SOP_NUMBER: 508.40
TITLE: Identification, Evaluation, and Treatment of Gender Dysphoria
WORD_COUNT: 1276
POWERDMS_URL: https://public.powerdms.com/GADOC/documents/624777
URL: https://gps.press/sop-data/508.40/

========================================================================
FULL TEXT:
========================================================================

|GEORGIA DEPARTMENT OF CORRECTIONS<br>Standard Operating Procedures|Col2|Col3|
|---|---|---|
|**Policy Name:**Identification, Evaluation, and Treatment of Gender Dysphoria|**Policy Name:**Identification, Evaluation, and Treatment of Gender Dysphoria|**Policy Name:**Identification, Evaluation, and Treatment of Gender Dysphoria|
|**Policy Number:** 508.40|**Effective Date:** 9/20/2023|**Page Number:** 1 of 5|
|**Authority:**  <br>Commissioner|**Originating Division:** <br>Health Services Division<br>(Mental Health)|**Access Listing:** <br>Level I: All Access|



**I.** **Introduction and Summary:** The purpose of this policy is to describe the process
by which offenders are identified, evaluated, and treated by mental health services
for Gender Dysphoria. This policy also identifies the requirements for interdepartmental communication associated with specific concerns of Gender NonConforming offenders.


**II.** **Authority:**

A. Prison Rape Elimination Act (2012); and

B. Georgia Department of Corrections Standard Operating Procedures (SOPs):

208.06 PREA-Sexually Abusive Behavior Prevention and Intervention Program,
220.09 Classification and Management of Transgender and Intersex Offenders,
507.04.68 Management and Treatment of Offenders Diagnosed with Gender
Dysphoria, 508.14 Mental Health Reception Screen, and 508.15 Mental Health
Evaluations, and.

**III.** **Definitions:**

A. **Gender Dysphoria**    - A mental health disorder characterized by clinically

significant distress and impairment in social, occupational, or other important
areas of functioning secondary to a marked incongruence between an
individual’s experienced/expressed gender and assigned gender.

B. **Gender Identity**    - A category of social identity that refers to an individual’s

identification as male, female, or some category other than male or female.
Gender Identity is an internal construct independent of anatomical genitalia at
birth or sexual orientation.

C. **Gender Non-Conforming**    - When a person’s appearance or manner does not

conform to traditional societal gender expectations.

D. **Intersex**    - When a person’s sexual or reproductive anatomy or chromosomal

pattern does not seem to fit typical definitions of male or female.


|GEORGIA DEPARTMENT OF CORRECTIONS<br>Standard Operating Procedures|Col2|Col3|
|---|---|---|
|**Policy Name:**Identification, Evaluation, and Treatment of Gender Dysphoria|**Policy Name:**Identification, Evaluation, and Treatment of Gender Dysphoria|**Policy Name:**Identification, Evaluation, and Treatment of Gender Dysphoria|
|**Policy Number:** 508.40|**Effective Date:** 9/20/2023|**Page Number:** 2 of 5|
|**Authority:**  <br>Commissioner|**Originating Division:** <br>Health Services Division<br>(Mental Health)|**Access Listing:** <br>Level I: All Access|



E. **Transgender**    - When a person’s Gender Identity does not correspond to that

person’s biological sex assigned at birth. Only determined by self-report.

**IV.** **Statement of Policy and Applicable Procedures:**

A. Screening and Evaluation of Diagnostic Offenders:


1. Mental Health Reception Screen (Form M30-01-01):


a. During the diagnostic process a Mental Health Reception Screen (SOP

508.14 Mental Health Reception Screen), will be completed by a mental
health counselor, mental health technician or behavior specialist. This
screen will assess for potential mental health problems and Gender
Identity issues including Transgender, Gender Non-Conforming, and/or
Intersex concerns.

b. If the mental health professional notes Gender Identity concerns, the

offender will be referred for further evaluation in accordance with SOP
508.14.


2. Mental Health Evaluation for Services (Form M31-0001):


a. If an offender is referred for further mental health evaluation, Form M31
0001, in accordance with SOP 508.15 Mental Health Evaluations, will be
completed by a mental health counselor, mental health technician or
behavior specialist. This evaluation will assess for mental health
symptoms and service needs including concerns related to Gender
Identity.

b. If significant symptomatology is noted, the offender will be referred for a

diagnostic evaluation by a psychologist/psychiatrist/Advanced Practice
Registered Nurse (APRN).


|GEORGIA DEPARTMENT OF CORRECTIONS<br>Standard Operating Procedures|Col2|Col3|
|---|---|---|
|**Policy Name:**Identification, Evaluation, and Treatment of Gender Dysphoria|**Policy Name:**Identification, Evaluation, and Treatment of Gender Dysphoria|**Policy Name:**Identification, Evaluation, and Treatment of Gender Dysphoria|
|**Policy Number:** 508.40|**Effective Date:** 9/20/2023|**Page Number:** 3 of 5|
|**Authority:**  <br>Commissioner|**Originating Division:** <br>Health Services Division<br>(Mental Health)|**Access Listing:** <br>Level I: All Access|



