A Pilot Study of Provision For Transsexual and Transgender People in The Criminal Justice System, and the Information Needs of their Probation Officers

Authors:
Dr Stephen Whittle, Paula Stephens,
The School of Law,
The Manchester Metropolitan University, Gaskell Campus, Hathersage Rd,
Manchester M13 0JA
United Kingdom
Tel: 0161 247 6444, Fax: 0161 247 6309, email: s.t.whittle@mmu.ac.uk

Contents

Background:

1. Previous Research on Transgender and Transsexual prisoners

2. Prevalence of Transsexual and Transgender People in Custodial Settings

3. Issues in the Imprisonment of Transsexual and Transgender People

4. Crimonogenic Factors and the Role of the Probation Service

Aims and Objectives

5. Aims of this Pilot Study

6. Objectives of this Pilot Study

Method

7. A Survey of Probation Service Areas

9. Focus group with Probation Officers from the Bedfordshire probation service

9. Needs Assessment of Transsexual and Transgender People

Results Of Data Collection

10.Results Of Probation Service Survey Including Telephone Interviews

Survey Results Summary

Telephone Survey

Results

11. Results of Focus Group with Probation Officers from The Bedfordshire Probation Service

The nature of the probation officer’s job

The knowledge probation officers have about transsexual social and health care issues

The methods and sources of information pertaining to relevant matters that probation officers would use

When it would be appropriate for a transsexual person to reveal their status to a Probation Officer

The consequences of that revelation, and what methods probation officers can use to ensure their client’s privacy

Follow-on work within the prison environment, and the role of resettlement teams

12. Results Of Needs Assessment Of Transsexual And Transgender People Within The Criminal Justice System

Summary Of Results And Recomendations

National Organisations for Transsexual and Transgender People

Tables:
Table 1: Results of Probation Officer Survey results
Table 2: Needs Assessment on Arrest and Detention (incl. Remand)
Table 3: Needs Assessment on Court Appearance
Table 4: Needs Assessment on Arrival at a Custodial Institution
Table 5: Needs Assessment on Serving a Custodial Sentence
Table 6: Needs Assessment on Rehabilitation and Release

14-05-2001, ã Stephen Whittle v.2

Background

“After spending a short year in prison, most transsexuals will have forgotten what it means to actually be happy.” (Jessica Maria Brooks)ⁱ

1. Previous Research on Transgender and Transsexual prisoners:

Prior to this study, little if any research has been done with transsexualⁱⁱ and transgenderⁱⁱⁱ people who come into contact with the Criminal Justice System (CJS), whether as a victim, witness, offender or employee.

In 1996 Peterson, Stephens, Dickey and Lewis^iv published a survey of the differences in international policies on imprisonment. The authors surveyed the policies of custodial facilities as they relate to transsexual prisoners. The study covered facilities in Europe, Australia, Canada, and the U.S. The survey concluded that of the

“64 corrections departments that responded to the survey, only 20% reported any kind of formal policy in the housing or treatment of incarcerated transsexuals with another 20% reporting an informal policy. Perhaps in itself this should not be surprising since the incidence of transsexualism within the general population is relatively small. However, given the complexities of dealing with such inmates within a prison population, one would have to wonder at the lack of formal policy planning.”^v

In 2000, the Australian Institute of Criminology published Blight’s review^vi of the Australian state policies on transgender inmates. The review considered the matters of:

• Choice of Institution for the housing of transgender inmates
• Self harm and/or Sexual Assault: possible methods of risk reduction
• Hormonal and Surgical Intervention: the basis for provision
• Need for Statistics: the need to identify and record transgender inmates, and further research and policy development

The review concludes that

“Transgender inmates present a unique set of issues that, if not appropriately dealt with, could lead to a greatly increased incidence of assault and self-harm in that population. Failure to implement appropriate policies may also amount to a breach of anti- discrimination legislation and/or human rights obligations.”^vii

2. Prevalence of Transsexual and Transgender People in Custodial Settings

It is known that the social stigma associated with non-conventional gender behaviour or cross-gender identity still leads to social isolation for many transsexual and transgender people. The social stigma takes many forms, from experiencing personal violence in the home and in public arena’s^viii, to job or home loss, financial difficulties, loss of contact with families and communities, and to have great difficulties in their personal relationships. Further factors complicating the lives of transsexual and transgender people include the limited availability of gender reassignment services and the lack of personal privacy due to the failure to legally recognise a change of gender identity^ix.

As such, despite the enormous media interest in the exposure of a transsexual or transgender persons status, and in disclosing the minutiae of their lives, it is surprising that it is so rare to come across news reports of transsexual and transgender people being involved in the CJS.

It is maintained that most transsexual and transgender people will do everything possible to avoid such contact^x. Certainly the experience of the lead researcher has been that, even when victims of serious crime, transsexual and transgender people will avoid making a report and if that is unavoidable will prefer not to have charges pressed. The combination of disclosure of status in court and social reaction often create larger problems in themselves, than the initial crime, for the person involved.

Similarly, it might be considered surprising that so few cases concerning to conviction or incarceration of transsexual and transgender people become known. However despite the social exclusion that they suffer, on interview most maintain that a criminal conviction would lead to the loss of so much, especially access to hormonal and surgical therapy that there is little temptation to consider crime as a possible solution to any problem.

However, some transsexual and transgender people do find themselves charged, and convicted of crimes. In March 2001, Home office minister, Paul Boateng, in reply to a parliamentary question on the prevalence of people within the prison system currently undergoing or requesting assessment for treatment for gender reassignment replied:

“Information is not routinely collected centrally on the number of prisoners with gender dysphoria, or who are receiving treatment for that condition in prison. However, sixteen cases of prisoners needing assessment, care or treatment for gender dysphoria have been drawn to the attention of Prison Service Headquarters in recent years”^xi

Whether this is a true picture of the number of transsexual people currently incarcerated in the United Kingdom’s prison system is difficult to evaluate. Overall, prevalence studies in the general population are very problematic, with little formal ’counting’ of transsexual people being undertaken. Certainly no attempt has been made at counting those people who are transgender - whether because they do not wish to have gender reassignment treatment, are unable to undergo such treatment, or even those who are living in their new gender role but have not yet decided to undertake the route to gender reassignment.

The ’Report of the Interdepartmental Working Group’ on Transsexual People’^xii, published in April 2000 states:

“Studies carried out in the Netherlands suggest that the prevalence of transsexualism is between 1:11,900 and 1:17,000 in men over 15 years of age. The number of female-to-male transsexual people is far smaller, possibly in the region of one to every five male-to-female transsexual people. These estimates are supported by a recent study carried out in primary care units in Scotland which estimated the relevance in men over 15 years at 1:12,400, with an approximate sex ratio of one to four in favour of male to female patients. These studies suggest that in this country there are between 1,300 and 2,000 male to female and between 250 and 400 female to male transsexual people.”^xiii

On that basis, with a male prison population of 58,470 and a female population of 3,150^xiv one would expect 4 or 5 male to female transsexual prisoners and only 1 female to male transsexual prisoner. In reality, despite the answer given by the Home Office minister, when this study was being undertaken, these figures are clearly just the tip of a much more significant figure lurking underneath. During the course of this study, Press For Change the lobby group for transsexual people was approached for contact details of any prisoners they might know currently serving custodial sentences. They gave details of 14 prisoners currently serving sentences that have sought their advice.

Further, the support groups for transsexual and transgender people report a much higher incidence of transsexual and transgender people. For example, the national support organisation for female to male transsexuals has over 430 of its members claiming to be living in their new gender role, and seeking, completing or have completed gender reassignment treatment, out of a total current membership of just over 700^xv. It is highly unlikely that such a group would meet all of its target audience, and it is more likely the case that its membership consists of a minority, albeit sizeable, of the total number of female to male transsexual people in the United Kingdom.

Finally whilst the research was being conducted, in our discussions with Probation Officers, and staff working within parts of the prison service, on several occasions they mentioned transsexual or transgender inmates they were working with or who they had worked with. Most said that the individuals concerned were known by staff and fellow prisoners as transsexual or transgender. Some were receiving ongoing treatment for gender related issues, some were ’living’ in effect in their new gender role, some were not and were seeking assessment or treatment, and some had been transitioned into their new gender role for some time and were simply receiving their continued hormone therapy albeit that they were not able to live in role in their particular custodial setting.

It is our conclusion that albeit that the numbers of transsexual and transgender people in custodial settings is small, it is however almost certainly more than one might expect from current prevalence figures within the general population. It may well be that there are numbers which just do not feature in the official figures as they are not seen as needing special provision.

3. Issues in the Imprisonment of Transsexual and Transgender People

Imprisonment for transsexual and transgender people presents a particular set of problems. Before genital reconstructive surgery, they will almost certainly be incarcerated in a prison for people from their natal sex grouping. In that environment it may well be almost impossible for them to continue or to commence living in their chosen gender role and, if they do, their transsexual or transgender status will always be known by both prison staff and other inmates.

That, in itself, makes them vulnerable to bullying, sexual assault and violence. Further if prisoners have started hormone therapy it may well be stopped in the short term at least whilst consideration is given to its continuance, and for some this can cause particularly distressing problems e.g. baldness in male to female transsexual women, and menses in female to male transsexual men.

