Experiences of transgender prisoners and their knowledge, attitudes, and practices regarding sexual behaviors and HIV/STIs: a systematic review

Bromdal, Annette ORCID: https://orcid.org/0000-0002-1307-1794 and Mullens, Amy B. ORCID: https://orcid.org/0000-0002-0939-9842 and Phillips, Tania M. and Gow, Jeff ORCID: https://orcid.org/0000-0002-5726-298X (2019) Experiences of transgender prisoners and their knowledge, attitudes, and practices regarding sexual behaviors and HIV/STIs: a systematic review. International Journal of Transgenderism, 20 (1). pp. 4-20. ISSN 1553-2739


Background: Despite transgender people being more visible in prison systems, research suggests they are at higher risk of experiencing sexual violence compared to other prisoners. Research also suggests that transgender prisoners experience harassment, and physical and sexual assault by fellow prisoners, and prison officers who lack transgender-specific health knowledge. There exist no systematic reviews on the experiences of transgender people in prisons. This review aims to fill this research gap. The following question developed in consultation with transgender, sexual health/HIV and corrective services stakeholders has guided the systematic review: What are transgender and gender-diverse prisoners’ experiences in various prison settings and what are their knowledge, attitudes and practices regarding sexual behaviors and HIV/STIs?

Methods: The review followed the PRISMA guidelines and searches were conducted in four databases for the period of January 2007 to August 2017. Studies were assessed against predetermined inclusion and exclusion criteria. Included studies were peer-reviewed, written in English with online full-text availability and reported data on transgender and gender-diverse prisoner experiences relevant to the research question.

Results: Eleven studies (nine qualitative, one quantitative, one mixed-methods; nine in USA, two in Australia) met the criteria for review. Four studies were of high quality, six were of good/acceptable quality, and one study was of modest quality. Transgender and gender-diverse prisoners reported a range of challenges which included sexual assault, discrimination, stigma, harassment, and mistreatment. Information on their sexual health and HIV/STIs knowledge, attitudes, practices is in short supply. Also, their lack of access to gender-affirming, sexual health/STIs and mental health services is commonplace.

Conclusions: The experiences of transgender prisoners as reported in this review are almost uniformly more difficult than other prisoners. Their 'otherness' is used as a weapon against them by fellow prisoners through intimidation and violence (including sexual) and by prison officers through neglect and ignorance.

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Item Type: Article (Commonwealth Reporting Category C)
Refereed: Yes
Item Status: Live Archive
Additional Information: Permanent restricted access to Published version, in accordance with the copyright policy of the publisher.
Faculty/School / Institute/Centre: Historic - Faculty of Business, Education, Law and Arts - School of Linguistics, Adult and Specialist Education (1 Jul 2013 - 30 Jun 2019)
Faculty/School / Institute/Centre: Historic - Institute for Resilient Regions - Centre for Health, Informatics and Economic Research (1 Aug 2018 - 31 Mar 2020)
Date Deposited: 30 Jan 2019 06:06
Last Modified: 13 Jul 2022 00:36
Uncontrolled Keywords: gender-diverse; incarceration; lived experiences; prison officers; sexual coercion; transgender; vulnerable group
Fields of Research (2008): 16 Studies in Human Society > 1699 Other Studies in Human Society > 169901 Gender Specific Studies
Fields of Research (2020): 44 HUMAN SOCIETY > 4405 Gender studies > 440599 Gender studies not elsewhere classified
Funding Details:
Identification Number or DOI: https://doi.org/10.1080/15532739.2018.1538838
URI: http://eprints.usq.edu.au/id/eprint/35188

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