# How far should the prison system go to accommodate transpersons **URL:** \ **Category:** Great Debates\ **Created:** [August 23, 2013, 3:39am UTC](https://boards.straightdope.com/t/how-far-should-the-prison-system-go-to-accommodate-transpersons/666944 "2013-08-23T03:39:07Z")\ **Posts on this page:** 9\ **Page:** 5
**Author:** ![Shodan](https://avatars.discourse-cdn.com/v4/letter/s/9f8e36/32.png) [@Shodan](https://boards.straightdope.com/u/Shodan)\ **Post date:** [August 26, 2013, 4:52pm UTC](https://boards.straightdope.com/t/how-far-should-the-prison-system-go-to-accommodate-transpersons/666944/81 "2013-08-26T16:52:38Z")
> [@Miller](#): > > I don’t really care if prisoners are happy or miserable in prison. I mostly care if, after they get out, they’re going to break the law again or not. It seems to me that, if our attitude towards prisoners is we don’t care how much they suffer while in prison, they are much more likely to come out worse than they went in. Are there good studies showing that hormone treatments make prisoners less likelty to re-offend after they are released? Regards, Shodan ---
**Author:** ![Qadgop\_the\_Mercotan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/qadgop_the_mercotan/32/83_2.png) [@Qadgop\_the\_Mercotan](https://boards.straightdope.com/u/Qadgop_the_Mercotan)\ **Post date:** [August 26, 2013, 5:19pm UTC](https://boards.straightdope.com/t/how-far-should-the-prison-system-go-to-accommodate-transpersons/666944/82 "2013-08-26T17:19:09Z")
> [@Shodan](#): > > Are there good studies showing that hormone treatments make prisoners less likelty to re-offend after they are released? > > Regards, > Shodan If you’re looking for studies based on inmates, forget about it. The numbers of transgendered inmates are too small, the barriers to doing studies on inmates too high, to generate meaningful data. If you want data on how hormone therapy improves lives for those with Gender Dysphoria, there’s a lot of fairly good data that it does. [Hormonal Treatment Reduces Psychobiological Distress in Gender Identity Disorder, Independently of the Attachment Style](http://www.ncbi.nlm.nih.gov/pubmed/23574768) [Hormone-treated transsexuals report less social distress, anxiety and depression](http://www.ncbi.nlm.nih.gov/pubmed/21937168). I dug up the above on the fly; lacking access to my usual resources at the moment. ---
**Author:** ![Miller](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/miller/32/481_2.png) [@Miller](https://boards.straightdope.com/u/Miller)\ **Post date:** [August 26, 2013, 6:14pm UTC](https://boards.straightdope.com/t/how-far-should-the-prison-system-go-to-accommodate-transpersons/666944/83 "2013-08-26T18:14:41Z")
> [@Shodan](#): > > Are there good studies showing that hormone treatments make prisoners less likelty to re-offend after they are released? > > Regards, > Shodan I was not referring specifically to transsexuals in that post. ---
**Author:** ![Try2B\_Comprehensive](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/try2b_comprehensive/32/65_2.png) [@Try2B\_Comprehensive](https://boards.straightdope.com/u/Try2B_Comprehensive)\ **Post date:** [August 28, 2013, 3:36am UTC](https://boards.straightdope.com/t/how-far-should-the-prison-system-go-to-accommodate-transpersons/666944/84 "2013-08-28T03:36:00Z")
> [@Der\_Trihs](#): > > That’s not an argument for treating prisoners badly, it’s an argument for treating non-prisoners _better._ Well, I’d like to see non-prisoners treated better for sure. Let’s not bomb somebody and spend the money helping people go to college instead; let’s tax the rich a little more and fix some roads, put up some solar panels &etc. I don’t think refusing SRS amounts to treating prisoners badly though. Will we give them liposuction too? How about hair implants? I don’t mean to trivialize their condition, I simply think SRS is an expensive, optional course of action. Hormones, fine. And there is the concern that a post-op trans will come out of prison and shout, “Prison drove me mad, then they altered me surgically!!! I want $10 million.” Bound to happen eventually. ---
**Author:** ![Fear\_Itself](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/fear_itself/32/19637_2.png) [@Fear\_Itself](https://boards.straightdope.com/u/Fear_Itself)\ **Post date:** [August 29, 2013, 1:08am UTC](https://boards.straightdope.com/t/how-far-should-the-prison-system-go-to-accommodate-transpersons/666944/85 "2013-08-29T01:08:45Z")
> [@Czarcasm](#): > > Why? What if the prison psychiatrist determines that hormone therapy is necessary for the prisoner’s mental well being? The simple condition of _being in prison_ impacts a person’s mental well being. Are the transgendered the only class whose well being is an issue? ---
