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CITY COUNCIL MEETING DATE:
MAY 17, 2016
TITLE:
RECEIVE AND FILE UPDATE ON SANTA
ANA JAIL; AUTHORIZATION TO DEVELOP
AND ISSUE A REQUEST FOR
QUALIFICATIONS FOR JAIL RE -USE
STUDY; AUTHORIZATION TO ENTER INTO
NEGOTIATIONS FOR EARLY RETIREMENT
INCENTIVES; AUTHORIZATION TO
ENTER INTO AN AGREEMENT FOR A
TRANSGENDER CARE PILOT
{STRATEGIC PLAN NO. 1, 4A}
CITY MANAGE
RECOMMENDED ACTION
CLERK OF COUNCIL USE ONLY:
❑ As Recommended
❑
As Amended
❑
Ordinance on 151 Reading
❑
Ordinance on 2n6 Reading
❑
Implementing Resolution
❑
Set Public Hearing For
CONTINUED TO
FILE NUMBER
1. Receive and File Council Update on Santa Ana Jail from February 2, 2016 City Council
meeting.
2. Authorize City Manager to work with community members and labor representatives from the
Police Officers Association to develop and issue a Request For Qualifications for a consultant to
conduct a Jail Re -Use Study budgeted up to $100,000.
3. Authorize the City Manager to enter into an agreement for a Transgender Care and
Classification Committee Pilot program.
4. Authorize City Manager to enter into negotiations with Police Officers Association to offer early
retirement incentives to full -time staff in the Jail Facility.
On February 2, 2016 the City Council directed staff to "Deny contract amendment, engage
community in developing solutions and request City Manager work with Police Chief in
strategizing sustainability of jail without the use of Federal dollars, if not feasible, propose options
to terminate jail services." City Manager's Office staff met with the individuals that spoke on the
issue during the Council meeting and attended several meetings to further discuss their
concerns.
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Update on Santa Ana Jail
May 17, 2016
Page 2
The City Manager, Police Chief, and Jail Administrator conducted eight meetings with community
members and advocacy organizations (Exhibit 1) to discuss their concerns. These meetings were
held on the following dates and locations:
Meeting # 1
Meeting # 2
Meeting # 3
Meeting # 4
Meeting # 5
Meeting # 6
Meeting # 7
Meeting # 8
March 3, 2016
March 4, 2016
March 7, 2016
March 17, 2016
March 30, 2016
April 4, 2016
April 6, 2016
April 11, 2016
Center OC
CMO Office
Ross Annex Room 1600
Ross Annex Room 1600
CMO Office
Center OC
Ross Annex Room 1600
City Hall 831 (With P.O.A.)
The conversations were focused around two major policy areas. The first focus area was
regarding improvements to the overall conditions at the Santa Ana Jail facility, the handling of the
transgender population at the facility, the facility's strip search policy, release procedures, and
specifics regarding the proposed transgender population module. The Jail Administrator worked
with the United States Immigration and Customs Enforcement (ICE) to provide good faith efforts
to reduce the need for strip searches for detainees that are not mixed with populations from other
facilities. Staff will continue working toward improvements to ensure that the Santa Ana Jail
facility provides high quality and dignified care.
The second area of concern focused on discussing mid -to -long range strategies for phasing out
the ICE contract at the Santa Ana Jail facility. Initial discussions with community members
highlighted the lack of support for the privatization of the jail facility. These community members
indicated that they would not be able to support a single approach for re -use. The conversation
concluded with the preference for a re -use study of the facility with multiple options. Staff
recommends working with the involved stakeholders to draft and review a Request for
Qualifications (RFQ) to identify a consultant to study jail re -use options for the Santa Ana Jail
Facility.
During the two month span of conversations with the community, the Santa Ana Jail facility
experienced a decline in ICE detainees, from a population of 237 to a low of 165. This decrease
in population resulted in a $3,097,755 annual reduction. As of May 9 2016, the population
increased to 182. The transgender population has decreased to 27 people in a module designed
for 64 and is not financially feasible under the current agreement. If the City Council does not
approve the Transgender Care and Classification Committee Pilot program, staff would need to
combine the transgender and gay /bisexual modules.
Members from the Lesbian, Gay, Bi- Sexual, Transgender (LGBT) community provided
suggestions to improve the conditions for the transgender detainees. The Transgender Care
Memorandum is a document intended for ICE personnel, which directs them to house
transgender females in a facility with a Transgender Care and Classification Committee (TCCC)
program. The Santa Ana Jail would be the first facility to form a committee that would take into
consideration the transgender detainees' preferences as it relates to their custody and housing
placement within the facility (Exhibit 2). However, some type of financial assurance would be
required in order to provide increased levels of specialized care for the facility's transgender
population.
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Update on Santa Ana Jail
May 17, 2016
Page 3
During the community meetings, members of the community provided an alternative to the TCCC
as outlined in the draft policy (Exhibit 3). Changes or additions to City policy require formal review
and legal analysis prior to implementation. Furthermore, ICE also requires a contract amendment
in order to adhere to proposed changes. Any City policy change impacting federal detainees
would require a mutually agreeable contract amendment to use beds consistent with operational
need and availability.
In addition to the $16.6 million cost of operating the facility there remains a need to pay the Jail
facility debt of $24.3 million remaining debt balance with $3 million payment annually through
2024.
Staff recommends:
1. Authorizing the City Manager to work with community members and labor representatives from
the Police Officers Association to develop and issue a Request For Qualifications for a consultant
to conduct a Jail Re -Use Study, budgeted up to $100,000.
2. Authorizing the City Manager to enter into an agreement for a Transgender Care and
Classification Committee Pilot program (Exhibit 4).
3. Authorizing the City Manager to enter into negotiations with Police Officers Association to offer
early retirement incentives to full -time staff in the Jail Facility.
STRATEGIC PLAN ALIGNMENT
Approval of this item supports the City's efforts to meet Goal #1- Community Safety, Objective #4
(Ensure a sound fiscal model for jail operations through coordinated efforts with personnel from
the City Manager's Office, Police Department, City Attorney's Office, Finance and Personnel),
Strategy A (Modify the Santa Ana jail business model and identify short and long -term goals).
