Improving Transgender Healthcare in the New York City Correctional System
PURPOSE:
Correctional
settings create unique challenges for patients with special needs, including
transgender patients, who have an increased rate of overall discrimination,
sexual abuse, healthcare disparities, and improper housing. As part of our
correctional health quality improvement process, we sought to review and
evaluate the adequacy of care for transgender patients in the New York City
jail system.
METHODS:
Using
correctional pharmacy records, transgender patients receiving hormonal
treatment were identified. A brief in-person survey was conducted to evaluate
their care in the community before incarceration, medical care in jail, and
experience in the jail environment.
RESULTS:
Survey
findings and analysis of transgender patient healthcare-related complaints
revealed opportunities for improvements in the provision of care and staff
understanding of this population. Utilizing these findings, we conducted
lesbian, gay, bisexual, and transgender (LGBT) trainings in all 12 jail clinics
for medical, nursing, and mental health staff. Three months after LGBT
training, patient complaints dropped by over 50%. After the development and
implementation of a newly revised transgender healthcare policy, complaints
dropped to zero within 6 months.
CONCLUSION:
Our
efforts to assess the quality of care provided to transgender patients revealed
significant areas for improvement. Although we have made important gains in
providing quality care through the implementation of policies and procedures
rooted in community standards and the express wishes of our patients, we
continue to engage this patient population to identify other issues that impact
their health and well-being in the jail environment.
- 1Bureau of Correctional Health Services , New York City Department of Health and Mental Hygiene, Queens, New York.
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