If you identify as transgender, gender non-conforming, or intersex, a facility should “assess”, or determine, the right placement for you during your first intake with the Connecticut Department of Corrections (CTDOC). Prison staff may ask you if you are gender non-conforming or intersex. If you are transgender, gender non-conforming, or intersex, you can answer yes to that question because they will use it to give you a referral for assignment to a gender-affirming facility. 

The facility should base your initial assessment on your safety and security. If this “assessment” has been done before you get to the place you’ll be housed, then you should be transported to the right facility from the start. If you get to an intake facility and they have not received your request from the Judicial Marshals or other officials, then the Unit Administrator at your facility will notify their boss. 

The “Referral for Gender Assessment,” also called a CN 81701, is an important form you’re entitled to. It should be completed either by the staff member you disclosed your transfer request to, or the staff member who is regularly conducting a Prison Rape Elimination Act (PREA) screening. That staff member will submit your Referral and it should be submitted to the CTDOC Chief of Psychiatric Services within 72 hours.

The Prison Rape Elimination Act (PREA) is a federal law passed in 2003. Under PREA, rather than automatically assigning people to a facility, transgender and intersex people are assessed for potential safety threats and housed “on a case-by-case basis” according to gender identity. Correctional staff have to consider housing and program assignments at least twice a year to review any threats to safety experienced by transgender and intersex people living in prison. 

According to the law, they also have to take into account the individual’s own view of their safety. They are not allowed to separate them for housing or other program placements based solely on their LGBT+ status. 

PREA also protects “involuntary segregation”, or the removal of a person to a different housing assignment against their will. A person cannot continue to be kept in a different part of the prison against their will unless prison officials have determined that there is no other way to keep them safe. They have to make that determination within the first 24 hours if they do place them in separate housing against their will. People cannot be segregated against their will for more than thirty days, and they must be given access to all of the same work, educational, and programming opportunities as any other person.

In July 2018, the Connecticut legislature passed Senate Bill 13 § 8, a new statute in line with the Prison Rape Elimination Act, to require that transgender people in correctional facilities are housed in accordance with their gender identity. 

After your Referral form is submitted, staff should house you separately from any other people until the facility has finished all other custody and medical assessments. You have a right not to be given a medical or physical health examination for the sole purpose of identifying your gender. Staff should continue to house you separately until a CTDOC committee called the Gender Non-Conforming Review Committee is consulted. Additionally, you should be given a mental health assessment within three days of your Referral submission.

If you have been receiving gender affirming care in the community, you can share that and any treatment or medications you take with the individual completing your health services screening. The medical provider doing your intake will seek a Release of Information (ROI) from you in order to obtain your medical records from outside providers. 

If you don’t want to agree to an ROI, your current treatment plan may be changed or stopped altogether. This depends on a “complete medical assessment” by a licensed physician or person called an advanced practice registered nurse (APRN). This may include things like having blood work done. If you were taking non-prescribed gender affirming hormones prior to incarceration, a referral will be made for you to meet with a licensed physician or APRN to complete an evaluation within three days. 

If you are housed separately, you still have a right to participate in any orientation, recreation, and social time with everyone else in your unit. You should also be allowed to shower separately from other people. The facility should ask you what gender officer you would prefer to do your pat-down and/or strip searches. Facilities are instructed to take into account what your preferences are and accommodate them if possible. In routine pat and strip searches, the facility will consider your request, but reserves the right to place facility safety first in an emergency event. 

Once the facility’s PREA Compliance Manager reviews your case and makes a recommendation, your programming and housing assignments may change. 

If you feel that you have been segregated against your will, you can file an appeal about your placement, detailing any parts of the segregation that you feel are unfair or are impacting your stay and safety. You should be as specific as possible about what you would like to challenge and why.

Staff are supposed to maintain your privacy and confidentiality to the fullest amount possible once you have shared that you are gender non-conforming or intersex. The only information shared should be things that are necessary for particular staff members to do their specific job duties. 

It is illegal for you to be discriminated against due to your gender identity. All people are afforded the same treatment and protection guaranteed under harassment policies.

It can be more difficult to request a transfer if you’ve been in a facility for a while, but there is a procedure to do so. If a Judicial Marshall or other official has not informed an intake facility about your gender identity, then you will just move forward with an intake like everyone else. Once you are at the new facility, you can tell an official that you would like an intake for a gender-affirming facility. 

The Unit Administrator there will notify their District Administrator and then have a staff member complete a Referral. The custody staff member completing the PREA screening (or the staff member to whom you told about your request) will submit the referral form to their Unit Supervisor. That person must forward the form to the CTDOC Chief of Psychiatric Services within 72 hours. Once that is complete, the same procedure will happen as though you told an official about your request during your initial intake.