FISCAL IMPACT
There are no immediate fiscal impacts associated with this item. The cost of implementing follow
up actions will be provided to the City Council after directions on the recommended actions have
been provided to staff.
Exhibits: 1. List of Agencies and Individuals Consulted
2. Transgender Care and Classification Committee Memorandum
3. Community Proposal - Draft Policy Regarding Transgender People in Custody
4. Amended Agreement with Immigration and Customs Enforcement Agency
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Organizations Consulted During Meetings
1. ACLU
2. De Colores
4. OCIYU
5. Transgender Law Center
6. LA LGBT Center
7. LGBT Center OC
8. UCI Law Students,
9. Mexican Consulate
10. Local and Federal I.C.E representatives
11. La Famila
12. CIVIC
13. Friends of the Orange County Detainees
14. El Centro Cultural de Mexico
15. Santa Ana Building a Healthy Community
16. Human Rights Watch
Exhibit 1
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MEMORANDUM FOR:
FROM:
SUBJECT:
Purpose
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Washington, DC 20536
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June 19, 2015
Assistant Directors
Deputy Assistant Directors
Field Office Directors
Deputy Field Office Directors
Assistant Field Office Director
ICE Health Service Corns-
Thomas Homan
Executive Assot
Further Goance Regarding the Care of Transgender Detainees
This memorandum provides further guidance regarding the placement and care of transgender
adult detainees in the custody of U.S. Immigration and Customs Enforcement (ICE),
Enforcement and Removal Operations (FRO).
Background
This guidance complements existing ICE detention standards, ICE Policy 11062.2: Sexual Abuse
and Assault Prevention and Intervention (SAAPI) (May 22, 2014), and the requirements of the
U.S. Department of Homeland Security (DHS) regulation titled, "Standards to Prevent, Detect,
and Respond to Sexual Abuse and Assault in Confinement Facilities," 79 Fed, Reg. 13,100 (Mar.
7, 2014), hereafter DHS PREA Standards. The security and safety of ERO employees,
detainees, detention staff, and members of the public are paramount in the exercise of this
guidance.
As in all cases, if an individual is not subject to the requirements of mandatory detention, Field
Office Directors (FODs) should continue to consider whether the use of detention resources is
warranted for a given individual and shall consider, on a case by case basis, all relevant factors in
this determination, including whether an individual identifies as transgender. While the FODs
may exercise prosecutorial discretion at any stage of an enforcement proceeding, it is generally
preferable to exercise such discretion, if warranted, as early in the case or proceeding as possible.
Exhibit 'I
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Further Guidance Regarding the Care of Transgender Detainees
Page 3 of 18
.Do you identify as a man, a woman, or as transgender?
If the detainee indicates he or she self - identifies as transgender, or has a gender identity
different from his or her biological sex, ERO personnel shall record the initial
determination in the appropriate data systems.
d. If the individual identifies that he or she is transgender, the same should also be noted on
the Form I -213 and the Form I -213 should indicate any other information he or she
disclosed related to his or her gender identity.
e. When processing an individual who identifies as transgender, ERO personnel should be
aware that he or she may:
i. Exhibit a gender expression (i.e., external and objective manifestations of gender,
such as, but not limited to, one's preferred name, pronouns, clothing, makeup,
haircut, behavior, voice, or body characteristics) that appear to indicate a gender
different from the sex listed on the detainee's identity documentation.
ii. Carry official documentation, including medical documentation, recognized by ICE
officials or a government entity (local, state, or federal) that indicates a gender
identity different from the detainee's biological sex or lists the detainee's gender
identity as transgender.
iii. Possess prescription medication (e.g., hormones), as verified by a qualified medical
professional, that indicates a gender identity different from the detainee's biological
sex.
f. The detainee shall not be disciplined for refusing to answer any gender identity- related
questions during processing, for not disclosing complete information in response to
questions asked about gender identity, or for falsely reporting that he or she is not
transgender.
g. If at any time during initial processing ERG personnel determine additional privacy is
needed to further address issues, questions, or answers referenced above with the
detainee, the FOD, to the extent practicable, shall ensure ERO personnel make
appropriate accommodations (such as using an office or unoccupied holding cell) to
converse with the detainee in private.
h. Pursuant to the DHS PREA Standards, the FOD shall ensure sensitive information, such
as a detainee's gender identity, is not used to the detainee's detriment by ICE personnel
or detention facility staff or other detainees, is not shared with other detainees, and is not
shared with others who do not have a need to know the information.
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Further Guidance Regarding the Care of Transgender Detainees
Page 5 of 18
Care of Transgender Detainees in ICE Facilities: ERO Custody Management, in consultation
and collaboration with other relevant ICE Directorates or Programs and components
(including the Office of Acquisition Management and the Office of Detention Policy and
Planning), will work with willing ICE service vendors to incorporate the model procedures
outlined in Attachment 2, "ICE Detention Facility Contract Modification for Transgender
Care" into facility contracts.
6. ERO LGBTI Field Liaisons
a. Each ERO FOD shall designate a specially trained employee at the supervisory level to
serve as an LGBTI Field Liaison'. The LGBTI Field Liaison will regularly communicate
with the National ERO LGBTI Coordinator (See section 7 below) and report to ERO
Headquarters on the progress of implementing and maintaining the provisions of this
memorandum. The LGBTI Field Liaison will also coordinate with the Prevention of
Sexual Assault (PSA) Coordinator in his or her Field Office where their responsibilities
and work overlap.
b. In detention facilities that have adopted the "ICE Detention Facility Contract
Modification for Transgender Care," the ERO LGBTI Field Liaison will be available to
actively participate on the facility's TCCC.
c. Each ERO LGBTI Field Liaison will also participate in all relevant training offered by
ERO Headquarters on the subject of this memorandum.
