Transgender Texas prison inmates can start hormone therapy

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AUSTIN, Texas (AP) — A change in Texas prison system policy means transgender inmates who hadn’t started hormone therapy before incarceration can do so behind bars if they go through a thorough process to confirm the diagnosis.

Previously, Texas Department of Criminal Justice policy said only transgender inmates who were already taking hormones when they entered the system could continue to do so, the Houston Chronicle reported Thursday.

TDCJ spokesman Jason Clark played down the change, saying Texas’ policy remained among the most conservative in the nation.

“Offenders are prescribed hormone therapy only after going through a rigorous process that includes being reviewed by a gender dysphoria specialist, an endocrinologist, and having an affirmative diagnosis,” Clark said. “Only then would it be considered medically necessary and require the minimum level of treatment which is hormone therapy.”

The Texas policy was updated in August “to reflect community standards of care” after the American Psychiatric Association updated its manual of mental disorders to include “gender dysphoria” as a diagnosable condition, Clark said.

Transgender refers to someone who identifies as a different gender than their sex at birth. For transgender men, hormone therapy often involves getting recurring testosterone shots, usually once a week. Transgender women often take estrogen pills, one or two a day, experts say. Texas does not offer sex reassignment surgery to inmates.

Advocates welcomed the policy change, but raised concerns that the TDCJ process is onerous enough that transgender inmates could have to wait months, even years, to receive treatment.

“We’re hearing from people that, for example, if they’re not close to the point where they’re going to try to perform surgery on themselves, or commit suicide or something like that, that their needs for treatment are not being taken seriously,” said Demoya Gordon, an attorney at Lambda Legal, a national law firm that specializes in lesbian, bisexual, gay and transgender issues.

“Texas seems to have, I don’t know, some sort of vested interest in not being seen as respecting the constitutional rights of transgender people,” Gordon said.

As of August, the Texas prison system had 212 inmates who self-identify as transgender. Of those, 21 are receiving hormone therapy, 10 of whom started while in prison, according to Clark.

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