3. Initial Psychiatric/Psychological Evaluation (Form M60-01-06):


a. The psychologist/psychiatrist/APRN will review the completed Mental

Health Evaluation for Services, conduct a mental status examination, and
assign a diagnosis as appropriate.

b. If a diagnosis of Gender Dysphoria and/or other mental health condition

is assigned, the offender will be placed on the mental health caseload and
classified at an appropriate level of care.

c. Offenders self-identified as Transgender that do not meet criteria for

Gender Dysphoria will have this condition documented on the Problem
List located in the medical record. A Mental Health Diagnosis List (Form
M20-01-05) will be completed that documents Transgender condition
with an explanation of why the offender does not meet criteria for Gender
Dysphoria (i.e., absence of clinically significant distress or functional
impairment secondary to Transgender status). The offender will be
designated as Level 1 and not added to the caseload, unless the offender
has additional diagnoses requiring mental health treatment.


B. Evaluation of Gender Dysphoria in Offenders Currently on the Mental Health

Caseload:

1. An offender on the mental health caseload may be self-referred or staff

referred for an evaluation by a psychologist/psychiatrist/APRN for Gender
Dysphoria.

2. If a diagnosis of Gender Dysphoria is assigned by the
psychologist/psychiatrist/APRN, then appropriate changes shall be made on
the Diagnosis List and the Comprehensive Treatment Plan (Form M50-0102).


|GEORGIA DEPARTMENT OF CORRECTIONS<br>Standard Operating Procedures|Col2|Col3|
|---|---|---|
|**Policy Name:**Identification, Evaluation, and Treatment of Gender Dysphoria|**Policy Name:**Identification, Evaluation, and Treatment of Gender Dysphoria|**Policy Name:**Identification, Evaluation, and Treatment of Gender Dysphoria|
|**Policy Number:** 508.40|**Effective Date:** 9/20/2023|**Page Number:** 4 of 5|
|**Authority:**  <br>Commissioner|**Originating Division:** <br>Health Services Division<br>(Mental Health)|**Access Listing:** <br>Level I: All Access|



C. Evaluation of Gender Dysphoria in Offenders Not Currently on the Mental

Health Caseload:

1. Upon receipt of a self or staff referral other than through the diagnostic

process, a mental health counselor, mental health technician or behavior
specialist will complete a Mental Health Evaluation for Services. The
information obtained shall be documented on the Mental Health Evaluation
Form (Form M31-01-01) and on the lower portion of the Mental Health
Referral Form (Form M35-01-01). If it is determined the offender has
symptoms/concerns related to Gender Identity, referral will be made to the
psychologist/psychiatrist/APRN to complete the Initial
Psychiatric/ Psychological Evaluation.

2.  If it is determined that the offender is not in need of mental health services or

further evaluation, the Mental Health Referral Form with the Mental Health
Evaluation Form will be placed in the offender’s medical record (section 5).

D. All offenders who identify as Transgender and request hormone treatment,

whether or not they meet criteria for Gender Dysphoria, will be referred to the
Medical Department to be evaluated and referred to an endocrinologist or other
appropriate provider.

E. Mental Health Treatment for Gender Dysphoria:


1. All mental health clinical staff will be trained in gender-informed sensitivity.

2. Treatment for Gender Dysphoria will be reflected on the Comprehensive

Treatment Plan.

3. The full range of mental health services at a facility will be available to the

offender with Gender Dysphoria as clinically appropriate.


|GEORGIA DEPARTMENT OF CORRECTIONS<br>Standard Operating Procedures|Col2|Col3|
|---|---|---|
|**Policy Name:**Identification, Evaluation, and Treatment of Gender Dysphoria|**Policy Name:**Identification, Evaluation, and Treatment of Gender Dysphoria|**Policy Name:**Identification, Evaluation, and Treatment of Gender Dysphoria|
|**Policy Number:** 508.40|**Effective Date:** 9/20/2023|**Page Number:** 5 of 5|
|**Authority:**  <br>Commissioner|**Originating Division:** <br>Health Services Division<br>(Mental Health)|**Access Listing:** <br>Level I: All Access|



F. Inter-Departmental Communication:


1. If a Transgender offender communicates concerns about safety,
discrimination, or medical needs to a mental health staff member, these
concerns will be immediately communicated to the mental health unit
manager and clinical director/staff psychologist, who will immediately
convey the concerns to the relevant departmental manager and warden.

2. Mental Health Disciplinary Report Evaluations (Form M34-01-01 and M34
01-02) of Transgender offenders will consider gender issues as a mitigating
factor.

**V.** **Attachments:** None.

**VI.** **Record Retention of Forms Relevant to this Policy:** None.