7. National ERO LGBTI Coordinator
a. ERO will designate a National LGBTI Coordinator. The National ERO LGBTI
Coordinator will: (1) serve as the primary point of contact and subject matter expert for
ERO regarding the care and treatment of LGBTI detainees in ERO custody; (2) evaluate
information collected from EAGLE, EARM, RCA and other relevant ICE information
technology systems regarding the care and custody of LGBTI detainees; (3) assist the
field and ERO Headquarters Directorates in utilizing information about LGBTI detainees
to help ensure compliance with the provisions of this memorandum; (4) continue to refine
and deliver training on the provisions of this memorandum; and (5) coordinate with
ICE's PSA Coordinator where their responsibilities and work overlap.
b. The National ERO LGBTI Coordinator shall also organize and convene a standing
working group to assess the implementation and maintenance of this memorandum,
advise agency leadership on issues affecting LGBTI detainees in ERO custody, further
explore best practices and strategies, and make additional recommendations when
necessary. The standing working group should meet no less than quarterly and at a
'The ERO LGBTI Field Liaison selected by the FOD may also be the local field ERO Prevention of Sexual Assault
(PSA) Coordinator or other HQs collateral duty assignment (e.g. Segregation Review Coordinator).
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Further Guidance Regarding the Care of Transgender Detainees
Page 7 of 18
ATTACHMENT 1: ICE Detention Facility Contract Modification for
Transgender Care
[ (FACILITY)] will comply with the following requirements related to the care
and custody of transgender detainees:
Transgender Care
1) Intake: Upon arrival at the detention facility, intake personnel shall review the detainee's
record and documentation. If the record indicates the detainee's gender identity differs from
his/her biological sex, intake personnel shall only ask questions related to gender identity
when such information is necessary to ensure the safety and security of other detainees and
staff. In addition, the facility shall ensure that sensitive information, such as the detainee's
gender identity, is not used to the detainee's detriment by facility personnel or other
detainees.
a) Intake personnel shall accurately record the detainee as transgender. The detainee shall be
treated as a protective custody detainee for the duration of the intake process.
b) The detainee shall be temporarily housed (i.e., in a location away from the general
population, to include in a medical unit or protective custody) for no more than 72 hours
(excluding weekends, holidays, and exigent circumstances) until classification, housing,
and other needs can be assessed by a Transgender Classification and Care Committee as
delineated below. In particular, placement into administrative segregation due to a
detainee's identification as transgender should be used only as a last resort and when no
other viable housing options exist.
2) Transgender Classification and Care Committee
a) The facility shall create and operate a Transgender Classification and Care Committee
(TCCC).
b) In facilities staffed by the ICE Health Service Corps (IHSC):
i) The TCCC shall be comprised of a dedicated facility medical representative, facility
mental health representative, a facility classification supervisor, the Enforcement and
Removal Operations (ERO) Lesbian, Gay, Bisexual, Transgender, and Intersex
(LGBTI) Field Liaison, and a supervisory representative designated by the Field
Office Director (FOD) (the supervisory representative from the ERO FOD can be the
ERO LGBTI Field Liaison).
ii) The TCCC may utilize remote forms of communication (i.e., phone or video -
teleconference) to facilitate meetings and other activities.
c) For facilities not staffed by IHSC:
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Further Guidance Regarding the Care of Transgender Detainees
Page 9 of 18
iv) Observations provided by medical or mental health representative(s), to include those
based upon the latest Diagnostic and Statistical Manual of Mental Disorders (DSM)
criteria for the diagnosis of Gender Dysphoria.
d) Detention Plan: Once the TCCC determines the detainee's transgender classification, the
TCCC shall construct an individualized Detention Plan for each transgender detainee. As
part of its Detention Plan assessment, the TCCC shall, at a minimum, consider:
i) All records and prior assessments, including medical /mental health records, and an
assessment of the effects of any housing placement on the detainee's health and
safety that has been conducted by a medical or mental health professional;
ii) The detainee's preferences and requests;
iii) The detainee's self - assessment of his or her safety needs (i.e., does the detainee feel
threatened or at risk of harm ?);
iv) The detainee's documented criminal history and past and/or current behavior;
v) The TCCC's determination of the detainee's safety/security needs, including
documented and self - reported history of sexual assault, victimization, or predatory
behavior;
vi) The detainee's physical, medical, or mental health, or special needs;
vii) Privacy issues, including showers, single -cell sleeping arrangements, etc.;
viii) Available beds and/or housing;
ix) Whether the housing assignment would pose a safety risk to other detainees (See
Section 3.e.ii "Safety, Security, and Privacy "); and
x) Effects of housing assignment on resources, including facility staff.
e) Requirements within the Detention Plan: Consistent with existing ICE policy and
detention standards, the individualized Detention Plan shall, at a minimum, contain the
following requirements:
i) Housing Assignment: Options to include:
a. General housing consistent with the detainee's biological sex;
b. General housing consistent with the detainee's gender identity;
c. A protective custody unit; or
d. Medical or administrative segregation.
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Further Guidance Regarding the Care of Transgender Detainees
Page 11 of 18
and appropriate medical professionals and administered pursuant to the applicable
ICE detention standards.
f) Decision: The TCCC will attempt to reach consensus on all decisions.
i) The TCCC shall retain summary notes of each meeting to document persons
attending and conclusions reached. A copy of the notes shall be placed in the
detainee's detention file.
ii) Absent extraordinary circumstances, a written Detention Plan by the TCCC for the
detainee, including housing assignment, shall be forwarded to the facility
classification supervisor within 72 hours (excluding weekends, holidays, and
emergencies) of the detainee's arrival at the facility, and maintained in the
detainee's detention file; a copy of the plan and housing assignment shall also be
provided to the detainee.
g) Implementation of Detention Plan: The classification supervisor shall notify line staff
of the TCCC's Detention Plan and housing assignment decision.
i) Detention facility staff shall follow the Detention Plan outlined by the TCCC. If a
detention facility staff member identifies a safety or security risk posed by the
TCCC's plan, the staff member must inform the TCCC directly, or must notify
his/her supervisor as soon as practicable, and that supervisor must notify the TCCC.