The continuance of hormone therapy is very much determined by medical professionals on whether the patient is continuing the ’real life test’ wherein they must live in their new gender role, and often a prison environment makes this virtually impossible. If hormone therapy is to be continued, research has shown that many institutions only permit the continuation of therapy at a ’level’ setting. In other words, even if outside of prison normally the hormonal therapy of an individual would be adjusted to a higher level after some period, within a custodial setting it will only be allowed at those levels prescribed prior to arrival within prison. Further, the same research has shown that, in the USA, where such therapy actually increases feminisation or masculinisation, it will be withdrawn on the basis that the prisoner should be maintained at the same level of body configuration as on their arrival^xvi.

The provision of surgical procedures will rarely be considered by Gender Identity Clinicians unless the ’real life test’ has been undertaken for at least 12 months. Imprisonment will certainly delay any plans for such interventions, and if a long sentence has been received, it may well lead to the end of any such hope on the part of the prisoner.

There are other matters that must also be considered; appropriate and safe housing in prison, the need of the prisoner to feel secure and safe in their appropriate gender role, along with a way of expressing their identity and the re-introduction of the prisoner into society on their release, which can be particularly difficult for transsexual and transgender people who may well have little social support outside of prison.

For many of those transsexual and transgender people who come into the CJS, the Probation Service will provide their main contact with the outside world. They will be viewed as the prime source of support, and they may well be placed in a position of having to quickly gain an expertise and understanding of a matter previously known only through their reading of the popular press. As such, they find themselves seeking help from outside organisations but contact and information can be difficult to find.

Most support organisations for transsexual and transgender people are un-funded, providing support for their current members from stretched resources, and despite good intentions are unable to meet the needs of the Probation officers, or this particularly vulnerable group of people. Some organisations will also feel that they are trying to provide mechanisms of support for those who are trying to ’blend-in’, and as such will regard those who have been convicted of crime as being either troublesome, in that they damage the reputation of other transsexual and transgender people, or likely to have become involved in social crimes such as prostitution which again damage the reputation of others.

As such it is hypothesised that little work has been done as to the unmet needs of transsexual and transgender people in the CJS, that such people face particular difficulties, and methods of meeting those needs have yet to be evaluated and trialed.

4. Crimonogenic Factors and the Role of the Probation Service

The probation services’ primary duty is to protect the public from the harm of those it supervises^xvii. This is achieved, among other things, by the setting of clear objectives based on theoretical or empirical evidence^xviii. It is anticipated that this culminates in a deterrent from re-offending or the elimination of the propensity to re-offend^xix.

As an offender, a transsexual person should be in exactly the same position as any other person who commits a crime^xx. However, the issue of physical determinants that ultimately decide whether a transsexual person is placed in a male or female prison^xxi may be precisely those that contributed to the crimonogenic element that led to the offence being committed in the first place. As Lord Bingham of Cornhill, Lord Chief Justice of England and Wales put it, in his speech to the Probation 2000 Conference:

"Most of us, I venture to think, have never had to resist the temptation to kill, or wound, or rob a bank, or commit rape, or traffic in drugs or forge £50 notes. This does not mean we are better people; it just means that we have been lucky enough to pass our lives in social milieus in which such temptations are not commonly encountered."^xxii

Whilst there are no service guidelines on the treatment of transsexual people by the Probation Service. The treatment of such people is considered locally, taking account of ’local issues’.^xxiii An outcome through which a transsexual offender ceases to re-offend and begins to make a positive contribution to the community (an outcome that the public rightly expects)^xxiv therefore depends on furnishing probation officers with relevant and appropriate support and information so that factors of social exclusion cease to be a crimongenic element in the offender’s behaviour^xxv. As the Lord Chancellor Irvine of Laing proposed to Parliament in his summary — Modernising Justice in 1998:

"The more people are helped to become citizens with a stake in society, the less society has to fear from one of the worst effects, and causes, of social exclusion: crime."^xxvi

Though many offenders, with which the Probation Service come into contact, experience chaotic and disorganised lifestyles^xxvii, research indicates that ’programmes which target needs related offending (criminogenic needs) are likely to be more effective — the need principle^xxviii.

Transsexual people are no different in this respect. However, the ’effective execution of the sentences of the courts so as to reduce re-offending and protect the public’^xxix rely on an effective individually designed ’one-to-one’ offender programme. To be effective, this must take account of the limits of knowledge, skills, and abilities available so that effective team work (which may include ’outside partnerships’) are fully utilised and valued^xxx. The purpose of this pilot study is therefore to assess what knowledge, support, information and skills are available to probation officers supporting transsexual clients.

Aims and Objectives

5. Aims of this Pilot Study:

1. To estimate how frequently Probation Officers are required to work with offenders (or those awaiting trial) who are transsexual or with other offenders who have identified, or who the Officer considers to have an unconventional gender identity, behaviour or lifestyle (transgender people), which may or may not relate to their offending behaviour.
2. To clarify what transsexual and transgender people, who have current experience of the criminal justice system (CJS) as convicted offenders, would consider as their unmet needs in relation to matters that arise from their gender identity and associated medical treatments.
3. To determine which of these unmet needs they would seek help in meeting from their Probation Officers.
4. To ascertain what support Probation Officers would wish to have available in their work with offenders (or those awaiting trial) who are transsexual or transgender.
5. To report on the results of this pilot study, to make initial conclusions as to the unmet needs of transsexual and transgender people who encounter the CJS, and to make recommendations as to future research needs in this area.

6. Objectives of this Pilot Study:

1. To survey several probation service areas, and to determine the prevalence of transsexual and transgender people who encounter the probation services, as offenders or whilst awaiting trial.
2. To contact a group of transsexual and transgender prisoners currently serving custodial sentences.
3. To ascertain from those prisoners what problems arose in the pre-custody period, and during custody, which are related to their gender identity and in which they sought the support, or would have liked to seek the support of their Probation officers.
4. To identify a group of Probation Officers who have encountered transsexual or transgender people as offenders.
5. To ascertain from those officers what problems were highlighted with this group of services users, and what information and support they would have found helpful.

Method

7. A Survey of Probation Service Areas

A 5-question survey was prepared for probation service staff. Liz Stafford of the West Midlands Probation Service forwarded this to several probation areas. The survey was distributed via the ACOP members in various areas, using the internal email system. 172 responses were received from 11 probation service areas. Of these 172 responses, 47% indicated that they had experienced working with a transsexual or transgender person as an offender or as a person awaiting trial.

Telephone interviews were conducted of a random selection of these officers, and 9 interviews have been conducted. The interviews concentrated on

1. Whether the officer felt they had or could access the appropriate information they needed to respond to the client’s questions, requests and perceived needs.
2. What methods probation officers use to access information relevant to a client’s needs
3. What views the probation officers had on their experience of working with transsexual and transgender clients
4. What knowledge probation officers had about transsexuality
5. What particular matters arose with the transsexual and transgender client
6. What sorts of support and information the probation officer would have liked in dealing with these matters

8. Focus group with Probation Officers from the Bedfordshire probation service

An initial focus group was held with 2 transsexual probation service employees: 1 probation officer, and a probation service support worker.

This meeting concentrated on methods whereby probation officers gained information about offenders, particularly before the production of a pre-sentence report.

Time was spent exploring with the officers the ways in which the probation service worked with offenders. Secondly what mechanisms were available to probation officers to gain further information about details they learnt at this stage about the offender, and how they made judgements as to what information they might include in a pre-sentence report and why.

Time was spent focusing on what the officer’s felt might fall within their remit as probation officers.

Following this a focus group was held at the Luton probation service office. This office was chosen as the staff members include a transsexual probation officer, as such the officers had all had some experience of discovering what they did or did not know about transsexuality. The focus group concentrated on the following areas:

1. the nature of the probation officer’s job
2. what knowledge the probation officers had about transsexual and transgender social and health care issues, particularly those matters beyond simply the recognition that individuals would undergo hormonal and surgical treatment
3. the methods and sources of information pertaining to relevant matters that probation officers would use
4. points within the job at which it would be appropriate for a transsexual person to reveal their status, and for the probation officer to act upon the information received
5. the consequences of that revelation, and what methods probation officers can use to ensure that the information does not enter the public domain
6. follow on work within the prison environment, and the role of resettlement teams

9. Needs Assessment from the Interviewing of Former Prisoners and Others.

Two transsexual people who have had prior recent experience of the prison system, one on remand, one as an offender were been interviewed. These interviews were used to evaluate the particular problems, issues and needs that arose both immediately on their incarceration and during the completion of their jail term. A further informal interview was held with a serving prisoner who had personal contact and regular visitation from the lead researcher.

It had been envisaged that the research team would interview several prisoners currently serving sentences. Unfortunately, permission was not forthcoming from the Prison Health Ethics Committee for these interviews to be conducted.

Informal interviews were held in person or over the phone with professionals who work within prison environments including a solicitor, consultant psychiatrist, psychologist, several probation officers.

Informal interviews were held in person or over the phone with transsexual and transgender people who did not have experience of the CJS.

Letters received during the last 4 years by Press For Change (the campaigning group for trans people) from 14 serving transsexual or transgender prisoners were consulted for information.

