Law and Policy Initiative), Carrie Davis (NYC LGBT Community Services Center)
and Dean Spade (SRLP) during 2005 negotiations with the Human Resources Administration of
New York City to create a Best Practices Guide for HRA workers serving transgender, intersex,
and gender non-conforming clients. That document has not yet been adopted by HRA officially,
and the text has been adapted as a model policy in other advocacy contexts.
136 See Bodies Like Ours at http://www.bodieslikeours.org; Intersex Initiative at http://www.intersexinitiative.org; and Intersex Society of North America at http://www.isna.org for more information about this surgery and its physiological and psychological ramifications.
137 A Human Rights Investigation into the Medical “Normalization” of Intersex People. Intersex
Society of North America. April 2005. 4 December 2006
<http://www.isna.org/files/SFHRC_Intersex_Report.pdf>.
138 See http://www.isna.org/faq/frequency.
139 Dibble, Suzanne, Stacey Hart, Lori Kohler, Emily Newfield. “Female-to-Male Transgender
Quality of Life.” Quality of Life Research. 15 (2006): 1447-1457.

Acknowledgements
This report was written by D. Morgan Bassichis and edited by Dean Spade. We wish
to thank the many community members, activists, and advocates whose generous
contributions and fearless determination made this project possible. Invaluable
feedback and editorial support were provided by Gabriel Arkles, Jessica Brooks,
Cecilia Chung, Tamar Kraft-Stolar, Jennifer Lawless, Alexander Lee, Robin Levi,
Andrea Ritchie, and Stefanie Rivera. Emily Drabinski and Emily Thuma served as
dedicated and thoughtful copy editors. Jamie Stafford-Hill and SRLP’s Public
Education Team provided expert design and technical support throughout the
process.
Financial support for this project was provided by the Starr Fellowship at
Brown University. Thanks to Arcus Gay and Lesbian Fund, Kicking Assets Fund of
Tides Foundation, the New York Foundation, Open Society Institute, The Paul
Rapoport Foundation, and the Union Square Awards, a project of the Tides Center,
for their continuing support of the Sylvia Rivera Law Project. We are grateful to
Bingham McCutchen LLP, and specifically to Joanna Bratt, Trent Norris, and Mary
Morgan, for generously donating their time and resources to ensure this report’s
publication.