The TCCC shall review the case and make adjustments to the Detention Plan, if
necessary, within 72 hours (excluding weekends, holidays, and emergencies) of
receiving notification.
ii) In the case of an immediate threat to the safety or security of the transgender
detainee or others, the detention facility staff may make a temporary change(s) to
the TCCC's plan (to include housing assignment), but should notify the TCCC as
soon as possible. Only the TCCC can approve permanent change(s) to the
Detention Plan.
h) Reassessment: The TCCC shall reassess a transgender detainee's Detention Plan and
housing assignment after 30 days following the initial determination and then every 60
days thereafter or at any other time if additional relevant information becomes known, or
following any incident of victimization or threats to safety experienced by the detainee.
As part of its reassessment, the TCCC shall, at a minimum, consider:
i) Changes in the transgender detainee's housing preferences;
ii) Variations in the detainee's medical and/or mental health status;
iii) Safety/security of the detainee, other detainees, and/or facility staff;
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Further Guidance Regarding the Care of Transgender Detainees
Page 13 of 18
TCCC Determination Questions Guide
In preparation for the TCCC meeting, the designated facility medical representative(s), shall
meet with the detainee no later than 72 hours (excluding weekends, holidays, and emergencies)
after the detainee's arrival to the facility to gather information necessary to verify the transgender
classification, and to solicit detainee's preferences and requests with regards to housing,
searches, and other matters. The ERO LGBTI Field Liaison may also participate in any meeting
with the detainee. The following questions are provided to assist in this initial meeting, but may
be used in other settings as deemed appropriate.
1) Do you identify as transgender?
IF YES to #1, then proceed to ask the following questions:
Name
2) Do you go by or use any other name(s) or aliases?
3) What pronoun(s) do you prefer others use to refer to you?
Medical Issues
4) Prior to coming here, were you taking any hormonal medications?
a. If yes, what were they?
b. How often were you taking them?
c. Were these prescribed by a doctor?
Hvgiene and Grooming
5) Do you prefer to wear male or female clothing?
6) Are there any specific clothing items (e.g., undergarments) that you need that have not
been provided?
7) Are there any specific personal hygiene items that you need that have not been provided?
Housing
8) Do you feel you are at risk for your safety based on your gender identity?
a. Would you feel safer being housed with men or women?
b. Would you feel safer being housed with transgender women or men?
c. Would you feel safer being housed in a cell with someone else or by yourself?
Programming
9) Do you feel comfortable being around male and female detainees during recreation,
organized programs, or other types of group activities?
a. If not, would you prefer to be separated from males or females?
b. Do you feel you require complete separation, or would specific types of
safeguards (e.g., sight or sound separation, staff escort) address your concern(s)?
Searches
10) Do you have a preference for whether a male or female staff member searches you? If so,
which would you prefer?
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Further Guidance Regarding the Care of Transgender Detainees
Page 15 of 18
ATTACHMENT 2:
PREA and PBNDS Requirements Related To Transgender Detainees
Pursuant to Section 3(e) of this memorandum, applicable requirements from ICE detention
standards and the DHS PREA Standards include:
a) Classification and Housing
i) At facilities governed by the DHS PREA Standards or PBNDS 2011, facility staff
must consider the detainee's gender self - identification and an assessment of the
effects of placement on the detainee's health and safety, when making classification
and housing decisions for transgender or intersex detainees. A medical or mental
health professional must be consulted as soon as practicable on this assessment. The
facility may not base placement decisions solely on identity documents or the
physical anatomy of the detainee; rather, a detainee's self - identification and self -
assessment of safety needs must always be taken into consideration as well.
ii) At facilities governed by PBNDS 2008 or NDS, and which use ICE's Detainee
Classification System, facility staff must take into consideration and document
whether a detainee requires protective custody to ensure his/her safety and well-
being, such as because of perceived or actual sexual orientation or gender identity.
b) Showering and Privacy
i) At facilities governed by the DHS PREA Standards, transgender and intersex
detainees must be given the opportunity to shower separately from other detainees
when operationally feasible.
ii) At facilities governed by PBNDS 2011 or PBNDS 2008, transgender detainees must
be provided with a reasonably private environment for bathing and toilet facilities, in
accordance with safety and security needs.
c) Personal Hygiene and Grooming
i) The detention standards do not restrict the provision of gender appropriate clothing.
In general, brassieres should be provided to individuals who request them, as
appropriate.
ii) At facilities governed by PBNDS 2011 or PBNDS 2008, transgender detainees should
be allowed freedom in personal grooming, and access to commissary items (including
those appropriate for the detainee's identified gender) absent a valid safety, security,
or medical concern that is fully justified and documented.
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Further Guidance Regarding the Care of Transgender Detainees
Page 17 of 18
ATTACHMENT 3: Definitions
The following definitions apply for purposes of this memorandum 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.
5. 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 known 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. Intersex. Having sexual or reproductive anatomy or chromosomal pattern that do not
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Draft Policy Regarding Transaeuder People in Custody
A. TRAINING
B. ACCURATE TERMINOLOGY
C. DISCRIMINATION AND HARASSMENT
D. NAMES AND PRONOUNS
E. MEDICAL & MENTAL HEALTH PROTOCOLS
F. INTAKE
G. HOUSING
H. TRANSGENDER CARE AND CLASSIFICATION COMMITTEE (TCCC)
I. REVIEW OF HOUSING AND CLASSIFICATION
J. PROGRAMMING
K. PRIVACY
L. CLOTHING AND GROOMING
M.SEARCHES
Exhibit 3
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"feminine." California law defines "gender" as sex, and includes a person's gender
identity and gender expression. Cal. Penal Code § 422.56.
Gender Identity means an individual's internal, personal sense of their own gender,
which may or may not be associated with a person's assigned sex at birth.
Gender Expression means a person's gender - related appearance and behavior whether
or not stereotypically associated with the person's assigned sex at birth. Cal. Penal Code
§ 422.56.
Intersex: A general term used for a variety of conditions in which a person is born with a
reproductive or sexual anatomy that doesn't seem to fit the typical definitions of female
or male.
Transgender: An umbrella term for persons whose gender identity, gender expression or
behavior does not conform to that typically associated with the sex to which they were
assigned at birth.
C. DISCRIMINATION AND HARASSMENT
SACJ's staff, contract provider employees, interns, and volunteers are prohibited from
engaging in any form of discrimination or harassment against transgender people in
custody, including discrimination or harassment based on actual or perceived gender
identity or expression or based on association with a transgender person.
