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ICE Detention Facility Contract Modification for Transgender Care Definitions The following definitions apply for purposes of this modification only: 1. Biological Sex. An individual's biological status as either male or female, typically assigned at birth, and associated primarily with physical attributes such as chromosomes, hormone prevalence, and external and internal anatomy. 2. Detainee. An individual detained in ERO custody. 3. Detention Plan. A plan for a transgender detainee, constructed by the Transgender Classification and Care Committee at an ICE detention facility with instructions for how to address issues including, but not limited to, housing, clothing, showering, grooming, name and pronoun use, recreation, programming, escort, transportation, searches, privacy, etc. 4. Diagnostic and Statistical Manual of Mental Disorders (DSM). The standard classification of mental disorders used by mental health professionals in the United States as published by the American Psychiatric Association. DSM -5 (Fifth Edition) is the most current edition of the drafting of this guidance. S. Gender Affirming Surgery. Surgical alteration of male or female genitals, or the reshaping, by any surgical procedure, of a male body into a body with female appearance, or vice versa. Also referred to as "sex reassignment surgery (SRS)," "gender reassignment surgery (GRS)," or by other names. Note: gender affirming surgery is the preferred name. 6. Gender Dysphoria. Medical diagnosis in the American Psychiatric Association's DSM -5 that describes the distress that may accompany the incongruence between an individual's experienced or expressed gender and the individual's biological sex. This was previously Icnown as Gender Identity Disorder. 7. Gender Expression. The ways in which an individual communicates /displays his /her gender identity to others; a combination of appearance, demeanor, and behavior. 8. Gender Identity. An individual's internal sense of being a man, woman, or another gender. It is not necessarily based on the individual's biological sex or on the individual's sexual orientation. Because gender identity is internal, it is not necessarily visible to others, but may be externally manifested in the individual's appearance, behavior, demeanor or other aspects of the individual's life. 9. Gender Non - Conforming. Having an appearance or manner that does not conform to traditional societal gender expectations. 10. lntersex. Having sexual or reproductive anatomy or chromosomal pattern that do not seem to fit typical definitions of male or female, Intersex medical conditions are sometimes referred to as disorders of sex development. 91P 1 �� 25D -13