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The purpose of this paper is to briefly address three interrelated areas of concerns – victimization, housing placement and healthcare provision – related to the health and welfare of transgender women in jails, prisons and other types of detention facilities.

Drawing on a growing body of research on health risks for transgender women who are detained in facilities in California and elsewhere, the authors provide recommendations for policy and practice that constitutes gender-affirming healthcare for transgender women behind bars.

Policymakers, correctional leaders, and prison-based clinicians have a number of opportunities to address the welfare of transgender women in jails, prisons and other types of detention facilities.

This policy brief offers concrete steps government officials can take to better meet their professional and constitutional obligations, provide higher quality care for transgender women involved in the criminal justice system, and effectuate positive changes in transgender women’s health and welfare both inside and outside of carceral environments.

What I refer to as a “monological” tendency is clearly seen in Spector and Kitsuse’s definition of their central term: …we define social problems as the actions of individuals or groups making assertions of grievances and claims with respect to some putative conditions (2001, p. 75).There is no mention here of audiences who hear such claims and grievances. The definition suggests that social problems are spoken into existence unilaterally by those who are especially aggrieved by perceived conditions of group life. Speakers are thus of primary importance, while listeners are not. There is likewise no reference to interactions between speakers and their audiences.

For more than a decade, public opinion polls have shown that nearly 80% of Americans support hate crime legislation as a response to violence committed because of the victim's race, color, religion, and sexual orientation. Americans' widespread support for legislation aimed at bias-motivated crimes is not matched by the federal and state efforts devoted to responding to such crimes. This chapter describes the myriad factors contributing to America's limited police and prosecutorial response to hate crimes. After a discussion of the patchwork of state and federal legislation aimed at hate crimes, the chapter analyzes the substantial legislative and administrative structures that hamper the enforcement of hate crime law in the United States.