D. NAMES AND PRONOUNS
Regardless of where housed, all transgender individuals in custody shall be addressed by
their preferred name or last name, as well as the pronouns consistent with that
individual's gender identity (e.g. "he," "she," or gender neutral pronouns such as "they ").
Consistent use of the wrong name or pronoun constitutes prohibited harassment. A
person's preferred name and gender pronoun shall be used when referencing the person
within the text of documentation and records, unless otherwise required by law.
E. INTAKE
a. Upon conducting an intake, SACJ staff will ask each person if they would like to
disclose whether they are transgender —i.e., whether they have a gender identity
or gender expression that differs from those typically associated with their birth -
assigned sex.
b. Conversations about an individual's gender identity or expression will be held in a
private space, such as an office or unoccupied holding cell.
c. All questions shall be asked in a respectful manner and the information gathered
will be kept confidential.
d. If a person in custody indicates that they are transgender— either upon intake or at
a later time —staff will ask them to complete a Statement of Preference Form (see
Appendix A). The Statement of Preference Form will indicate the individual's
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factors such as the individual's security threat level, criminal and disciplinary history,
medical and mental health information, vulnerability to sexual victimization, and
likelihood of perpetrating abuse when making a classification recommendation.
Segregation:
Transgender individuals shall not be involuntarily placed in segregated cells solely
because of their gender identity or expression or for their own protection, except for the
period not to exceed three business days while the TCCC makes its determination.
A transgender person may choose to be placed in a segregated cell if the individual has
safety concerns about being housed with other people. If a transgender person is placed in
a segregated cell voluntarily due to their own safety concerns, the reasons for this
housing placement must be documented in the individual's medical file and signed by the
individual. This placement shall not exclude the individual from participating in
programming.
For all transgender individuals housed in segregation, a mental health evaluation shall be
conducted every 10 days to ensure all mental health needs are being met.
Lockdowns
Lockdowns will never be used as punishment. Lockdowns will only occur in the rare
circumstance that there is a specific and articulable security concern, and with the written
approval of a supervisor. Every lockdown, along with the specific and articulable
security concern, will be noted in the person in custody's records, and available for
review by the TCCC, the independent oversight committee, and the person in custody's
attorney (if any). Abuse of lockdown protocol will result in employee discipline.
Additionally, even while locked down, all individuals are permitted at least one hour of
daily out -of -cell time.
H. TRANSGENDER CARE AND CLASSIFICATION COMMITTEE (TCCC)
The Transgender Care Classification Committee (TCCC) is a multi - disciplinary body of
four to five members and shall include one classification expert, one member of the jail's
mental health team, one staff member from the Santa Ana County Department of Public
Health or the OC Human Relations Commission, and at least one individual who
identifies as a person of transgender or gender- variant experience and is not employed as
a custody or police officer. If consensus cannot be reached, the TCCC's determinations
will be made by majority vote.
The purpose of the Committee is to determine whether a transgender person should be
classified for placement in the general population, single cell, double cell, or
administrative segregation. The Committee's function is not to assess the validity of a
transgender person's gender identity or to determine whether the person will be housed in
a men's or women's facility, or the transgender module. The Committee shall evaluate
65A -29
65A -30
The TCCC shall issue its determination and reasoning in writing within three business
days of the transgender person's admission to SACJ custody, or, for an individual
already in SACJ custody, the person's request for a new placement.
I. REVIEW OF HOUSING AND CLASSIFICATION
Within the first 15 days of being assigned housing and classification, a transgender
person in custody will be interviewed —in as private a setting as possible —about any
safety concerns they may have with their placement, and will be asked again in which
housing and classification assignment they feel they would be safest and. Thereafter, a
transgender person in custody will be offered an optional follow -up interview every 60
days, in as private a setting as possible, to identify any problems related to their housing
or classification assignment and any need to reconsider. An interview and reassessment
of housing or classification assignment shall also be conducted immediately if a
transgender individual indicates they feel unsafe in their current housing or classification
assignment or there is evidence they may be unsafe in their current housing or
classification assignment.
Regardless of housing assignment, all transgender individuals must be permitted to
participate in all recreation, programming, employment, and other activities available to
other persons in custody, even when an individual is housed in administrative segregation
if such placement is unrelated to disciplinary action.
K. PRIVACY
All transgender individuals regardless of housing area shall be allowed to "shower,
perform bodily functions; and change clothing without nonmedical staff of a different
gender viewing their breasts, buttocks, or genitalia, except in exigent circumstances or
when such viewing is incidental to routine cell checks." z For purposes of this policy,
"staff of a different gender" means staff with a gender different from the person's gender
identity, regardless of where the individual is housed.
L. CLOTHING AND GROOMING
Regardless of where housed, all people in custody shall have access to clothing and
grooming items, accessories, and all other items consistent with their gender identity or
gender expression, including makeup, bras, gender appropriate underclothes, etc.
M. SEARCHES
All searches shall be conducted consistent with PREA and Department search policy.
1. When a search of a transgender individual is required, the search will be
28 C.F.R. § 115.15(d).
65A -31
65A -32
AMENDMENT OF SOLICITATION (MODIFICATIONOFCONTRACT 1' c. D
1 � 2
2. AMANDMANWINICATION NO
S. EFFECTME OATS
4 RAQUTAITION(FUNCHASERAO. NO
E, PROJECT No. (if aAplla4WO1
P00001
Sea Block 1fC
a ISAUEOST 0. A ICE /DM /OC- 1AQUNA
7,AbMINI TER DDP111411wlhan fdm Is CODS ICE /DM /DC- LAQUNA
ICE /Detant Mngt /DQtent Contract -LAC
ICE /Decant. Mngt /Detent Contract-LAQ
Immigration and customs Enforcement
Immigration and Customs Enforcement
Office of Acquisition Management
Office of Acquisition Management
24000 Avila Road, Room 7104
24000 Avila Road, Room 3104
Attn: Natasha Nguyen 949)425-7030
Attn1 Natasha Nguyen, 49491425 -7070
Laguna Niguel CA 92677
Laguna Niguel CA 92677
@. MAtdE MJDARDRESS OF CON CTORId?,aeea. AaANAarwawrinLagi
A
9A. AM9140MANTOF SOLICITATION NO.. ..