Results Of Data Collection

Results Of Probation Service Survey Including Telephone Interviews

A 5-question survey was prepared and forwarded to several probation areas. The questions asked officers whether they had encountered transsexual or transgender people, or people they thought may be transsexual or transgender as offenders or as people awaiting trial. They were also asked whether they had encountered people who they considered to have a gender issue which they were unable to classify within the above terms.

172 responses were received, from 11 probation service areas in total. Further responses were received from a Drug Team worker in HMP Littlehey, and a forensic psychologist in the Thames Valley area. Of these 172 responses, 47% indicated that they had experienced working with a transsexual or transgender person, or someone they thought may be transsexual or transgender or had gender identity issues, as an offender or as a person awaiting trial.

Survey Results Summary:

• 30% of the respondent Probation officers had worked with a Transsexual offender
• 12.4% of the respondent Probation officers had worked with a Transsexual person who was awaiting trial
• 10.6% of the respondent Probation officers had worked with a Transgender offender
• 4.2% of the respondent Probation officers had worked with a Transgender person awaiting trial
• 51.2% of the respondent Probation officers had worked with a client who was transsexual, transgender or who had other gender identity issues.

Although survey respondents were more likely to be those probation officers for which the questions provided a note of resonance (because of their work experience), the survey clearly indicates that transsexual and transgender people are not an uncommon feature of the working career of a probation services officer.

Telephone Survey

Ten people were randomly selected from the sample of 172 responses to take part in a semi-structured telephone interview. Whilst the methodology of randomisation meant that a small proportion of those interviewed had never knowingly worked with a trans client, their perceptions were relevant to the aims and objectives of our study. This is especially so, given the strong possibility, as probation workers, that they will be required to support a trans person at some point during their career, as evidenced by our research. The interviews concentrated on the following:

1. Whether they felt they had (or could) access the appropriate information needed to respond to the client’s questions, requests and perceived needs?
2. What methods were (or would) be used to access information relevant to a client’s needs?
3. What were their views (or perceptions) in terms of their experience(s) of working with transsexual and transgender clients?
4. What knowledge did they have about transsexuality?
5. What particular matters arose with the transsexual or transgender client?
6. What sort of support and information would they have liked to have in dealing with those matters?

Results

1. Did you feel you had (or could) access the appropriate information needed to respond to the client’s questions, requests and perceived needs?

   Responses

   • 50% of those interviewed believed they did not have (or could not) access the appropriate information needed to respond to the client’s questions, requests and perceived needs.
   • 20% of those interviewed believed they did have (or could have) accessed the appropriate information needed to respond to the client’s questions, requests and perceived needs.
   • 20% of those interviewed believed they only had limited access to appropriate information needed to respond to the clients questions, requests and perceived needs.
   • 10% of those interviewed believed they did not require information to respond to the clients questions, requests and perceived needs.

   Table 1: RESULTS OF PROBATION SERVICE SURVEY

   Probation Service Area	Tot Res.	TS Off	TS Tr.	MB TS Off	MB TS Tr.	TG Off	TG Tr.	MB TG Off	MB TG Tr.	Oth G.I Off.	Oth G.I Tr.	Nu. Exp	NO Exp
   Bedfordshire	25	9	4	5	4	1	0	4	1	7	3	14	11
   Berkshire	22	6	2	5	2	1	1	3	0	5	1	13	9
   Gtr Manchester	25	5	4	3	0	5	3	2	1	8	5	10	15
   Hereford & Worcester	2	2	1	1	1	1	1	1	1	1	1	2	0
   Humberside	5	2	2	2	1	0	0	0	0	2	1	4	1
   Northamp-tonshire	7	1	0	1	0	0	0	0	0	1	0	2	5
   Northumbria	19	3	0	4	1	3	1	1	0	1	0	4	15
   Nottinghamshire	7	4	3	3	2	1	1	1	1	2	1	6	1
   Oxford & Bucks	14	6	2	4	0	1	0	1	2	1	0	8	6
   West Midlands	13	4	0	5	1	1	0	6	1	3	1	7	6
   West Sussex	28	7	3	5	1	3	0	6	2	5	2	10	18
   Unknown area	4	2	0	3	1	1	0	2	1	0	0	3	1
   TOTAL: Probation Service	170	51	21	41	14	18	7	27	10	36	15	83	87
   Non Prob. officers	2	2	0	1	1	1	0	1	0	0	0	2	0
   TOTAL	172	53	21	42	15	19	7	28	10	36	15	85	87

   KEY
   Tot Res.	Total number of responses
   TS Off	Worked with a transsexual Offender
   TS Tr.	Worked with a transsexual person awaiting trial
   MB TS Off	Worked with an offender who may have been transsexual
   MB TS Tr.	Worked with a person awaiting trial who may have been transsexual
   TG Off	Worked with a transgender offender
   TG Tr.	Worked with a transgender person awaiting trial
   MB TG Off	Worked with an offender who may have been transgender
   MB TG Tr.	Worked with a person awaiting trial who may have been transgender
   Oth G.I Off.	Worked with an offender with a gender issue unable to be classified as transgender or transsexual
   Oth G.I Tr.	Worked with a person awaiting trial with a gender issue unable to be classified as transgender or transsexual
   Nu. Exp	Number of respondents with experience of working with a client with transsexual, transgender or other gender identity issue
   NO Exp	Number of respondents with NO experience of working with a client with transsexual, transgender or other gender identity issue

2. What methods were (or did) you use to access information relevant to a client’s needs?

   Responses

   • Asked client for contact details of medical consultant.
   • Asked client questions to which they provided answers and information.
   • Accessed the Lesbian Gay and Transgender Notice board through an internal database system.
   • Visited the central library but was unable to find anything.
   • Contacted an information unit that had no information.
   • Would contact the gay switchboard, gay press, or local community helplines.
   • Would consult with colleagues.
   • Would engage in a discussion with the client.
   • Contacted a transgender group (known through work in a previous occupation).
   • Attended a presentation by the Gender Trust^xxxi.
   • Would explore what support might be available from an outreach psychiatrist.
3. What are your views (or perceptions) in terms of your experience(s) of working with transsexual and transgender clients?

   Responses

   • Incarceration would cause great problems for a trans person, the environment in which they would be placed being opposite to their orientation. This would lead to difficulties of a psychological nature.
   • Despite obvious problems, trans people would inevitably be placed in custody in any case.
   • Impressions of trans people within the criminal justice system are skewed because professionals only encounter trans people within that particular environment.
   • Trans people require a broad range of support because (as with other members of society) they may also be alcoholics, drug addicts, suffer from depression/anxiety etc.
   • Hostels should have a part to play in picking up the pieces of difficult to place people. Prisons are bound by rules and regulations in terms of how they classify people. Hostels can be more flexible.
   • A trans person would be better off in a hostel environment than in prison because (at some hostels), the environment is divided into two distinct areas, (one being for people of a ’sensitive disposition’). Under this system, a trans person would typically reside in their own room and have the use of a private bathroom. Additionally, (where hostels operate a ’two-file’ system,) access to sensitive information is restricted. This allows information and personal details relating to a trans person’s ’status’ to be kept confidential.
   • The issues raised in working with trans people are complex because of their legal status. This impacts on the availability of accommodation because there is only one hostel available in most areas. Questions therefore inevitably arise about whether a particular person should be placed in a male or female hostel. Even in the case of a mixed hostel, the question remains about whether they should be placed in the women’s bit or the men’s bit?
   • Safety issues must be considered when considering housing trans people. Although some hostels housed clients in single rooms, not all hostels were able to do this. Similarly, while some had a disabled room with an en suite bathroom (ideal for housing trans people) this was not always the case.
   • If the trans person is a Schedule 1^xxxii offender, finding accommodation is difficult. A male (at birth) wouldn’t necessarily be accepted unless they were deemed to be no risk.
   • Never having met a trans person, I would panic and be quite anxious on meeting someone for the first time.
4. What knowledge do you have about transsexuality?

   Responses

   • Whilst I have no idea what medical or personal needs a trans person requires whilst in prison, I know that not all trans people want to go through a physical medical procedure.
   • I felt unskilled and unknowledgeable when meeting a trans client for the first time.
   • I am not aware what special needs and issues are relevant to trans people in custody, although I am aware that a male to female transgender offender would be placed in a male prison.
   • Knowing very little about trans issues I am unable to communicate any knowledge to my client.
   • A trans person would typically feel isolated and have problems with day-to-day interaction. They would also be sensitive about their personal details being known to others.
   • The issues raised in working with trans people are complex because of their legal status.
5. What particular matters arose with the transsexual or transgender client?

