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There’s been a great deal of concern raised over the increased mental health support needed for transgender prisoners and the latest report released by Nigel Newcomen, Prisons and Probations Ombudsman (PPO), makes it abundantly clear that more needs to be done. 

As any offender healthcare professional will be more than aware, when a person enters prison, they are suddenly removed from whatever support they had in their community; a transition which the PPO’s report points out, can be incredibly difficult for transgender prisoners. This makes them particularly vulnerable. 

Nigel Newcomen has laid out six lessons learned following the investigation of 33 transgender equality complaints, received between April 2012 and the end of August 2016. His guidance is also as a consequence of the five transgender prisoners who have died in custody since 2008, including two in quick succession last year. 

Importance of appropriate residence

The first and second lessons in Mr Newcomen’s bulletin are in response to the death of case study Ms A. Having been placed in a male prison despite living as a female since she was very young, she threatened to self-harm and was assessed by mental health teams. 

Following their evaluation, no further mental health support was offered to her, while a GP prescribed her with anti-depressants without meeting her in person. In addition, the prison’s equalities team did not consider a move to a women’s institution, and Ms A was not directly involved in their discussions. She later took her own life. 

Lesson one therefore states: “The location of a transgender prisoner should be proactively evaluated based on an individual assessment of their needs, and the possibility of residing in the estate of their acquired gender should be given appropriate consideration. The location agreed must allow them to live safely in their gender.”

Multidisciplinary case reviews

Meanwhile, the second advisory note asserts: “Case reviews for transgender prisoners should be multidisciplinary, and should be attended by all relevant people involved in a prisoner’s care.”

As a result of the “poor handling” of two Discrimination Incident Reporting Forms (DIRFs) submitted by case study Ms B, the third lesson says: “Allegations of transphobic bullying and harassment should be meaningfully investigated so prisoners have confidence in the process, and so steps can be taken to challenge and prevent this behaviour in future.” 

Ms B had waited for four and a half months for feedback on her DIRFs. The prison’s eventual letter stated that due to officers not meeting the 28-day response timeframe, they could not investigate her concerns satisfactorily. 

Case study Ms C took her own life following sexual assault allegations against her by another prisoner; she feared that this would have a detrimental impact on an impending review into her category A status. It was also believed that she was in a sexual relationship with two other prisoners on her wing. 

Following her death, the ombudsman raised concerns that officers seemed unaware of either the allegations or the relationships. Due to this, they were not able to foresee or try to prevent her suicide. 

Being aware of vulnerabilities 

Lesson four stresses: “Personal officers should have regular, meaningful contact with transgender prisoners; staff should be aware of their vulnerabilities, and challenge inappropriate behaviour.” 

The wearing of make-up by transgender prisoners was also found to be a thorny issue. Ms D’s privileges were downgraded because she wore lipstick; she complained to the ombudsman and it was adjudged that the prison had interpreted guidance on the matter more restrictively than necessary. 

Mr Newcomen’s lesson five therefore reads: “Ensure local policies concerning the support and management of transgender prisoners are in line with national guidance, do not impose unfair additional restrictions, and are not interpreted more strictly than the Prison Service Instruction allows.”

In a similar incident, transgender prisoner Ms E was told she had to remove make-up to have her security photograph taken. When her complaint was investigated, it was decided that an image of her wearing make-up would indeed have been a more realistic representation of her. 

The need for reasonable adjustments

Resultantly, the sixth and final lesson states: “Reasonable adjustments should be made for transgender prisoners to help them to live in their gender role, when such adjustments can be made safely without compromising security. Consideration should be given to the practices of establishments that house the gender with which they identify.”

Mr Newcomen concludes: “While some prisons do take steps to make reasonable adjustments to support transgender prisoners, it is clear from the cases in this bulletin that there are still lessons to be learned."
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