SANTA ANA CITY OF
W CIVIC CENTER PLAZA
Ss, DATED f6EE+r4M 111
SANTA ANA CA 92701
N
p4AA, AA11ppppII TT pp OF
E'ROIGSAAI SN DU RA07 /OR0AR NO.
07 qNT
1@B. DATED JEWS ITEM ISI - - - - -
D5/3012D1.5
CODE D83163247
FAOILITP ODE
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9R, TMIa 1PAMOMI.YAFP6IE@ T? MODIEIDAnOR W DONPRACT@IORDEA@� R MODIFIER THE 0ONTaAOTIDNDER nQ.AS D9@aAl@ ®D IN ITEM 14,
A. ;MIA rnoGA ORDER.1@ IAAUSD PIJRADANT TO (EFMy AWAWW THE CHANGES SET FONTH IN ITEM 14 ARE MAYS A THE CONTRACT
@ THE AEpYSNUM9ERAD 49di�B. CT( O�AFtiS. MQDIPIE4' TA. R9FI .SGTttl @AQMIdITTAATNE..GMAHGAS tawM+aadNfreammaannaaEUq.
X jMutu4l Agreement of the Parties
Z RIPORUNT: CmMm AIAIli. efgµUUg4IqN�uuA'4x4manlaM.(ANm. QNMAiR!.Nab4gil@ .
14. DESCRIPTION OF AMENOMENTIMOMFICATION (OTAN9009y UCFwdi n114adq& mWnSA4fImf4lWAkonfr4MtifA(IPI maRaPN9I4mAtaarpb)
DUNSNumberl 083154247
COB POC/ Aaryoosh Mackay, (213) 633 -4977 or e-mail at Oaryooah.A.MackayQi".dhs,gov
Alternate. COB FOCs Daniel Pomplun, (760) 561 -6327 or e� -.mail at daniel..a,pomplunQica.dhF , pov
This modification is to incorporate the following:
1) To Incorporate provisions for tranagender care outlined on the Attachment 6 -
Tranagender Cara, see attached.
2) Add assurance for 64 Weds to separate and dedicate. for Tranagondar datainaaa.
Continued. ..,
%T. Halls
nRW � nimowmpr
P OW%444Nnk 44rla
Prgae Why
FAR (4E CFR)
65A -33
65A -34
ATTEST;
MARIA HUIZAR
Cleric of the Council
APPROVED AS TO FORM.
SONIA R. CARVALHO
City Attorney
Laura A. Rossini
Senior Assistant City Attorney
CITY OF SANTA ANA
DAVID CAVAZOS
City Manager
65A -35
65A -36
CONTINUATION SHEET I REFERENCE NO. OF DOCUMENT BRING CONTINUED PACE OF
EROIGSA -I9- 0007 /P00QQI 12 1 2
NAME OF OFFEROR OR CONTRACTOR
SANTA ANA CITY OF
ITEM NO,
(A)
SUPPEIRS IRRVICES
(B)
QUANTITY
(C)
UNIT
(B)
UNITPRICE
(E)
AMOUNT
(F`)
3) Remove the number of beds stated in Article 3
- Covered Services, Section A - Bedspaco to state
that the Service Provider and ICE shall use beds
consistent with operational need and availability
Exempt Action: x
LIST OF CHANGES:
Reason for Modification ; S9Applemental Agreement
for work within scope
Period of Perfor.mancei 07/01/2015 to 06/30/2020
NtlN YGCA.R140 AARR/ 9RTIQN& FPRM ARA IA-AR!
AS 7 WpnnAQrol by WA
65A -31 FARpA QFRI 4RdiR
65A -38
EROIGSA -15 -0007, P49001 Attachment b - Transgender Care
[Santa Ana Jail FACILITY] will comply with the followtng requirements related to the care and
custody oftransgender detainees;
Transgender Care
1) Intake: Upon arrival at the detention facility, intake personnel shall review the detainee's
record and documentation. If the record indicates the detainee's gender identity differs from
his/her biological sex, intake personnel shall only ask questions related to gender identity
when such information is necessary to ensure the safety and security of other detainees and
staff. In addition, the facility shall ensure that sensitive information, such as the detainee's
gender identity, is not used to the detainee's detriment by facility personnel or other
detainees:
a) Intake personnel shall accurately record the detainee as transgender. The detainee shall be
treated as a protective custody detainee for the duration of the intake process.
b) The detainee shall be temporarily housed (i.e,, in a location away from the general
population, to include in a medical unit or protective custody) until classification,
housing, and other needs can be assessed by a Transgender Classification and Care
Committee as delineated below, When feasible, the facility will initiate the review
process within 72 hours (excluding holidays, and exigent circumstances and not to
exceed 10 calendar days. In particular, placement into administrative segregation due to
a detainee's identification as transgender should be used only as a last resort and when no
other viable housing options exist.
2) Transgender Classiflcation and Care Committee
a) The facility shall create and operate a Transgender Classification and Care Committee
(TCCC).
b) In facilities staffed, by the ICF Health Service Corps (IHSC):
i) The TCCC shall be comprised of a dedicated facility medical representative, facility
mental health representative, a facility classification supervisor, the Enforcement and
Removal Operations (ERCi) Lesbian, Uay, Bisexual, Transgeadcr, and Intersex
(LOOTi) Field Liaison, and a supervisory representative designated by the Field
Office Director (FOD) (the supervisory representative from the CRCs FOD can be the
ERO I. HTI Field Liaison),
11) The TCCC may utilize remote forins of communication (i.e., phone or video -
teleconference) to facilitate meetings and other activities,
c) For faellitles i t- tafl'ed by MSC:
i) The TCCC shall include the IHSC Field Medical Coordinator (FMC), in addition
to a dedicated facility medical representative, a facility mental health representative,
65A -39
65A -40
EROIGSA -13 -4007, F00001 Attachment b - Transgender Care
a facility classification supervisor, facility ICE compliance officer or security
supervisor, the ERO LGBTI Field Liaison, and asupervisory representative
designated by the FOD (at the FOD's discretion, the supervisory representative can
include the ERO LOBTI Field Liaison).
d) The TCCC shall be chaircdjointly by a representative from the facility and an FRO
representative, preferably the ERO LGBTI Field Liaison,
e) In coordination with FRO LGBT1 Field Liaison, the facility staff members, including
medical and mental health personnel, will have appropriate training and experience in
working with transgender persons. Training provided will be pursuant to a training plan
mutually agreed upon by the parties,
3) Transgender Classylication and Care Committee Determinations:
a) Meeting with the Detainee, In preparation for the TCCC meeting, the TCCC designated
facility medical representative(s) shall meet with the detainee as soon as practicable after
the detainee's arrival to the facility to gather information necessary to solicit the
detainee's preferences and requests with regard to housing, searches, i and other matters.
