B/c I’ve refused to discuss this ridiculousness, perhaps Amnesty International USA Fact Sheet might lead the rest of the world to claim otherwise:
The Issue: Medical Neglect of Women in US Prisons
Women are denied essential medical resources and treatments, especially
during times of pregnancy and/or chronic and degenerative diseases.
- Failure to refer seriously ill inmates for treatment and delays
Women inmates suffering from treatable diseases such as asthma, diabetes,
sickle cell anemia, cancer, late-term miscarriages, and seizures have little
or no access to medical attention, sometimes resulting in death or permanent
injury. Instances of failure to deliver life-saving drugs for inmates with
HIV/AIDS has also been noted.
- Lack of qualified personnel and resources and use of non-medical
There is too few staff to meet physical and mental health needs. This often
results in long delays in obtaining medical attention; disrupted and poor
quality treatment causing physical deterioration of prisoners with chronic
and degenerative diseases, like cancer; overmedication of prisoners with psychotropic
drugs; and lack of mental health treatment. The use of non-medical staff to
screen requests for treatment is also common.
- Charges for medical attention
In violation of international standards, many prisons/jails charge inmates
for medical attention, on the grounds that charging for health care services
deters prisoners from seeking medical attention for minor matters or because
they want to avoid work. In some supermaximum prisons, where prisoners cannot
work at all, the US Justice Department has expressed concern that charging
prisoners impedes their access to health care.
- Inadequate Reproductive Health Care
In 1994, the National Institute of Corrections stated that provision of gynecological
services for women in prison is inadequate. Only half of the state prison
systems surveyed offer female-specific services such as mammograms and Pap
smears, and often entail a long wait to be seen.
- Shackling During Pregnancy
Shackling of all prisoners, including pregnant prisoners, is policy in federal
prisons and the US Marshall Service and exists in almost all state prisons.
Only two states have legislation regulating the use of restraints (belly chain,
leg irons and handcuffs) Shackling during labor may cause complications during
delivery such as hemorrhage or decreased fetal heart rate. If a caesarian
section is needed, a delay of even 5 minutes may result in permanent brain
damage to the baby.
- Lack of treatment for substance abuse
The gap between services available and treatment needs continues to grow.
The number of prisoners with histories of drug abuse is growing, but the proportion
of prisoners receiving treatment declined from 40% in 1991 to 18% in 1997.
- Lack of Adequate or Appropriate Mental Health Services
48-88% of women inmates experienced sexual or physical abuse before coming
to prison (as many as 90% in New York and Ohio prisons), and suffer post-traumatic
stress disorder. Very few prison systems provide counseling. Women attempting
to access mental health services are routinely given medication without opportunity
to undergo psychotherapeutic treatment.
Along with the Amnesty list, which focuses on cis gendered women, recent research documents how transwomen continue to be denied treatment as well. While the court recognizes the medical model surrounding transgendered identity, it does so in a way that both stigmatizes transwomen and refuses to interfere with the individual decisions of prison medical personnel. Meaning that transwomen are often denied access to their hormone treatments even when they have a diagnosis of gender dysmorphia. Post-op patients who transitioned in other countries not requiring this diagnosis have even less ground to stand on in U.S. courts and may be denied both hormone treatments (when used), medical interventions for botched “surgeries” like Brazilian silicon injections or other low cost options that may be simply transitory or physically harmful. This is particularly disconcerting since a 2005 study found that transwomen were particularly vulnerable to incarceration and HIV (which the Amnesty statistics already show is poorly treated in women’s prisons for cisgendered women and would thus be all the more so for transgendered ones). And a 1997 study of 393 transwomen living in San Francisco found that 65% had been incarcerated at some point in their lives for any number of reasons (some of which were simply walking while trans).
The following flow chart comes from Lori Kohler’s 2005 study of incarcerated transwomen. The larger presentation maps how lack of medical care in the outside world can lead to incarceration but also how that same lack can lead to both psychologically and physically dangerous situations in prison.
Kohler also found that “prisoners who withdraw rapidly from hormone therapy are at risk for psychiatric symptoms.” Unlike Paris Hilton, such symptoms do not raise the alarm for prison guards nor result in early release. In fact, such symptoms play into transphobic judicial decisions (like the comments made by the maggert vs. hanks case that upheld refusing hormone treatment on the basis of prison physician’s opinion) and abusive treatment in prisons by guards and inmates. The Torry South case decision that enforces the right to hormone treatments has done little to change the prevailing attitudes or amendment violating denial of treatment.
Kohler also found that some prisons were using hormone treatments, or knock off treatments, as income or barter. In other words, the lack of access to hormones through prison physicians has led to a black market hormone trade within prisons in which favors are exchanged for drugs administered by non-medical personnel and potentially without proper cross-checks (anything could be in the syringe). This finding also implies another potential problem in which prison officials could easily use the treatments as a privilege rather than as necessary medical treatment, refusing treatment to prisoners who “misbehave.” Thus medical treatment becomes a tool by which transwomen are intentionally stigmatized and manipulated but not granted early release. No women but Hilton have received this “plain Jane” honor.
Too bad Tookie’s last name wasn’t Hilton.