Iowa prisons draft policy on transgender inmates

Iowa prison officials are in the midst of drafting a policy addressing the treatment of transgender inmates, although it’s not clear yet whether state officials will approve spending taxpayer money for sex-reassignment surgery.

California prison officials last week set the first standards in the nation for sex-reassignment surgery for inmates after spending years in litigation battling over the issue.

Fred Scaletta, assistant director of the Iowa Department of Corrections, said Monday a state prison system medical committee is currently drafting a policy regarding transgender inmates. The committee is headed by Dr. Harbans Deol, the prison system's medical director, and it includes nurses, psychiatrists, psychologists, and pharmacists, Scaletta said. The policy is expected to become final in two to three months.

Iowa’s prisons, which on Monday held more than 8,300 men and women in nine state institutions, currently house one transgender inmate being held in a correctional institution for men, while one other transgender inmate was recently released, Scaletta said.

“The inmate we currently have on count is receiving hormone treatment," Scaletta added, explaining that the prisoner is male transitioning to be female. He declined to identify the inmate, citing medical privacy regulations. "No medical procedures have taken place at this time," he said.

To qualify for sex-reassignment surgery in California, inmates must: be diagnosed with what is medically known as gender dysphoria; have lived as a member of the preferred gender for at least 12 months; and have expressed a desire for sex-reassignment surgery for at least two years. Prison mental health professionals will make referrals for surgery.

The Corrections Department has historically not paid the costs when transgender inmates have requested sex-reassignment surgery, Scaletta said, defining it as elective surgery to be covered at the offender's expense.

Gov. Terry Branstad declined to say Monday whether he would support the use of state funds for gender-reassignment surgery for transgender Iowa prisoners.

“This is the first time that question has ever come up,” Branstad told reporters at his weekly news briefing at the Capitol. “I would certainly want to consult with the Department of Corrections with regards to this and also find out what the cost would be. … I think that is something that is a huge public policy issue that the state has previously not addressed.”

Donna Red Wing, executive director of One Iowa, the state’s largest organization advocating for gay, lesbian and transgender people, said California has considered the issue of transgender prisoners very seriously. She described the California requirements as “especially rigorous.”

“I believe that as there is more understanding and acceptance of transgender persons and issues, as gender dysphoria diagnosis is understood, gender reassignment surgery will be covered by health insurance policies and eventually included in the procedures available in our prisons,” Red Wing said.

She added, “There will be much more discussion. California leads the way. It will, I hope, be followed by the rest of the nation.”

The eight-page California policy calls for inmates who request the surgery and meet the criteria to be referred for evaluation to a committee of two doctors, two psychiatrists and two psychologists that would make a recommendation to a higher-level panel of medical professionals.

The California policy prohibits procedures that are considered merely cosmetic, including hair removal, face-lifts, breast augmentations or other implants.

A California prison spokeswoman estimated the cost of full transgender procedures could approach $100,000 per inmate, though the Transgender Law Center said that is exaggerated.

Not everyone in California approves of the new policy.

"I don't think it's a proper use of taxpayer money," said Kent Scheidegger, legal director at the Sacramento-based Criminal Justice Legal Foundation that represents crime victims. "This is basically an elective procedure. I mean, you're surgically altering body parts which have nothing wrong with them because the person has a psychological issue."

This story includes information from the Associated Press