**Author:** ![Little\_Nemo](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/little_nemo/32/3120_2.png) [@Little\_Nemo](https://boards.straightdope.com/u/Little_Nemo)\ **Post date:** [August 29, 2013, 7:28am UTC](https://boards.straightdope.com/t/how-far-should-the-prison-system-go-to-accommodate-transpersons/666944/86 "2013-08-29T07:28:15Z")
> [@bump](#): > > I was under the impression that the thread wasn’t referring to post-op transgender people, but rather pre-op. So by that assumption, I’m saying that the prisoners should be sorted by genital type. Then you should know your terms are going to confuse people as to what you mean. “Born a man” and “born a woman” are usually used to express the principle that you’re the physical gender you were born in and you can’t change that - even if you have sexual reassignment surgery. That’s the law in some places - if you’re born a man, you’ll always legally be considered a man, even if you now have a vagina. ---
**Author:** ![Shodan](https://avatars.discourse-cdn.com/v4/letter/s/9f8e36/32.png) [@Shodan](https://boards.straightdope.com/u/Shodan)\ **Post date:** [August 29, 2013, 8:24pm UTC](https://boards.straightdope.com/t/how-far-should-the-prison-system-go-to-accommodate-transpersons/666944/87 "2013-08-29T20:24:47Z")
> [@Qadgop\_the\_Mercotan](#): > > If you’re looking for studies based on inmates, forget about it. The numbers of transgendered inmates are too small, the barriers to doing studies on inmates too high, to generate meaningful data. No, I didn’t mean inmates specifically. > [@](#): > > If you want data on how hormone therapy improves lives for those with Gender Dysphoria, there’s a lot of fairly good data that it does. > > [Hormonal Treatment Reduces Psychobiological Distress in Gender Identity Disorder, Independently of the Attachment Style](http://www.ncbi.nlm.nih.gov/pubmed/23574768) > [Hormone-treated transsexuals report less social distress, anxiety and depression](http://www.ncbi.nlm.nih.gov/pubmed/21937168). > > I dug up the above on the fly; lacking access to my usual resources at the moment. Thanks, but that isn’t quite what I was looking for. The suggestion seems to be that we as a society ought to provide transsexuals with hormone treatment because gender dysphoria is a life-threatening condition. This is because so many transsexuals attempt suicide. There does not seem to be much good evidence that SRS helps with these high suicide rates. I think that is condeded. So the suggestion was made that hormone treatments are the way to go to treat gender dysphoria. I would like to know if there is good evidence that hormone treatments affect suicide in transsexuals. Because I would think there is a stronger case for providing hormone treatment if it made transsexuals less suicidal than simply if it reduced their psychosocial stress. Likewise, **Miller** seemed to be suggesting (although he seems to have backed off from the position) that hormone treatments affect recidivism, in that transsexual inmates do better after release having been hormone-treated while incarcerated. I also would like to see hard evidence that this is the case. I mention sucide and recidivism because both are objectively measurable outcomes. This would constitute harder evidence that treating transsexuals with hormones actually affects their situation in demonstrable ways. Also, a follow up question - do prison physicians ever diagnose gender dysphoria and prescribe hormone treatment for inmates who are not already taking hormones before conviction? Or is it that their hormone treatments continue while they are behind bars? As usual, thank you for your willingness to share your expertise. Regards, Shodan ---
**Author:** ![even\_sven](https://avatars.discourse-cdn.com/v4/letter/e/dfb087/32.png) [@even\_sven](https://boards.straightdope.com/u/even_sven)\ **Post date:** [August 29, 2013, 10:16pm UTC](https://boards.straightdope.com/t/how-far-should-the-prison-system-go-to-accommodate-transpersons/666944/88 "2013-08-29T22:16:01Z")
> [@Fear\_Itself](#): > > The simple condition of _being in prison_ impacts a person’s mental well being. Are the transgendered the only class whose well being is an issue? Of course not. We regularly provide health care to prisoners for pretty much all recognized conditions. Why should being transgender be the exception. ---