   Responses

   • Despite living in a male gender role, the client was placed in a female prison. That caused crisis and problems.
   • The client took on an ambiguous appearance which drew attention to her.
   • The client reacted to her situation by excessive drinking, always turning up drunk. This masked her trans issues.
   • Despite being a post-operative male to female, the client was living in an isolated area where there was no support. As a result of tremendous social pressure she wanted to go back to being male.
   • Though never having worked with a trans person, I would be concerned that people in the office might snigger or make comments.
   • It felt awkward meeting a trans person for the first time.
   • The transgender client was not considered appropriate for surgery or hormones because of a personality disorder.
   • The relationship with the client (a Schedule 1 offender who took hormones) was a difficult one because I had to focus on the potential risk to the public which the client did not like.
   • The first time I worked with a man behaving in a feminine way I felt quite uncomfortable. That uneasiness came across.
   • It caused a bit of problem when a man attended the office dressed as a woman.
   • Although fine with me, the client was quite threatening to other staff - sometimes a victim, and sometimes aggressive.
   • Though living in a traditional sexual role, I think the client was a victim of domestic violence.
6. What sort of support and information would you have liked to have in dealing with those matters?

   Responses

   • It is important to know the terminology. For example, whether a female transsexual person was a male at birth or a female.
   • The experience and support of someone who has been trans for several years or more and who has a broad experience of life.
   • The name of a supportive person (without their own agenda) with knowledge and up-to -date resources.
   • An appropriate entry in NAPO^xxxiii (the national probation officer directory) because every probation office in the country has a copy of this.
   • There wouldn’t be much support or information needed unless the client’s offences were linked to their needs.
   • Access to medical reports to assess a person’s psychological state.
   • A transgender person, accessible by telephone, to answer questions.
   • Trans people to visit probation areas and chat with probation officers so that. This would raise profiles and awareness.
   • Training for probation officers on trans issues.
   • Access to basic information rather than theoretical resources.
   • Although clients’ medical consultants are generally helpful, it would be nice to be able to access information about medical and psychiatric issues so that I could have some picture of what the client is likely to be feeling and going through.
   • Information relating to what a trans person’s needs might be within a prison environment.
   • There isn’t any specific support required other than being listened to by a senior.
   • The level of support that can be provided depends on whether the client raises the issue of being trans.
   • A simple and understandable resource from the Home Office that covers ALL areas of diversity and addiction, etc. This should provide a telephone number for each appropriate agency in the voluntary sector willing to discuss, provide information, and support to professionals in that specific area. However, this would only be useful if those organisations were willing to talk to professionals as professionals and not just about themselves.
   • A central resource unit that had knowledge and experience and could guide you. Somewhere to ring up and say that we have somebody here what do you think we should be looking at?
   • Information via the internet.
   • The help of more understanding colleagues.
   • Information resources, for example, if the person was going into custody, information about what their rights were - e.g. would they go into a male prison?
   • The ability to access information on trans people’s rights generally.
   • Information about what support groups and information resources are out there and which ones can be linked with nationally.
   • A handbook or something would be really useful. What if you’ve got a colleague who’s had gender reassignment? We should be more aware, which I don’t think we are at the moment.
   • Training materials would be useful, particularly if they include reading matter which facilitates understanding of the whole area better.
   • There are a lot of people who are trans who get labelled and that’s not useful. A consultancy and wider-knowledge base should be available to which questions can be referred for specific services.

Results Summary:

1. Of those interviewed:
   • 50% believed they did not have (or could not) access the appropriate information needed to respond to the client’s questions, requests and perceived needs.
   • 20% believed they did have (or could have) accessed the appropriate information needed to respond to the client’s questions, requests and perceived needs.
   • 20% believed they only had limited access to appropriate information needed to respond to the client’s questions, requests and perceived needs.
   • 10% believed they did not require information.
2. When asked what methods were (or would) they use to access information relevant to a client’s needs, those interviewed said they had (or would) seek access through:
   • the client
   • lesbian and gay database/community helplines
   • colleagues
   • libraries
   • information units
   • outreach psychiatrists
   • various transgender and transsexual information and help groups
3. When asked for their views (or perceptions) in terms of their experience(s) of working with transsexual and transgender clients, those interviewed believed:
   • incarceration would cause great problems leading (perhaps) to psychological difficulties
   • despite problems trans people would inevitably be placed in custody
   • impressions of trans people within the CJS are skewed
   • trans people require a broad range of support
   • trans people would be better off in a hostel than prison
   • the issues raised are complex because of the legal status of trans people
   • safety issues must be considered when housing trans people
   • it is difficult to find accommodation for a trans person if they classified as a Schedule 1 offender
   • meeting a trans person would cause them panic and anxiety
4. When asked what knowledge did they have about transsexuality, those interviewed said:
   • they had very little knowledge
   • they had no knowledge and felt unskilled and unknowledgeable
   • not all trans people want to go through a physical procedure
   • a trans person typically feels isolated and has problems with day-to-day interaction
   • trans people would be sensitive to personal details being disclosed
   • the issues raised by working with trans people are complex because of their legal status
   • a male to female transgender offender would be placed in a male prison
5. When asked what particular matters arose with the transsexual or transgender client, those interviewed recalled:
   • despite living in a male gender role the client was placed in a female prison
   • the client took on an ambiguous appearance
   • the client masked her trans issues by excessive drinking
   • the client had no support and experienced tremendous social pressure
   • there were concerns about whether people in the office might snigger or make comments
   • it felt awkward meeting a trans person for the first time
   • the client suffered from a personality disorder
   • the relationship with the client was a difficult one
   • the client picked up on the uneasiness of the probation officer
   • it caused a problem, a man attending the office dressed as a woman
   • the person was threatening to staff
   • the client was sometimes a victim and sometimes aggressive
   • there was a belief the client was a victim of domestic violence
6. When asked what sort of support and information would they have liked to have in dealing with those matters, those interviewed said:
   • a knowledge of terminology
   • the broad experience and support of someone trans for several years
   • the name of a supportive person with knowledge and resources
   • an appropriate entry listing in NAPO.
   • access to medical reports
   • a transgender person accessible by telephone
   • visits by trans people to probation offices
   • training on trans issues
   • access to basic information
   • information about medical and psychiatric issues
   • a senior to listen to their concerns
   • a resource from the Home Office that covers ALL areas of diversity, addiction etc. and includes the telephone numbers of agencies in the voluntary sector providing support and information
   • a central resource unit contactable by telephone
   • information via the internet
   • the help of understanding colleagues
   • information resources (e.g. rights whilst in custody)
   • access to information on trans people’s rights
   • information identifying information resources and support groups through which links could be established
   • a handbook covering trans issues
   • training materials
   • a consultancy and wide-knowledge base to which questions could be referred
   • not much support would be required unless the offence was linked to the trans issue
   • support would depend on the client raising the issue of being trans

11. Results of Focus Group with Probation Officers from The Bedfordshire Probation Service

On 13 January 2001, researchers facilitated a 2-hour focus group meeting at the Luton sessional office, one of 7 petty sessional areas of the Bedfordshire Probation Service.

SELECTION OF PROBATION AREA AND GROUP MEMBERS

The Bedfordshire Service is an example of a service that had successfully managed the transition of a transsexual probation officer, and was known to be interested and proactively involved in developing awareness and improvements in its ability to support its diverse communities, clients and personnel.

From the previous focus group undertaken in Salford, Greater Manchester, of 3 Probation Services transsexual employees it became clear that many officers and other employees within Bedfordshire possessed “actual” experience of working with transsexual and transgender people. To that extent, their knowledge and perceptions of transsexual and transgender people both as “clients” and personnel were more realistically and objective.

ATTENDANCE

The focus group was well-attended by 14 officers possessing considerable “actual” case experience, knowledge and expertise gained over many years’ involvement in varying roles, environments and related occupations. A transsexual woman CARAT^xxxiv worker from Littlehey Prison^xxxv, who had transitioned whilst working in that institution and so able to provide invaluable knowledge and experience of the prison environment.

ISSUES DISCUSSED

The focus group participated in a detailed exploration of 6 primary areas of concern, specifically seeking to ascertain from group participants:

1. The nature of the probation officer’s job
2. The knowledge probation officers had about transsexual social and health care issues, particularly those matters beyond simply the recognition that individuals would undergo hormonal and surgical treatment
3. The methods and sources of information pertaining to relevant matters that probation officers would use
4. Points within the job that it would be appropriate for a transsexual person to reveal their status and for the probation officer to act upon the information received.
5. The consequences of that revelation, and what methods probation officers can use to ensure that the information does not enter the public domain
6. Follow-on work within the prison environment, and the role of resettlement teams

The Nature Of The Probation Officer’s Job

QUESTION: It was asked what powers were available to probation officers to effect a process of recommending a sentence where clients had health-related issues.

RESPONSE: The preparation of a pre-sentence report (PSR) was one of the primary powers available to effect a process of recommending a sentence. The PSR primarily concerned with “the effect that prison would have” on the client, but was also concerned with other issues such as assessing a client’s suitability to complete a period of community service.

Where there were issues of medical concern, the probation officer would typically seeks access to medical information from the client’s GP. This requires the client to sign a consent form granting permission of access.

Because of limits on the time available to complete a pre-sentence interview (PSI) (typically 1 to 1.5 hours), probation officers experience difficulty conveying the relevance of a particular medical issue to the client, and it’s importance in assisting the court to decide what action they should take. It is also difficult, sometimes, persuading clients to disclose medical details to a complete stranger. Whatever provisions the PSR recommended (in the event of a custodial sentence), these would comply within fairly restricted guidelines (for example):

"In one case, it had been made clear to a transsexual remand prisoner that if she returned to the male prison in which she was held, she would not be placed on the health wing because she did not have an illness. However, it was also made clear to her that she could not be placed in a female prison. The issue about where she could safely be held was therefore a real and immediate concern."

