During the past 18 months, three openly transgender women have taken their own lives in custody in England: Vikki Thompson, Joanne Latham and Jenny Swift. Their deaths speak of the difficulties that transgender people face behind bars. The ongoing inquest into Thompson’s death sheds some light onto those experiences.

In her new book, Transgender Behind Prison Walls, Sarah Baker has added her voice to this conversation. As a transgender woman serving time in a men’s prison, Baker is all too aware of the lack of help, advice or information for transgender inmates or the staff responsible for their safety and well-being. Drawing upon her more than 25 years in custody, Baker seeks to help fill this gap. She has also spoken to me as part of my ongoing research into LGBT prisoners.

Baker’s personal story of life behind bars is shared in the book’s postscript. She describes in detail the discrimination, verbal, physical and sexual abuse that she has experienced since coming out as trans while in prison. Some of it makes for harrowing reading. Complaints she has made about her treatment have fallen on deaf ears. She alleges that she was blamed by an official for provoking attacks via her “lifestyle choice”, and finds herself unable to prove discrimination “without a paper trail”. The Ministry of Justice was contacted about these allegations by The Conversation but said it did not comment on specific cases.

In 2013, various newspapers wrongly reported that Baker had received gender confirmation surgery paid for by the NHS – sensationalist and transphobic coverage that Baker challenges in her book. Instead, she says that a gender identity clinic denied her both a diagnosis of gender dysphoria and any treatment while she is in prison. Baker writes that she was told that she must first live in her affirmed gender for two years outside of prison and, since she is serving a life sentence, this could be a number of years and depends on when she gets parole.

Ministry of Justice guidance on the care of transgender prisoners states that: “The prison GP must refer all applications for gender reassignment surgery to a consultant specialising in gender dysphoria and will ordinarily accept advice from the consultant about whether gender reassignment surgery is considered appropriate in a particular case.”

Having lived openly as a woman for five years in prison, Baker says in the book that in early 2017 she resorted to removing her own testicles with a razor in her prison cell. She explains that this “self-administered medical procedure” felt like her only option, given her longstanding and ongoing inability to access any treatment via official channels. In my own correspondence with her, Baker told me that she later went to hospital, and needed two operations.

Growing tolerance

Despite these distressing experiences, Baker is keen to emphasise that “most staff and prisoners have been kind”, and that prisons have come a long way since she first arrived in 1985, when “there was no public interest in diversity and equality”.

Transgender in Pakistan Show all 16 1 /16 Transgender in Pakistan Transgender in Pakistan Dancing at Shakeela's party, an event to celebrate a transgender life in middle-age Reuters Transgender in Pakistan Venue staff members watch people dance at Shakeela's party in Peshawar, Pakistan Reuters Transgender in Pakistan Security searches guests as people arrive at Shakeela's party in Peshawar, Pakistan Reuters Transgender in Pakistan Members of the transgender community dance at Shakeela's party in Peshawar, Pakistan Reuters Transgender in Pakistan Shakeela, a member of the transgender community, works in the kitchen at home in Peshawar, Pakistan Reuters Transgender in Pakistan 'It's the first time a transgender party has been held openly,' says activist Farzana Jan Transgender in Pakistan Farzana Jan, a member of the transgender community, poses for a photographer ahead of Shakeela's party in Peshawar, Pakistan Reuters Transgender in Pakistan Guests at Shakeela's party Reuters Transgender in Pakistan Money thrown by the guests is used by people to help them start a new business or project Transgender in Pakistan Rani smiles from behind her make-up as she prepares for the party Reuters Transgender in Pakistan Shakeela resting at her home in Peshawar Reuters Transgender in Pakistan A photo hangs on the wall in the home of members of the transgender community in Peshawar, Pakistan Reuters Transgender in Pakistan Make up lies on the floor as members of the transgender community prepare for Shakeela's party in Peshawar, Pakistan Reuters Transgender in Pakistan A guest counts money she plans to throw at Shakeela's party Reuters Transgender in Pakistan Bubbly helps Shakeela with her dress as members of her own family watch on Reuters Transgender in Pakistan Chahat, a member of the transgender community, prepares for Shakeela's party in Peshawar, Pakistan Reuters

Baker is aware that transgender prisoners are a diverse group, and that her story cannot be taken as entirely representative. She emphasises, for example, that: “As a pre-op male-to-female transgender prisoner within the male prison system, I can only speak confidently about the environment that I live in.” Yet she does contextualise her experiences, sharing excerpts of letters sent to her by three other prisoners. Transgender women Nicola and Deanne share similar experiences to Baker of being unable to access a diagnosis of gender dysphoria while in custody. Transgender man, Laura, received a diagnosis in the community but has not told prison staff about his gender identity, instead choosing to live as a woman while incarcerated in a women’s prison.

Useful tips

Baker’s book acts in part as a guide for transgender prisoners, with information such as how they can formally change their name. Baker also offers practical advice for transgender women in prison, with tips on clothing and footwear. Some of her advice might seem overly prescriptive or conservative. She counsels, for example, “in the interests of female etiquette and decorum, always cross your legs when sitting down”, and “do not wear anything that draws negative attention from other prisoners”. However, this is pragmatic guidance based on her experiences. As she explains: “Unfortunately, the clothes that we choose to wear will affect the way in which we are treated by others.”

Baker also summarises and comments on the Government’s new legislation on transgender prisoners, which stipulates that prisons must recognise gender-fluid and non-binary inmates, and improves the procedures for making prison allocation decisions. Baker fears that security concerns will continue to trump claims to gender-affirming clothes and accessories, let alone housing in gender-appropriate prisons. She also predicts that prisoners will still struggle to receive diagnoses of gender dysphoria, let alone any necessary treatment, while in custody.

This is Baker’s second book, and she has a third on the way. By introducing much-needed information about what it is like to be transgender behind bars, it helps us to understand why so many transgender prisoners self-harm or take their own lives. On the publication of her first book in 2013, Baker received a “barrage of abuse” from the media and people on social media about her transition. I have corresponded with Baker through my research into the experiences of LGBT prisoners, and I sincerely hope that her new book will be received with the interest and respect that it most thoroughly deserves.