The medical and mental health care of the adult in-custody lesbian, gay, bisexual, transgender, and intersex (LGBTI) population is a complicated topic requiring an understanding of a broad set of issues.
When addressing the management of LGBTI offenders in the custody of your agency, ask yourself the following fundamental questions:
- How and by whom should this individual be assessed?
- What sort of specific medical or mental health services will be required to meet the statutorily mandated duty to treat?
- Are the staff working in the medical and mental health units culturally competent in dealing with LGBTI patients?
In addition to the items above, you should be aware that:
- Groups such as lesbian and bisexual women, generally receive less routine care than other women, according to the U.S. Department of Health and Human Services.
- Men who engage in sex with other men account for a higher proportion of HIV/AIDS cases than any other demographic group in the United States, according to the Centers for Disease Control and Prevention.
- The use of hormone therapies and other treatments for gender identity disorder [gender dysphoria] are now being mandated by the courts in many jurisdictions.
Potential risk factors in the management of the LGBTI population include:
- Higher rates of depression and anxiety
- Higher rates of suicide and suicide attempts
- Potential self-mutilation due to extreme distress and/or psychiatric disorders
It is important to remember that the experiences of LGBTI individuals are not uniform and are shaped by factors of race, ethnicity, socioeconomic status, geographical location and age, any of which can have an effect on health-related concerns and needs, according to the Institute of Medicine, March 2011.
Links to current medical and mental health updates and information from government and other organizations are available on this page for your reference.