On that occasion, the argument was advanced that the offender should reside in a hostel. However, this was difficult to arrange because hostel provision is largely classified as either male or female accommodation with many using shared communal facilities.

The Knowledge Probation Officers Have About Transsexual Social And Health Care Issues

QUESTION: The focus group were asked, in relation to assessing what knowledge probation officers had, to consider generally, how effective clients were at communicating their needs at the PSI stage, prior to a custodial sentence being imposed.

RESPONSE: The view was expressed that the ability of clients to anticipate what problems might arise in a particular situation (e.g. the prison environment) on whether they had previous experience of prison environment

(for example): "One person, who had conveyed clearly at the PSR stage that she did not want to go to prison because, she was not only aware of the effect that the prison environment had on her (as a trans person), but also knew that her presence in that environment impacted on the other prisoners around her. She was only aware of those issues because she had been through the prison system before — the first time without a pre sentence report having first being prepared."

When asked by a researcher to consider (for example) whether probation officers present knew that a post-surgical transsexual woman would need to dilate (often daily) to maintain her vagina, none knew this would be necessary. The ability, at present of probation officers to gain knowledge of such issues depended largely on the client’s ability to assess their own needs and convey those to their Probation Officer. Unfortunately clients who are often socially excluded, and sometimes possess poor communication skills might not know this to be a relevant issue at the PSR stage, and/or be too embarrassed to mention it.

"The ability of clients to anticipate potential issues and convey these to their Probation Officer varied considerably. While some clients said nothing until faced with a crisis in the prison environment, others were articulate and able to eloquently communicate any issues and concerns."

QUESTION: The group were asked if it was acceptable to ask clients whether, at any time, they had undergone any major surgery or taken medication requiring special issues to be considered, in order to investigate how probation officers obtained sensitive information (not always confined to transsexual or transgender people)?

RESPONSE: the consensus was that:

" … a probation officer would never dream of saying to people well are you transsexual to every client who came in just as (they) …wouldn’t say to people well have you had a colostomy?"^xxxvi

However, the officers did point out that the body of the PSR interview that relates to ’Offender Assessment,’ (which is a process often involving open-ended questions relating directly to issues of accommodation, education, employment, health etc.) does provide the opportunity, prior to closing the interview, to ask the client if there is anything else they needed to discuss which may assist the court in deciding how to deal with them?

The Methods And Sources Of Information Pertaining To Relevant Matters That Probation Officers Would Use

QUESTION: The group was asked by a researcher if the probation service sent out material to clients, (prior to the pre sentence offender assessment interview), informing them, amongst other things, about what they can expect to happen during the PSI process, what kind of information will be relevant, and how an accurate and objective report, based on the client’s needs is important to both themselves and the court.

RESPONSE: Some officers were unclear as to whether such information is given to clients on every occasion, but others pointed out that some information is available. This information is provided by County Court Officers whose responsibilities do include providing clients with information “by hand.” Clients are also provided with an appointment letter, prepared by the probation service’s administrative staff. It informs them about the purpose of the PSR interview. Following a PSR request, the client is asked to wait until a probation officer is available to see them. The officer on duty then provides information about what a PSR report is for, so the client is aware of what is going to happen. In normal circumstances, the client’s solicitor will also have knowledge in this area and advise the client accordingly.

QUESTION: The group were asked if there was a mechanism whereby information can be given to those clients who might expect to serve a custodial sentence thus providing them with a realistic appraisal of the prison environment should such a sentence be imposed by the court^xxxvii. An example was given; that it was understood that male prisons had communal shaving areas (for daily use), whereas female prisons only allowed a person to shave perhaps once a week:

RESPONSE: It was stated that all prisons were very different. It was therefore only possible to provide clients with a ’general idea’ of what prison might be like. Further, that as Probation officers did not decide whether a person went to prison or not, it would be ’prejudicial’ to make a judgement as to whether someone would be likely to receive a custodial sentence before furnishing them with appropriate information. However, during the body of the interview, when the issue of custody is discussed, the client could be asked to convey their thoughts in terms of what might happen to them whilst in prison. They can also be asked if they have any particular concerns. In this respect, advice can be provided by probation officers on how to deal with their first day inside.

It was suggested that where a probation officer suspects there to be a deeper issue worthy of exploration this would be explored.

The conclusion of the pre-sentence report specifically deals with issues around what unusually adverse effects a prison sentence might have on a particular client. Consequently, in order to ascertain that information, open ended questions will be asked, effectively reminding the client what will happen unless they include in the report convincing reasons why they should not serve a custodial sentence.

However as it is very much up to the client, to provide appropriate information. But it was recognised that they may lack confidence, communication skills, be stressed and unfamiliar with the process.

There are mechanisms where information which may affect the PSR is divulged, which warrants further research, this can be undertaken after the interview, prior to arranging to meet again. The first point, at which research might start, would be via a through-care colleague, whose role meant they dealt with prisons and prisoners post-release. There is a possibility therefore they might possess information of assistance to the probation officer and client.

QUESTION: Officers were asked "Where would you begin if faced with a person with a particular issue?"^xxxviii

RESPONSE: The group said they would begin by ascertaining "the issues" from the client before seeking their ideas about sources of advice etc. However, courts expect probation officers to verify medical information with the client’s GP, consultant, hospital etc. Such verification requires officers to be "fully informed" about treatment needs etc.

Colleagues within the service would also be an additional resource, if they have encountered a similar issue in the past.

Approaches might also be made through associations or voluntary agencies concerned with a specific issue.

Similarly, probation departments based within prisons would be a useful source of information when addressing a particular issue in the PSR report. This allows the probation officer to ascertain the within the prison environment. Such contact can be made quite quickly by telephone.

While the internet is considered another valuable resource, this presented problems as the group lacked confidence and skills in the use of this particular resource.

Points When Which It Would Be Appropriate For A Transsexual Person To Reveal Their Status, And For The Probation Officer Act Upon The Information Received

QUESTION: The group was asked, having no experience of being in custody, to consider how they would react (as individuals) if they suddenly discovered they might receive a prison sentence.

RESPONSE: In this respect, they considered what hopes they would have immediately prior to the pre sentence interview that would inform them about what issues should be discussed.

One member of the group believed their primary requirement would be for legal advice because things are often said during the pre sentence interview which relate to other offences which haven’t been to court.

QUESTION: The group were asked to consider their child taking the role of the offender. In this respect, they were questioned as to how they would convey the seriousness of the situation (i.e. that their son or daughter must convey to their probation officer specific, sometimes deeply personal and private information if a custodial sentence is to be avoided).

RESPONSE: This was considered by some members of the group to be a very difficult question to ask them as probation officers because they "knew the system." Consequently they would be inclined to "give them lots of pep … stuff about how to influence the PSR."

Another member of the group (not a probation officer) believed she would wish to know "what a pre sentence report was all about, and what it was supposed to do." Apparently, it was reported, this was a typical response.

Probation officers considered these to be difficult questions to answer, particularly if people are unclear about the role of the probation officer when preparing a pre sentence report, which is not one of a friend, but one of providing an objective assessment to the court.

Consequently, it is understandable that some people object to certain things being included, such as a reference to an alcohol problem. This is because (as they didn’t understand what a pre sentence report is actually supposed to do), they often didn’t fully realise there to be an issue which the court needed to know about. It was also a possibility that if the matter related to the offending behaviour, it would give credence to a particular view.

QUESTION: It was asked whether transsexual and transgender people were right to fear that their status would be made public through the court room scenario^xxxix.

RESPONSE: One probation officer believed the issue of confidentiality within the court was a good reason to tell clients not to reveal anything they didn’t wish to be known publicly, though due consideration had to be given to the fact that the court had asked them for their opinion and assessment. Consequently, anything they felt was crucial will need to be referred to in some way — albeit there are different ways of doing that.

It was said that the court can be asked within the pre sentence report to keep certain things confidential, (i.e. it wouldn’t be mentioned in open court), but confidentiality can never be assured because the pre sentence report is sent to the prison.

QUESTION: The officers were asked, when referring people to a different probation service area or agency, what sort of information passes between the two, is it selective, or is the "entire range" of information passed on?

RESPONSE: Where another probation service is involved, all information is passed on.

If another agency is involved, then the probation officer tries to discuss and agree the kind of information that will be provided. This is dependant on the signed consent of the client, which is dependent on the client possessing the necessary confidence to be open about their situation if they are to be helped in any way.

QUESTION: It was asked whether that a discussion might take place with the client, during which they would be able to negotiate what approach will be most appropriate (i.e. how much did they wish to go into the report and what would the potential consequences be if this or that actually went in).

RESPONSE: there is a fine balance, with officers not wishing to facilitate discrimination by including issues that are unconnected with the offending behaviour yet which might ultimately affect the court’s perceptions of the client affecting the sentence imposed.

There were two things though that needed to be considered

• whether an issue was relevant to the offending behaviour, and
• whether it is relevant to the effect of a particular sentence.

