Getting hormone treatment for trans inmates in Washington State has never been easier. Just two yeas ago (2016) it was only possible to get hormone treatment in Washington DOC if you were taking the treatment on the streets. Even then, it had to be from licensed healthcare facilities and providers. Now, there are more than a few trans inmates receiving hormone therapy whom have never had the opportunity.


The flip side to this coin is in order to receive treatment one must engage with mental health to be diagnosed. When we mix in how many trans inmates have life caps (indeterminate sentences) and must see the parole board to be released, many inmates (myself included) are fearful of opening a new mental health case so close to our review dates.

Many trans folks have histories of mental health issues associated with their gender identities and depression. We come to prison and begin receiving treatment from mental healthcare folks who are not exactly fulfilling their lifelong dreams by working with felons. Many of us take advantage of our new resources and really tackle our emotional stressors and we can be “discharged” from mental health needing “no further treatment” as determined by a psychiatrist whom we have never seen.

Opening a new mental health case once you have been deemed healthy is dangerous for board cases. It may pose no actual risk to being flopped (denied parole) but the perception on our end (trans inmates under the board) is that this may make us look unstable.

So we go without treatment or speaking with mental health because of these perceptions and opinions. Let’s review:

1. Treatment providers are inexperienced with the specificity of trans inmate issues

2. Mental health providers in prison have a hard time convincing us they want to be here, this creates disingenuousness and mistrust.

3. Trans inmates are fearful an open mental health diagnoses will either get them flopped (more time) or will make the parole board add hefty financial burdens upon release demanding continued treatment the offender may not be able to afford, thus resulting in reincarceration.


We have made progress toward health, releasable trans inmates who are more readily able to cope with themselves. However, we still have a long ways to go, even if it is an issue of mistrust. After all, trans inmates have been the target of violence in prison for decades.

With Love
Jeff “Jeffebelle” Utnage