CHICAGO — In an effort to address health and safety problems of transgender prisoners, new policy adopted today at the American Medical Association’s (AMA) Annual Meeting challenges the status quo of prisons and jails in the United States that house transgender prisoners according to their birth or biological sex. The AMA urges that housing policies be changed to allow transgender prisoners to be placed in correctional facilities that are reflective of their affirmed gender status.

“The problem facing the safety and health of transgender prisoners is severe and well documented,” said AMA Immediate Past Chair Patrice A. Harris, M.D. “Transgender prisoners are disproportionately the victims of sexual assault, suffering higher rates of sexual assault than general population inmates. The new AMA policy acknowledges that the increased rate of violence largely stems from transgender prisoners being housed based on their birth sex, and not according to their affirmed gender.”

To ameliorate the risks and hazards of sex-based housing for transgender prisoners, physicians voted to adopt policy directing the AMA to:

• Support the ability of transgender prisoners to be placed in facilities, if they so choose, that are reflective of their affirmed gender status, regardless of the prisoner’s genitalia, chromosomal make-up, hormonal treatment, or non-, pre-, or post-operative status
• Support that the facilities housing transgender prisoners shall not be a form of administrative segregation or solitary confinement

Birth sex-based housing policy in correctional institutions is taken for granted. This status quo is founded on the “gender binary,” a social construct where only two genders are recognized: male or female.

One study showed that birth sex-based housing policy has allowed transgender prisoners to suffer from rape, harassment, and physical violence at a rate of 34 percent compared to 10 percent for the overall population. Another study of California prisons has shown that 59 percent of transgender prisoners experience sexual assault, versus only 4.4 percent of the overall prison population, with another study showing that the proportion of transgender prisoners in California experiencing sexual assault to be as high as 75 percent.

Under the status quo, many correctional institutions try to lessen the risks and hazards of sex-based housing by placing transgender prisoners in administrative segregation. Such segregation, in the interests of safety, isolates transgender prisoners from the general population, but the AMA does not consider this a viable solution. Administrative segregation often differs little from punitive segregation or solitary confinement. Such confinement acts as further punishment by removing prisoners from the companionship of others, denying prisoners access to prison programs, and is psychologically damaging.

The new position on correctional housing policies for transgender prisoners adds to several AMA policies aimed at protecting the health, welfare, safety and social equality for transgender individuals based on the gender identity.