For example, in respect of transsexual and transgender people, where the offence is be related in some way to prostitution, its relationship with that lifestyle invariably initialised through a necessity to raise money for treatment. Ultimately this fed into the stereotype perception of the transsexual or transgender person as someone involved in prostitution.

One member of the group believed it is important that prisons have as much information as possible about the offender - including those matters which the offender might seek to keep confidential. Her opinion is that a prison cannot assist people unless they are aware of all the issues. She believes one person had died in custody because a prison had been unaware of information that they needed to know about an inmate.

However, she was also aware (in respect of the case of one transsexual prisoner) that there were people prepared to kill that person simply for being transsexual. She believed this to be clear evidence, that it is important for the therapeutic staff within a prison to make the disciplinary staff aware of the things that are going on.

Group members confirmed that, where a custodial sentence is imposed, sealed envelopes are dispatched to the prison containing pre sentence reports, psychiatric reports and post sentence interview details (e.g. whether the prisoner would be a suicide risk or not). A copy will also go to the Governor of the prison, the discipline staff, and the probation department at that prison.

QUESTION: Could any use be made of post-sentence reports, where a prisoner fail to disclose their transsexual or transgender status until after sentencing?

RESPONSE: Post sentence reports are completed in the cells of the court. It involves the completion of a form — basically concerned with ascertaining if there is a risk of self-harm — though other issues (such as health or family matters) are covered as well. Therefore they are a possible point of intervention although it was important to allow every possible issue to be dealt with at the pre sentence report stage, if at all possible.

However, it was pointed out by one probation officer within the group that:

" … because of time pressure on the court, a post sentence report doesn’t always take place. Whilst a prisoner could ask to see a probation officer following the sentence being delivered: " … if the van’s ready … then they’ll go."

The Consequences Of That Revelation, And What Methods Probation Officers Can Use To Ensure That The Information Does Not Enter The Public Domain

QUESTION: What is the attitude of prisoners to transsexual or transgender people?

RESPONSE: As there are specific medical needs that are crucial to the maintenance of the transsexual individual’s well being, yet inherently embarrassing to talk about, they must be addressed.

When a transsexual person arrives in the prison system, they may be unable to see a health officer for some time, therefore some form of medical input from a practitioner as well as a separate psychiatric report might be beneficial in facilitating the proper medical care of the individual concerned.

It was deemed important, in terms of points of intervention, that the trans community needs to be aware that, in the event of an offence being committed, a custodial sentence might be recommended. It is therefore crucial to find some way of getting the message over to that community that it is both possible and essential to provide whatever intimate medical and personal information is relevant to their probation officer at the earliest opportunity. Such information has to be disclosed early in the process since there is a great deal of pressure on the amount of time probation officers are able to devote to clients on their case load.

Most officers readily admitted they had no idea of the general health and well being issues of transsexual people, beyond acquiring the ’sex-change operation. Other matters such as shaving, dilating or any other physical implications were completely unknown.

"Anything that could be made available in written form, and which could be easily referred to, dealing with the different stages of transition and the physical implications of that at a practical day-to-day level (such as shaving) would be really useful, since (as discussed earlier) if the client had never been to prison before, they themselves wouldn’t necessarily know it was an issue."

"Such information, if available in bite-size chunks, would mean that anticipating or dealing with potential issues whilst in custody (or even in the community) was not dependent on the knowledge or skills of the client. An easy resource pack dealing with the different stages of transition, completion, and implications on a day-to-day basis would certainly facilitate that."

"While such readily available information didn’t need to be "in the desk drawer" it did need to be within the resource office, or at least, in the event that the resource office was unable to provide answers comprehensively, it needed to be able to provide pointers — somewhere where information could be accessed (e.g. the internet or by telephone). However, it was essential that there was a "starting point" such as the resource office, to enable that process."

However, though useful, such information would only assist probation officers dealing with clients who were willing to disclose their status.

QUESTION: In the event that a person did not disclose their status, would the probation officer feel able to raise the issue.

RESPONSE: Many officers believed they would feel uncomfortable raising what, for them, they considered to be a taboo subject (even if a gender issue was apparent). It was suggested this situation might improve if there was training on transsexual and transgender issues, something that wasn’t at present covered.

An alternative view put forward is that the problem with more specific training is that so many different areas need to be covered because there are so many forms of discrimination, ("where do you start … where do you stop … and you can just go on forever").

However, probation officers believe the issue can be raised in other ways, for example, by asking the client whether they believe there might be any difficulties for them within a prison environment. Similarly, they might be asked if they have ever experienced bullying or discrimination. This approach, it was believed, might provide a useful key to unlocking the information sought, thus providing the client with the impetus to disclose the issue themselves.

It was certainly felt that the trans community should be aware that, in such circumstances, it was imperative they make their probation officer aware of their circumstances.

One member of the group however, believed that some transsexual people will not wish to be treated as "a transsexual" but as "whole person," someone for whom being "transsexual" is a minor part of their personality etc. However, this did not mean that their probation officer should not have ready access to information or, for that matter, that it was in the client’s interests not to disclose the issue, though it should be up to them.

QUESTION: Does the probation service provides clients with information informing them about what a pre sentence report actually is, and what it is intended to achieve PRIOR to attending for interview. They were also asked whether the opportunity to consider issues such as disclosure (particularly given that a court may impose a custodial sentence), is provided to the client PRIOR to the interview taking place — perhaps a fortnight or more before.

RESPONSE: It was suggested that a tick list format, followed by real case scenarios, such as requiring stoma care, diabetes, epilepsy, transsexual or transgender health care might provide both an opportunity for the client to consider what personal issues might be relevant and in their interests to disclose, along with the opportunity to consult with their GP, social worker etc.

It would also allow the probation service as a whole to demonstrate that transsexual or transgender issues are of real concern and ones which are more frequent than the client might think and for which resources and support available.

The quality of through care of prisoners varies enormously throughout the country. A view was expressed that:

" … prison tended to provide offenders with a willingness to leave behind the person and an opportunity to "re-invent themselves … it often brings to the gender issues to the fore because prisoners see their probation officer as somebody they can talk to in confidence."

On one occasion, when a prisoner’s female clothes had been confiscated, the probation officer was able to get those returned and arrange for a member of the Beaumont Society^xl to visit. The Beaumont Society had been contacted because the probation officer involved had previously worked as a psychosexual therapist so had knowledge of additional sources of support and information. If that had not been the case, the officer would have probably contacted the Citizen’s Advice Bureau or an organisation of that kind.

Many such organisations are listed in the back of Probation Service Diaries, but this listing could be extended to include far more organisations that currently exist, and be kept up-to-date.

Follow-On Work Within The Prison Environment, And The Role Of Resettlement Teams

QUESTION: The group were asked, in respect of the resettlement process, to explain their role as through care officers, particularly in respect of the provision, help or guidance they were able to provide in facilitating access to accommodation, employment, identifying support sources, and assisting people to get jobs etc.

RESPONSE: The provision of hostel accommodation posed a particular problem for transsexual and transgender people because it is usually designated for a single gender (e.g. either male or female accommodation). Despite this, for many transsexual or transgender people, the issue of accommodation is particularly crucial, particularly because, during the process of transition, they are often extremely vulnerable, (physically as well as mentally)^xli.

The probation officer’s role is primarily concerned with protecting the public and preventing the offending behaviour. Consequently, just because a client has problems, unless those are related to the offence, it did not necessarily fall within the probation officer’s remit to deal with these. There were other agencies and partnerships who could provide assistance and support much better than the probation service could.

In terms of through care, it was pointed out that trans issues (as with any other diverse community) are multi-factoral (for example) a socially excluded trans person living on the periphery of society may also be a recovering addict, suffer from depression and anxiety, use alcohol or drugs. Consequently, in addition to requiring rehabilitation facilities, which were limited and difficult to find in any case, there may also be a need to find rehabs that can facilitate the needs of transsexual or transgender people (i.e. cross dressing). It was suggested that since the rationale was that the primary focus was essentially concerned with the needs of the individual, these should be the main priority.

One member commented that if hostel places are unavailable for transsexual or transgender people who are vulnerable, then some probation hostels could be allocated specifically to cater for the needs of trans people.

It was also suggested that a local trans group or support organisation etc. should be approached in order to develop a relationship with a local probation office, which they could visit in order to bring along up-to-date information. The group believed it would be helpful if someone from outside the organisation were able to visit and be a source of information.

Despite there being some transsexual or transgender people employed by the probation service, it is considered unfair to expect them to be the source of all information.

Results Of Needs Assessment Of Transsexual And Transgender People Within The Criminal Justice System

There have been several calls for needs assessments to be made for transsexual and transgender people. However, few assessments have been made^xlii. The evaluation of the needs of those who find themselves involved with the CJS, are notably lacking.

