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Correctional Nursing: Transgender Inmates

Correctional Nursing: Transgender Inmates

Lorry Schoenly | Correctional Nurse

Change Management

What if the person is in the midst of hormonal therapy or SRS? What responsibilities are there for maintaining or continuing escalation of therapy? Policies regarding transgender treatment differ among state and county systems. Investigate the policy at your facility before you need to use it. Discuss the situation with your manager and medical director.

In a recent survey of correction system policies about transgender treatment, the majority of responding facilities had policies for the continuation of hormonal therapy, at least at the current level. Abrupt discontinuation of hormonal therapy can lead to physical and psychological side effects and should be avoided. Many facilities will use a ‘freeze-frame’ approach which continues the current therapy but does not escalate or advance the gender-change process.

Autocastration – Medical Emergency

Be aware that disturbed individuals may resort to autocastration or autopenectomy to reduce testosterone levels. The elasticity of the testicular arteries allows them to retract into the perineum making it very difficult to staunch the flow. Emergency transport, critical care and blood transfusion may be necessary.

More Resources on Transgender Treatment:

Lock Up Doc on KevinMD

Transgender Guidelines from NCCHC

Trans People in Criminal Justice by Justice Institute of BC

How Should Agencies Manage Transgender Inmates?

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