Being transgendered, described as feeling that one is of the opposite gender, can be a difficult experience in today's culture. Those who are transgendered and incarcerated experience much more stress. There is a significant population of transgendered individuals in today's prison system, with estimates suggesting that the number is higher proportionally than in the general population. The question of how to treat these individuals while maintaining the safety and security of the institutions remains unanswered. In this article, we review the epidemiology of transgendered individuals in the general population and correctional facilities, describe current guidelines for the standard of care, and discuss how various correctional systems in this country apply them. We will also review case law with respect to the management and treatment of transgendered incarcerated individuals. Finally, we discuss the challenges involved in serving this population, such as provision of safe housing and medically necessary treatment. This review is provided to help in educating the forensic expert on current questions and potential future directions in the management of this population.
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