In this study due the failure to manage to gain permission to formally interview prisoners who are transsexual or transgender, the needs assessment has to be based on:

• limited interviews of former prisoners
• an informal discussion with a current prisoner
• letters received by Press For Change from serving prisoners, over the last 4 years
• interviews with transsexual and transgender people who do not have experience of the CJS
• the detailed knowledge of the researchers, who are themselves both transsexual people
• informal discussions with professionals who work within prison environments including a solicitor, consultant psychiatrist, psychologist, several probation officers
• previously published work in this area

This needs assessment considered 5 stages of the process of involvement with the CJS:

• Arrest and Detention (including remand)
• Court Appearance
• Arrival at a custodial institution
• Serving a prison sentence
• Rehabilitation and Release

Each stage is considered in the light of the following stages in a transgender or transsexual person’s process, with separate reference where necessary to the distinct needs of ’female to male’ and ’male to female’ people :

• prior to transition to the new gender role
• post-transition but prior to completion of all desired surgical procedures
• completed procedures including where appropriate genital reconstructive surgery

The needs assessment considered the following areas of life in pre-custodial and custodial institutions

• housing
• personal appearance and personal expression
• the right to personal privacy in relation to:
  

  personal status
  bodily morphology
  medical confidentiality

• accessing or continuing medical therapy and surgical procedures
• personal safety both from self-harm and assault (sexual or not)

The results of the needs assessment are contained in Tables 2 to 6. Broadly the results may be summarised as :

1. Needs are different at different stages within the CJS.
2. The need for respect of the individual’s chosen path is crucial, such as using appropriate gender pronouns and name at all times.
3. There is a need to have respected the individual’s ability to contribute to the decision making process e.g. about where to be housed within a facility, about how a search is to be conducted, about their own health care needs.
4. Bodily integrity is crucial to the transgender and transsexual person. Consideration needs to be given to how personal privacy, whether for bathing, medical care, searching, or simply shaving or breast binding can be given.
5. A mechanism needs to be developed which would enable a medical assessment file to be created to follow the prisoner, from the point of sentencing to release.
6. Prompt assessment of medical needs is required on entering a custodial institution, whether the prisoner is pre-transition, post-transition or post-operative, so enabling continuity of care.
7. There are specific medical, personal and social needs relating to pre-operative and to post-operative transsexual people, relating to their continuation upon their chosen pathway. These need to be assessed on a personal basis, before receiving a sentence for a term of imprisonment, and to be reassessed during the term of imprisonment.
8. Medical needs are not just related to the process of obtaining gender reassignment, but also to the consequences of treatment for gender reassignment.
9. There is a need to respect the confidentiality of medical care and circumstances, and not to make unnecessary disclosure about the trans’s person’s status to other prisoners or staff, without an informed decision being made by the trans person and their express permission being given, if at all possible.
10. Rehabilitation requires a successful re-integration into society. For many transsexual and transgender people this is only possible if they are able to return to society successfully into their new gender role. Consideration needs to be given to enabling them to leave a prison of the appropriate gender role even when pre-operative, and to ensuring that their leaving records

 

NEEDS ASSESSMENT: Table 2: Arrest and Detention (including Remand) :

	prior to transition to the new gender role	post-transition but prior to completion of all desired surgical procedures	completed procedures including, where appropriate, genital reconstructive surgery
housing		to be placed in police station facilities of appropriate gender	to be placed in police station or remand facilities of appropriate gender
personal appearance and personal expression	Not to have differently gendered underwear or other clothing items commented upon	to be referred to using appropriate gender pronouns to be given facilities to adjust clothing, wigs, makeup if needed to maintain gendered appearance to be allowed to shave (mtf) if needed, particularly before court appearance	to be referred to using appropriate gender pronouns to be given facilities to adjust clothing, wigs, makeup if needed to maintain gendered appearance to be allowed to shave (mtf) if needed, particularly before court appearance
the right to personal privacy in relation to: personal status bodily morphology medical confidentiality	Not to have transgender status disclosed unnecessarily or made known to significant others who do not otherwise know	Not to have trans status disclosed unnecessarily, particularly to press or to employer. or other prisoners not to be required to undress unless essential to investigation and arrest To be consulted over sex of searching police officer, and provision to be made for appropriate privacy where search involves removal of clothing	Not to have transgender status disclosed unnecessarily, particularly to press, employers or to significant others who do not otherwise know, or to other prisoners not to be required to undress unless essential to investigation and arrest to be searched by police officer of same gender role to be given appropriate toilet access is standing urination is not possible (ftm)
accessing or continuing medical therapy and surgical procedures	to be allowed to take hormone therapy as required by current health care programme	to be allowed to make personal medical and health care e.g take hormones as required by current health care programme	to be allowed to make personal medical and health care e.g take hormones, or to dilate where post-operative care of neo-vagina is required (mtf) as required by current health care programme
personal safety both from self-harm and assault (sexual or not)	to be housed away from other prisoners in circumstances where full supervision cannot be provided, and there is any risk of assault	to be (exceptionally) housed away from other prisoners in circumstances if full supervision cannot be provided, and there is any risk of assault	to be (exceptionally) housed away from other prisoners in circumstances if full supervision cannot be provided, and there is any risk of assault

 

NEEDS ASSESSMENT: Table 3: Court Appearance:

	prior to transition to the new gender role	post-transition but prior to completion of all desired surgical procedures	completed procedures including, where appropriate, genital reconstructive surgery
Housing
personal appearance and personal expression		to be allowed to attend court in appropriately gendered dress without comment to be referred to using appropriate gender pronouns
the right to personal privacy in relation to: personal status bodily morphology medical confidentiality	to not have trans status disclosed in open court, if not relevant to the matter being tried If trans status is relevant consideration to be given to restricted reporting order being made	to not have trans status disclosed in open court, if not relevant to the matter being tried If trans status is relevant consideration to be given to restricted reporting order being made	to not have trans status disclosed in open court, if not relevant to the matter being tried If trans status is relevant consideration to be given to restricted reporting order being made
accessing or continuing medical therapy and surgical procedures	If an appearance for sentence, full preparation to be made for possible custodial sentence including preparation of personal file with details of on-going medical programme, and other relevant matters	If an appearance for sentence, full preparation to be made for possible custodial sentence including preparation of personal file with details of on-going medical programme, and other relevant matters	If an appearance for sentence, full preparation to be made for possible custodial sentence including preparation of personal file with details of on-going medical programme, and other relevant matters
personal safety both from self-harm and assault (sexual or not)

 

 

NEEDS ASSESSMENT: Table 4: Arrival at a Custodial Institution:

	prior to transition to the new gender role	post-transition but prior to completion of all desired surgical procedures	completed procedures including, where appropriate, genital reconstructive surgery
housing		to be housed in facility of appropriate gender role	to be housed in facility of appropriate gender role
personal appearance and personal expression		to not have gender role commented on inappropriately to be referred to at all times by appropriate gender pronouns, and by new name
the right to personal privacy in relation to: personal status bodily morphology medical confidentiality		to shower privately away from other prisoners to shave if needed (mtf) to be able to retain and maintain current medication	to be able to retain and maintain current medication
accessing or continuing medical therapy and surgical procedures		to have prompt access to medical services to maintain continuity of gender reassignment treatment	to have prompt access to medical services to assess continuing health care needs, including specific post-operative and hormonal needs, and contra-indications that arise e.g. osteoporosis (mtf & ftm), deep vein thrombosis risk (mtf) and liver damage (ftm)
personal safety both from self-harm and assault (sexual or not)		Accommodation should be made available affording personal bodily privacy, and safety, but not in isolation N.B. Where a facility of the appropriate gender have not been made, for whatever reason, then it must be recognised that safety may well prove more problematic (mtf)

 

 

NEEDS ASSESSMENT: Table 5: Serving a Custodial Sentence:

	prior to transition to the new gender role	post-transition but prior to completion of all desired surgical procedures	completed procedures including where appropriate genital reconstructive surgery
housing		to be housed in facility of appropriate gender role, affording personal bodily privacy without complete isolation
personal appearance and personal expression	to access electrolysis services if needed (mtf) to be allowed appropriate gender or unisex clothing where possible e.g. underwear in a male facility (mtf), masculine trousers in a female facility (ftm)	to have facilities for wig care if needed, including access to outside specialist facilities (mtf) to access electrolysis services if needed (mtf)	to access electrolysis services if needed (mtf) to have facilities for wig care if needed, including access to outside specialist facilities (mtf)
the right to personal privacy in relation to: personal status bodily morphology medical confidentiality	to be allowed to register for educational courses in new name and gender	to not have trans status disclosed to other prisoners to have privacy for bathing, showers etc. to have recognised the limitations afforded by breast binding (ftm) and wig wearing (mtf) such as the difficulties of working in very warm environments, or in very physical jobs. to be allowed to register for educational courses in new name and gender	to not have trans status disclosed to other prisoners to be afforded privacy for regular dilation of neo-vagina (mtf)
accessing or continuing medical therapy and surgical procedures	to be allowed to continue medical assessment if commenced prior to incarceration, including continuation to ’Real Life Test’ and surgical procedures if appropriate (particularly if a long term of imprisonment)	to be allowed to continue ’Real Life Test’ and to commence surgical procedures if appropriate (particularly if a long term of imprisonment)	to be allowed regular checks of hormonal efficacy, and threat of deep vein thrombosis (mtf) and liver damage (ftm) to be allowed to consult appropriate gender specialists if post-operative problems occur
personal safety both from self-harm and assault (sexual or not)	to be afforded enhanced safety consideration in the event of the trans status being visible to other prisoners	to be housed in facility affording personal bodily privacy, and safety away from other prisoners, without complete isolation (mtf)