**Author:** ![Una\_Persson](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/una_persson/32/346_2.png) [@Una\_Persson](https://boards.straightdope.com/u/Una_Persson)\ **Post date:** [August 29, 2013, 11:20pm UTC](https://boards.straightdope.com/t/how-far-should-the-prison-system-go-to-accommodate-transpersons/666944/89 "2013-08-29T23:20:13Z")
> [@Shodan](#): > > There does not seem to be much good evidence that SRS helps with these high suicide rates. I think that is condeded. Conceded by who? Better information has been posted numerous times in past threads. Better information is also available with a little legwork and spending a little money to get past paywalls. I’ve done the lion’s share of the legwork on this subject; lack of people posting at your demand doesn’t mean anything. Even when people tried to misinterpret the results of the NCTE study to show suicide rates increased, and I posted the truth, people on this board keep re-posting their misinterpretations. So I’m pre-emptively re-posting that refutation before it pops up AGAIN. And since the qualifier of “not good evidence” is a goalpost on wheels…(shrug). > [@](#): > > In terms of overall health, transsexuals have some other problems which complicate matters. Study 8 is a very long-term follow-up of 1,331 transsexuals (1,177 having had SRS) with an average time on hormones of 18.5 years, and found transwomen had a 51% higher mortality rate than the general population, primarily due to suicide, drug use, and AIDS. Transmen did not have a significantly higher than average mortality rate. Completed and attempted suicides are serious concerns for transsexuals, and although numerous studies showed SRS greatly reduced the risk of suicide, post-SRS suicide rates were still much higher than the general population.(See Studies 9 and 10) Two studies suggest high suicide attempt rates before SRS, 19-33% (Study 3 and Study 11). Review Study 7, a study of 141 Dutch transsexuals who underwent SRS showed a majority had a successful outcome, although suicide attempts were still abnormally high, with 1 in 7 transwomen and 1 in 36 transmen attempting such. The large meta-study 3 found rates of just over 1% post-SRS - compared to the general rate of 11.5 in 100,000 (Study 11) the situation is very sobering. However, Study 8 noted that before SRS, transsexual subjects have much higher rates of attempted suicides and drug use, most likely due to the psychological burden of living with gender dysphoria and social ostracism. > > Some bones are made of the findings in a study by the National Center for Transgender Equality (Study 16), where there is a quote which says “Those who have medically transitioned (45%) and surgically transitioned (43%) have higher rates of attempted suicide than those who have not (34% and 39% respectively).” This is often taken out of context to mean that SRS is harmful. Here’s the problem, though. The survey did not ask _when_ the suicide attempts occurred. “Our questionnaire did not ask at what age the respondents made suicide attempts and therefore it is difficult to draw conclusions about the risk of suicide over their life spans.” The actual survey is back on page 183, and I read it and found that ONLY question 54 asks about suicide, and it just asks “Have you ever attempted suicide?”. It does NOT ask “did you attempt before or after treatment.” All the study tells us is that someone who feels strong enough to undergo SRS really has difficulty with their gender dysphoria. > > 1. Michel, A. et al. “The transsexual: what about the future?” Eur. Psychiatry 17 (2002): 353-362. > > 2. Snaith, P., Tarsh, M.J., and Reid, R. “Sex reassignment surgery. A study of 141 Dutch transsexuals” British Journal of Psychiatry 68 (1993): 681-685. > > 3. Asscheman, Henk et al. “A long-term follow-up study of mortality in transsexuals receiving treatment with cross-sex hormones” European Journal of Endocrinology 164 (2011): 635–642. > > 4. Kesteren, Paul J.M. van and Asscheman, Henk. “Mortality and Morbidity in Transsexual Subjects Treated with Cross-sex Hormones” Clinical Endocrinology 47 (1997): 337-342. > > 5. Murad, Mohammad Hassan et al. “Hormonal therapy and sex reassignment: a systematic review and meta-analysis of quality of life and psychosocial outcomes” Clinical Endocrinology 72 (2010): 214–231. > > 6. Haas, Ann P. et al. “Suicide and Suicide Risk in Lesbian, Gay, Bisexual, and Transgender Populations: Review and Recommendations” Journal of Homosexuality 58 (2011): 10–51. > > 7. Grant, Jaime M., Lisa A. Mottet, Justin Tanis, Jack Harrison, Jody L. Herman, and Mara Keisling. Injustice at Every Turn: A Report of the National Transgender Discrimination Survey. Washington: National Center for Transgender Equality and National Gay and Lesbian Task Force, 2011. Using solely suicides as a metric seems false and to be blunt, pretty unfair and discriminatory. One should be concerned with quality of life, within reason in a prison setting, not the most extreme and eye-catching metric of suicides. There’s a lot of information on the effects of HRT on mood and quality of life. Go to the library and start searching. [Previous page](https://boards.straightdope.com/t/how-far-should-the-prison-system-go-to-accommodate-transpersons/666944.md?page=4)