The ERO LBTI Field Liaison may also participate in any meeting with the detainee.
The communication between the TCCC representative(s) and the detainee shall be in a
language and manner the detainee can understand and should be conducted using the
TCCC Determination Question Guide provided at the conclusion of this document.
b) Meeting of the TCCC.- The TCCC shall meet and provide a classification assessment no
later than 10 calendar days but when feasible, within 72 hours (excluding weekends,
holidays, and emergencies) after the detainee's arrival to the facility to assess medical,
psychological, housing, and other needs.
c) Class(fleattanAssessment; As part of the transgendcr classification assessment, the
TCCC shall, at a minimum, consider:
1) The detainee's self-Identification,
11) An assessment of the effect of possible placements on the detainee's health and
safety, conducted by a medical or mental health professional (which may colncide
with the full medical assessment done in accordance with the applicable ICE
detention standards),
iii) The detainee's record and available documentation, including forms and notes from
initial processing, medical/mental health records, booking records, identification
documents, etc,; and
iv) Documented observations provided by facility staff supervising the detainee in the
1 Whenever practicable, the detainee's request should be honored but not to the detriment of the satty and security
of the facility or facility staff,
21Patie^
65A -41
65A -42
EROIGSA -15- 0007, iA00001 Attachment G - Transgender Care
assigned housing unit; medical or mental health representative(s), to include those
based upon the latest Diagnostic and Statistical Manual of Mental Disorders (DSM)
criteria for the diagnosis of Mender Dysphoria,
d) Detention Plan: Once the TCCC determines the detainee's transgender classification, the
TCCC shall construct an individualized Detention flan for each transgender detainee. As
part of its Detention Plan assessment, the TCCC shall, at a minimum, consider:
i) All records and prior assessments, including medical /mental health records, and an
assessment of the effects of any housing placement on the detainee's health and
safety that has been conducted by a medical or mental health professional;
ii) The detainee's preferences and requests;
iii) The detainee's self assessment of his or her safety needs (i.e., does the detainee feel
threatened or at risk of harm ?);
iv) The detainee's documented criminal history and past and /or current behavior;
v) The TCCC's determination of the detainee's safety /security needs, including
documented and self-reported history of sexual assault, victimization, or predatory
behavior;
vi) The detainee's physical, medical, or mental health, or special needs;
vii) Privacy issues, including showers, single -cell sleeping arrangements, etc,;
viii) Available beds and/or housing;
ix) Whether the housing assignment would pose a safety risk to other detainees (See
Section 3.c.ii "Safety, Security, and Privacy "); and
x) Effects of housing assignment on resources, including facility staff.
e) Requirements within the Detention Plan: Consistent with existing ICE policy and
detention standards, the individualized Detention Plan shall, at a minimum, contain the
following requirements:
i) - Alou Amiumm: Options to include:
a. General housing consistent with the detainee's biological sex;
b. General housing consistent with the detainee's gander identity;
c, A protective custody unit, or
d, Medical or administrative segregation.
11) Safety. Secut itv and Pnvacr The TCCC shall address the safety, security, and
privacy needs for both the transgender detainee and the general detention
population when assessing the housing assignment. Discussion(s) may Include
65A -43
65A -44
EROIGSA -IS -0007, P00001 Attachment 6 - Transgender Care
guidance on appropriate staffing levels in the housing option assigned (e.g., single
or shared cell, or dormitory housing),
iii) Hygienc: Consistent with ICE detention standards, facility staff shall ensure that
transgender detainees are able to maintain acceptable personal hygiene practices
consistent with their gender identity and that ensure their safety. Transgender
detainees shall be provided the opportunity to shower in a setting that ensures safety
and privacy,
iv) Clothing and Commissary: Transgender detainees will be provided undergarments
consistent with their gender identity as assessed by the TCCC. Transgender
detainees shall be issued standard detention attire consistent with their assigned
housing unit. Transgender detainees shall also be allowed to possess or purchase
through the commissary those hygiene and personal items that are consistent with
their Detention Plan.
v) Searches; As prescribed by standard 2.10 of ICE's 2011 aeeYao ante - Berson
Nett nat t a . cts B ;DS, the transgender detainee's preference as to
the gender of the officer that will perform any necessary pat -down and strip
searches will be considered by the TCCC when drafting the Detention Plan and
followed by detention facility staff accordingly. Also with regards to strip searches
only, and pursuant to standard 2.10 of ICE's 2011 L NDS, special care should be
taken to ensure that transgender detainees are searched in private. Searches shall be
conducted in a professional and respectful manner, and in the least restrictive
manner possible, consistent with security needs. Pursuant to MIS PREA
Standards, at no time shall any search be conducted solely for the purpose of
determining a detainee's biological sex. Requests for transgender detainees to
remove appearance related items such as prosthetics, clothing that conveys gender
identity, wigs, and cosmetics shall he consistent with requirements for the removal
of similar items for other non- transgender detainees. All strip searches shall be
documented,
vi) Staff Com U ` ti ; Detention facility staff shall refer to transgender detainees
by their preferred pronouns or by the detainee's last name.