Senate Bill 13 states that any person who has a gender identity that differs from the person’s assigned sex at birth: 

1. Must be addressed by correctional staff in a manner consistent with the person’s gender identity;
2. must have access to commissary items, clothing, personal property, programming, and educational materials that are consistent with the person’s gender identity; and 
3. must have the right to be searched by a correctional staff member of the same gender identity unless the person requests something different or there is an emergency.

If you have a birth certificate, passport, or driver’s license that reflects your gender identity, you should provide that to correctional officers when you enter a facility or after you would like a transfer. If you don’t have those things, you can try to meet other established standards for obtaining that kind of documentation to confirm your gender identity. 

People must also have a diagnosis of “gender dysphoria,” as defined in the American Psychiatric Association’s “Diagnostic and Statistical Manual of Mental Disorders.” According to them, “gender dysphoria” refers to “psychological distress that results from an incongruence between one’s sex assigned at birth and one’s gender identity.”

If you have given them proof of your gender identity, you must be placed in a correctional institution with people of gender consistent with your gender identity. The only way for an official from CTDOC to prevent your transfer is to prove that the placement would present “significant safety, management, or security problems.” The Commissioner is required to give serious consideration to your views with respect to your safety.

Once the CTDOC Chief of Psychiatric Services and an APRN receive your Referral, they should schedule an in-person interview with you within 10 business days. This time is used to assess the situation and determine if you meet the criteria outlined for a diagnosis of “gender dysphoria.”

If you meet the guidelines for this diagnosis, you will have an appointment with a licensed physician or APRN and another facility psychologist for an evaluation to discuss possible medical and psychological support. If you are seeking gender affirming hormone care, but you have a medical condition that prevents this care from being prescribed, you will be informed by the medical provider what that condition is. The provider will also share these findings with the CTDOC Chief of Psychiatric Services and APRN. 

If you didn’t meet the criteria in your initial interview, a qualified mental health clinician within the CTDOC Health and Addiction Services, who was in no way involved in your initial interview stage, will conduct a second interview within five business days of your initial interview. 

If the second interviewer presents a finding of “gender dysphoria,” then you will be given a provisional diagnosis for “gender dysphoria” to be reviewed within six months. 

If you disagree with the diagnosis that was determined by the interviewers, then you have a right to file a Health Services Administrative Remedy form.

If you are awarded an inter-facility transfer, it will be done in accordance with Directive 9.3 overseeing all admissions, transfers, and discharges. Prior to the transfer occurring, a group of people called the Gender Non-Conforming Review Committee will be notified. The Review Committee will provide consultation with the receiving facility to make sure your care plan, called a Gender Non-Conforming Management Plan, can be honored and executed at the receiving facility.

A person with a diagnosis of “gender dysphoria” may be given an alternate commissary as part of their Gender Non-Conforming Management Plan. You can ask about this and make sure it is part of your Plan.

The Review Committee is a multi-disciplinary group that provides recommendations regarding people identifying as gender non-conforming and/or who identify as being intersex. The Committee is chaired by the CTDOC Chief of Psychiatric Services. Other members include CTDOC staff, contracted healthcare staff, and other people who are deemed appropriate for membership by the Review Committee chair. 

This committee is in charge of developing your Management Plan within 14 business days of the completion of the “gender dysphoria” assessment. The Management Plan will be kept in your master file and health record, only distributed to those who need to know the information.

The Review Committee reviews all existing Management Plans twice a year.

The Supervision Group is a group of Review Committee members who provide oversight and direction to the contracted healthcare staff members who provide direct care to people who identify as gender non-conforming or as being intersex. The Supervision Group meets quarterly to discuss care and custodial management issues. 

Each Unit Administrator or health service administrator from a contracted healthcare service is responsible for ensuring that a staff member who provides direct care or custody oversight of you or any other person who identifies as gender non-conforming will be present at each meeting.

After your Management Plan is provided by the Review Committee, a final review will be completed within 14 business days of the Review Committee’s recommendation. Once the Commissioner makes the final determination and approves your Referral and Management Plan, the Commissioner will send the approved Management Plan to the Review Committee, the facility-specific Unit Administrator, and the District Administrator. From there, those individuals will develop an implementation plan for your care. The Unit Administrator or designee will have you sign onto your Management Plan. 

If the Commissioner and/or designee reviews the Review Committee’s recommendations and denies any part of them, the Commissioner will direct the CTDOC Chief of Psychiatric Services and/or the Review Committee to recommend an alternative management plan within ten business days.

Once the alternative plan is established, the Review Committee will complete their typical review process outlined above until a new plan is approved. You will be given a copy of the Management Plan, and other copies will be kept in your health record and master file.