 

NEEDS ASSESSMENT: Table 6: Rehabilitation and Release:

	prior to transition to the new gender role	post-transition but prior to completion of all desired surgical procedures	completed procedures including where appropriate genital reconstructive surgery
Housing		If placed in bail hostel or similar, to be placed in facility of appropriate gender role	If placed in bail hostel or similar, to be placed in facility of appropriate gender role
personal appearance and personal expression
the right to personal privacy in relation to: personal status bodily morphology medical confidentiality		to be released from a facility of the appropriate gender role, enabling a successful re-integration into society in that role to have removed from prison release documentation any reference which might disclose former gender role or trans status	to be released from a facility of the appropriate gender role, enabling a successful re-integration into society in that role to have removed from prison release documentation any reference which might disclose former gender role or trans status
accessing or continuing medical therapy and surgical procedures	to have pre-release medical file prepared containing details of all ongoing medical treatment, for continuation of provision on release	to have pre-release medical file prepared containing details of all ongoing medical treatment, for continuation of provision on release	to have pre-release medical file prepared containing details of all ongoing medical treatment, for continuation of provision on release
personal safety both from self-harm and assault (sexual or not)

Summary Of Results And Recomendations

Accepting that at any time there will be a significant number of transsexual and transgender people involve with the CJS and that transsexual and transgender people who offend should be in no different situation than any other similar offender, it needs to be acknowledged that transsexual and transgender people are likely to have chaotic and disorganised lifestyles, which contribute to their crimonogenic behaviour. This chaos and disorder often results from the social stigma surrounding the trans person’s existence.

Thus for rehabilitative measures to have any chance of working, it is imperative that the social stigma and prejudice is not continued within the CJS and positive steps are taken to advance the social well being of the trans person.

Thus effective practice with transsexual and transgender people in the CJS needs to ensure

• safe housing, appropriate to gender role and that solitary confinement is not a satisfactory placement for accommodation
• the right to continue reasonable expression of the personal sense of gendered self and appropriate related personal appearance
• the right to personal privacy
• medical confidentiality
• commencing or continuing the medical therapy and surgical procedures
• personal safety both from self-harm and assault (sexual or not)

Each of these areas needs different considerations at the times of

• Arrest and Detention (including remand)
• Court Appearance
• Arrival at a custodial institution
• Serving a prison sentence
• Rehabilitation and Release

There should be separate and different consideration of the distinct needs of ’female to male’ and ’male to female’ people :

• prior to transition to the new gender role
• post-transition but prior to completion of all desired surgical procedures
• completed procedures including where appropriate genital reconstructive surgery

Transsexual and transgender people should be asked what gender pronouns and name they would like using.

Appropriate gender pronouns and name should be used at all times, by all staff within the CJS.

There is a need to have respected the individual’s ability to contribute to the decision making process concerned with social factors during their incarceration, particularly as to issues of disclosure of their status to family members, employers, co-workers, court and prison staff and fellow prisoners .

Bodily integrity is crucial to the transgender and transsexual person, just as it is to other inmates. Particular consideration needs to be given to how personal privacy, whether for bathing, medical care, searching, lavatory use, shaving or breast binding can be given.

In order for continuation of care and appropriate social acceptance, a mechanism needs to be developed which would enable a medical and social well being assessment file to be created to follow the prisoner, from the point of sentencing to release.

Prompt assessment of medical needs is required immediately on entering a custodial institution, whether the prisoner is pre-transition, post-transition or post-operative, so enabling continuity of care.

It must be recognised that medical needs are not just related to the process of obtaining gender reassignment, but also to the consequences of treatment for gender reassignment.

Accepting that the Probation Services’ primary duty is to protect the public from harm by the setting of clear objectives based on theoretical or empirical evidence and that this culminates in a deterrent from re-offending or the elimination of the propensity to re-offend through the supervisory and rehabilitative processes, and

That the Probation Service is in the unique position of following offenders through from the pre-sentencing stage to the post-release stage of punishment,

Probation Service officers should collate the information needed to determine the needs of individual transsexual and transgender people who are offenders and ensure the regular updating and safe passage of such information as it follows the prisoner from arrival in a custodial setting to their release and re-housing within the community.

In order to meet this requirement successfully, probation service officers need to communicate the need for full disclosure of possible needs by transsexual and transgender people.

This should be facilitated by sending, to all people facing a Pre-Sentence Report, a clear leaflet explaining why they are having a PSR, what a PSR will inform the court of and what will be the consequences of failing to disclose relevant matters at this stage

This leaflet should include, amongst other conditions, specific mention of transsexual and transgender people and the sort of matters that might be relevant.

Probation officers should be provided with easy to access information about transsexual and transgender people, not just about support groups but also about the day to day aspects of life which might be relevant to a custodial period.

This information should include a ’tick list’ relating to day to day health and social welfare issues for transsexual and transgender people, enabling the probation officer to cover the relevant matters.

This information should be commissioned from a reputable organisation or specialist working in the field of gender dysphoria.

The Probation Service diary should include details of support groups for transsexual and transgender people.

Such support groups should be helped provide guidance to their members on the ways in which their members could help the probation service when its officers are working with transsexual and transgender people, such as

• the development of an ’adopt your local Probation Service’ project
• providing relevant information to their membership

The Courts should give consideration as to whether a person’s transsexual or transgender status is relevant to the matter before them, and even where it is, whether that matter can be restricted from the public domain.

In the event that disclosure of the trans status is not made before sentencing, but within the court buildings before transfer to a custodial institution, the post-sentence report should be used to raise the relevant matters.

In the event of disclosure being made on arrival at a custodial institution, separate housing should be immediately provided for the inmate and within 24 hours a probation officer should be contacted to make an urgent visit to draw up a new post-sentence report.

Wherever possible, bearing in mind the need for personal safety, housing should be provided in an institution of the appropriate gender role, as lived.

Medical provision related to gender dysphoria should be provided on the same basis as if the person was free within the community (It should be recognised that this may lead to the ’coming out’ of a number of transsexual prisoners who have previously felt the system could ’offer them nothing’).

Wherever possible, if a person has not been able to be housed within a facility of the appropriate gender, the individual should be able to leave custody from an appropriately gendered facility.

All records, including educational and work records should be made in the name and gender that the person intends to live in when they leave the institution.

The person should leave with a complete medical file detailing their treatment to date, and on-going medical concerns.

It is also recommended that further research, and policy development is needed in this area to:

• Provide an outline of the ’normal’ gender reassignment process (including transition between genders) covering both NHS and Private routes as a basis for comparison.
• Discover examples of current best policy and practice related to transgender and transsexual people, and to ensure the greater exchange of excellence.
• Create guidelines for policy and practice, relating to transgender and transsexual people who have contact with the different parts of the CJS, particularly in relation to accessing different aspects of the transition and gender reassignment processes.

• Monitor the incidence of re-offending by transgender and transsexual people, to observe where guidelines have or have not been observed and to compare these with national levels of re-offending.
• Monitor the types of offences committed by transgender and transsexual people and whether there are any factors related to their trans status
• Develop links between transsexual employees within CJS
• Consider at what stage it is appropriate to change an individual’s name and gender indicator on criminal records.

National Organisations working with Transsexual and Transgender People

GENDER TRUST: PO Box 3192 Brighton BN1 3WR. 01273 424024 (office hours)

http://www.gendertrust.org.uk/
Helpline: 07000-287878 (7pm-11pm, Thurs). Information line: 07000 790347

Offers advice and support for transsexual and transgendered people, especially “male-to-female”, and to partners, families, carers and allied professionals. Has a membership society and produces a magazine: “Gems”.

FTM NETWORK: BM Network London WC1N 3XX.

http://www.ftm.org.uk/
Helpline: 0161-432 1915 (Wednesdays 8pm - 10.30pm only)

Offers advice and support to “female-to-male” transsexual and transgender people, and to families and professionals. Also a “buddying” scheme, newsletter: “Boys Own” and an annual national meeting.

BEAUMONT SOCIETY: BM 3084, London WC1N 3XX.

http://www.beaumontsociety.org.uk
Helpline: 07000-287878 (7pm and 11pm, Tues), Information line: 01582 412220

Provides advice and support for transvestite people, but also has some transsexual members. Runs local groups and produces a newsletter and publications.

MERMAIDS: BM Mermaids London WC1N 3XX.

http://www.mermaids.freeuk.com
Helpline: 07071 225895 (12noon to 9pm).

Support and information for children and teenagers who are trying to cope with gender identity issues and for their families and carers. Please send SAE for further information.

GIRES: Gender Identity Research and Education Society: Melverley, The Warren, Ashstead, Surrey, KT21 2SP

http://www.gires.org.uk
Telephone: 01372 801554

Exists to promote and communicate research that improves the lives of people affected by gender identity and intersex issues.

PRESS FOR CHANGE: BM Network London WC1N 3XX.

http://www.pfc.org.uk
In emergencies ONLY ring 0161-432 1915.

Campaign for equal civil rights for transsexual and transgendered people. Also provides legal help and advice for individuals, information and training for professionals, speakers for groups. Produces a newsletter and publications. Please send SAE for further details.

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