Guidelines

Gender Dysphoria

AUTHORITIES

PURPOSE

  • To provide continuity of care with respect to the provision of health services for inmates diagnosed with gender dysphoria

APPLICATION

Applies to staff and contractors who work with inmates diagnosed with gender dysphoria

RESPONSIBILITIES AND PROCEDURES

  1. The Correctional Service of Canada (CSC) recognizes that some offenders may have gender dysphoria. Where there are reasonable grounds to believe that such a condition exists, a referral by the institutional Psychiatrist will be made, at the earliest opportunity, to a Psychiatrist who is a qualified health professional in the area of gender dysphoria for an assessment and possible diagnosis of gender dysphoria. For those diagnosed with gender dysphoria, there must be continuity of care with respect to the provision of health services.
  2. Inmates with diagnosed gender dysphoria will be able to initiate or to continue hormone therapy as prescribed by either a Psychiatrist who is a qualified health professional in the area of gender dysphoria or other Specialist Physicians in the area of gender dysphoria or endocrinology.
  3. Pre-operative male to female offenders with gender dysphoria will be held in men's institutions and pre-operative female to male offenders with gender dysphoria will be held in women's institutions.
  4. For all placement and program decisions, individual assessments will be conducted to ensure that offenders diagnosed with gender dysphoria are accommodated with due regard for the vulnerabilities with respect to their needs, including safety and privacy.
  5. Sex reassignment surgery will be considered during incarceration when:
    1. a qualified health professional in the area of gender dysphoria has confirmed that the inmate has satisfied the criteria for surgery as set out in the most recent edition of the World Professional Association for Transgendered Health's Standards of Care for the Health of Transsexual, Transgender, and Gender Nonconforming People, including the Standards' requirement that certain specified surgeries require documented proof that the individual has lived 12 continuous months in an identity-congruent gender role.
    2. the qualified health professional in the area of gender dysphoria recommends surgery during incarceration.
  6. If the qualified health professional in the area of gender dysphoria provides an opinion that sex reassignment surgery is an essential medical service under CSC policy, CSC will pay the cost. In making the decision, the qualified health professional will consult with CSC.
  7. CSC will proceed without delay to determine the timing of the surgery, taking into account operational considerations and the offender's release date.
  8. The qualified health professional in the area of gender dysphoria will be the same health professional specialist who provided care to the offender throughout the gender transition prior to his/her incarceration, unless the offender and CSC agree to a different choice of specialist.
  9. The Institutional Head will ensure that staff who have regular contact with offenders with gender dysphoria have the necessary knowledge to effectively respond to their needs.
  10. Subject to operational considerations, offenders diagnosed with gender dysphoria will be permitted to wear clothing appropriate to their self-identified gender.

Assistant Commissioner,
Health Services

Original Signed by:
Jennifer Wheatley

ANNEX A

CROSS-REFERENCES AND DEFINITIONS

CROSS-REFERENCES

CD 001 – Mission, Values and Ethics Framework of the Correctional Service of Canada
CD 566-7 - Searching of Inmates
CD 567-1 - Use of Force
CD 800 - Health Services

DEFINITION

Gender dysphoria : distress that is caused by a discrepancy between a person's gender identity and that person's sex assigned at birth.

For more information

To learn about upcoming or ongoing consultations on proposed federal regulations, visit the Canada Gazette and Consulting with Canadians websites.