Recommended Guidelines for the Residential Placement and Support of Transgender Individuals within Social Service, Mental Health and Correctional Settings

Caution: A full understanding of these Guidelines will not be possible without reading the material contained within the Mental Health section. Additional information on institutionalized individuals is included in the Populations section.

1. It is recognized that transgender identification and gender identity issues are not mentally disordered, diseased or pathological. Thousands of transgender individuals lead well-adjusted lives as productive and law-abiding participants in society.

2. Transgender individuals are not known to have a higher incidence of mental health disorders than the general population, although stereotypes, social isolation and prejudice are known to exacerbate circumstantial difficulties within the lives of transgender people.

3. Because it is recognized that transgender identification and gender identity issues are not pathological conditions, the presence of a transgender identity or fulfilling transgender needs (such as a desire to cross-dress or live "in role," pursuing and undergoing hormone administration or Aesthetic or Genital Reassignment Surgery) is not a reason to institutionalize, incarcerate or unnecessarily detain transgender individuals within mental health, correctional or similar residential facilities.

4. Residential placement decisions within mental health, social service, and correctional settings are advised to take into account an individual's current gender presentation and her or his actual placement request, as well as the individual's gender-related history. Placement decisions should also take into account the needs of other populations served at the receiving facility, although any decisions made should not prove discriminatory to any population.

5. Where uncertainty exists with regard to residential placement and support services or where careproviders are unfamiliar with gender identity issues, a Gender Specialist should be consulted for assistance in the negotiation and evaluation of placement decisions, as well as for staff and peer sensitivity training.

6. Residential or correctional staff are advised that hormone administration should not be denied transgender individuals when they have a verifiable history of hormone usage, or when they fall within the criteria established in the Recommended Guidelines for Hormone Administration. Staff and physicians are reminded that within Article 1b of the aforementioned Recommended Guidelines, exceptions to the three month assessment period may be considered by the evaluating Gender Specialist or prescribing physician if a well-established transgender identity exists and when other aspects of the Recommended Guidelines for Hormone Administration are observed.

7. Residential staff and correctional officers are advised to refer to transgender individuals in a manner respectful of the individual's stated preference for gender presentation and name/pronoun usage requests. They should also direct peers to respect the gender self-identification of transgender residents.

8. Residential staff and correctional officers are advised that some transgender individuals may be unable to voice their gender identity related needs after suffering a crisis situation. Therefore, residential staff and correctional officers are advised to consult a professional consultation with a gender specialist whenever they are aware that an individual is transgender-identified but unable to speak on her or his own behalf.

9. Residential staff and correctional officers are advise that in order to maintain their gender identification transgender persons need gender-specific clothing, cosmetic and toiletry supplies. Male-to-Female individuals typically need shaving razors, cosmetics (lipstick, blush, foundation, mascara), brassiere, female clothing, etc. Female-to-Male individuals typically need binding material (large-size ace bandages), prosthesis, and small-size shoes. Supplies for transgender persons may need to be "exception" or "catalog" ordered if not included on standard residential or inmate supply order forms. Small-size shoes and large-size clothing may also need to be catalog ordered

10. Transgender individuals, in their interactions with mental health and social service providers, are advised that many staff and correctional officers may be unfamiliar with transgender identification and needs. With this understanding, transgender individuals are advised to express placement requests and support needs and to be prepared to explain their needs in calm, consistent, easy-to-understand language. If a careprovider or correctional officer seems unfamiliar with gender issues, and the needs of the transgender individual are not being met, the transgender person is advised to request to speak with a supervisor, or to ask that the agency consult with a Gender Specialist regarding transgender needs.