vii) M2dieal Cow Pursuant to existing ICE detention standards, transgender detainees
who were already receiving hormone therapy when taken Into ICE custody shall
have continued access to hormone therapy; those who have not yet begun treatment
will be assessed and treated, if deemed medically necessary and safe in the context
of their tither medical conditions, All transgender detainees shall have access to
continued mental health care and othertransgonder- related health care based on
medical need. Medical care for transgender detainees shall be provided by qualified
and appropriate medical professionals and administered pursuant to the applicable
ICE detention standards.
f) Decision.- The TCCC will attempt to each consensus on all decisions, In Situations
4 1 P a u e
65A -45
,� 1 I �J
ERGIGSA -15-0007, P00001 Attachment 6 - Transgender Care
where a consensus is not reached, the final decision shall rest with the CRO LGSTI Field
Liaison.
i) The TCCC shall retain summary notes of each .meeting to document persons
attending and conclusions reached. A copy of the notes shall be placed In the
detainee's detention file.
ii) Absent extraordinary circumstances, a written Detention Plan by the TCCC for the
detainee, including housing assignment, shall be forwarded to the facility
classification supervisor within 72 hours (excluding weekends, holidays, and
emergencies) of TCCC's decision, and maintained in the detainee's detention
file; a copy of the plan and housing assignment shall also be provided to the
detainee.
g) ,implementation nfFetention Plan; The classification supervisor or designee shall
notify line staff of the TCCC's Detention Plan and change of housing assignment
decision.
i) Detention facility staff shall follow the Detention Plan outlined by the TCCC. If a
detention facility staff member identifies a safety or security risk posed by the
TCCC's plan, the staff member must inform the TCCC directly, or must notify
his/her supervisor as soon as practicable, and that supervisor must notify the TCCC.
The TCCC shall review the case and make adjustrnents to the Detention Plan, if
accessary, within 72 hours (excluding weekends, holidays, and emergencies) of
receiving notification.
li) In the case of an Immediate threat to the safety or security of the transgender
detainee or others, the detention facility staff may make a temporary change(s) to
the TCCC °s plan (to include housing assignment), but should notify the TCCC as
soon as possible. Only the TCCC can approve permanent change(s) to the
Detention Plan.
h) Reassessment. The TCCC shall reassess a transgender detainee's Detention Plan and
housing assignment after 30 days following the initial determination and then every 60
days thereafter or at any other time if additional relevant information becomes known, or
following any incident of victimization or threats to safety experienced by the detainee.
As part of its reassessment, the TCCC shall, at a minimum, consider:
P�
I) Changes in the transgender detainee's housing preferences;
ii) Variations in the detainee's medical and /or mental health status;
iii) Safety /security of the detainee, other detainees, and/or facility staff;
iv) Any threats to safety experienced by the detainee,
65A -47
,t 1 I oo
EROIGSA -15 -0007, P00001 Attaehment 6 - Transgender Care
v) Continued availability of housing; and
vi) The detention facility's documented concerns,
i) .Education: Upon adoption of this Contract Modification, the facility, in partnership with
ICE FRO, will produce orientation training and /or materials describing the various
housing options at the facility, including the possibility of placing a transgender detainee
in general housing consistent with that detainee's gender identity. This training and/or
materials will be provided to each detainee upon admission, as well as to detainees
already placed in the facility.
4) Hod Space Financial Assurance; The Service Provider and ICE agree on a assurance of 64
beds to separate and dedicate Transgender detainees.
5) 19tal ICE Waiam Parming to,be Housed with 5cryfig : The Service Provider and
ICE agree to modify FRQIC,SA -15 -907, specifically Article 3 "Covered Services ", Section A
" B,edspacc," to state that the Service Provider and ICE shall use beds consistent with operational
need and availability,
61Pag,�
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EROIGSA -15-0007, JP00001 Attachment 6 - Transgender Care
TCCC Determination Questions Guide
In preparation for the TCCC meeting, the designated facility medical representative($), shall
meet with the detainee when feasible within 72 hours (excluding weekends, holidays, and
emergencies) and no later than ten (10) calendar days after the detainee's arrival to the facility to
gather information necessary to verify the transgender classification, and to solicit detainee's
preferences and requests with regards to housing, searches, and other matters. The BRO LOBTI
Field Liaison may also participate in any meeting with the detainee. The following questions are
provided to assist in this initial meeting, but may be used in other settings as deemed appropriate.
1) Do you identify as transgender?
IF YES to ##1, then proceed to ask the following questions:
Name
2) Do you go by or use any other name(s) or aliases?
3) What pronoun(s) do you prefer others use to refer to you?
Medical issues
4) Prior to coming hare, were you taking any hormonal medications?
a, If yes, what were they?
b. How often were you taking them?
c. Were these prescribed by a doctor?
Hygiene and Grooming
S) Do you prefer to wear mole or female clothing?
6) Are there any specific clothing items (e.g„ undergarments) that you need that have not
been provided?
7) Are there any specific personal hygiene items that you need that have not been provided?
uQuaing
g) too you feel you are at ride for your safety based on your gender identity?
a, Would you feel safer being housed with men or women?
K Would you feel safer being housed with transgender women or men?
c. Would you feel safer being housed in a colt with someone else or by yourself?
Programming
0) Do you feet comfortable being around male and female detainees during recreation,
organized programs, or other types of group activities?
a. If not, would you prefer to be separated from males or females?
b. Do you feel you require complete separation, or would specific types of
safeguards (e.g., sight or sound separation, staff escort) address your Concern(a)?
S.oamlics
10) Do you have a preference for whether a. male or female staff member searches you? If so,
which would you prefer?
other
7 1 P a g e
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EROIGSA -15-0007, P00001 Attachment 6 - Transgender Cara
11) is there anything else we should know about you related to being transgender —airy
particular concerns?
12) Are there any other specific precautions and/or accommodations you think you would
like to have to ensure your safety and welfare while at this 'facility?
65A -53
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EROIGSA- 134007, P00001 Attachment 6 - Transgender Fare
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,
3. 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. Nate: 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 known as Gender Identity Disorder,
7. Gender Expression. The ways in which an individual communicates /displays his /tier
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 tither 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. Intersex. 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.
91Pzt
65A -55
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) ROIGSA -15 -0007, P00001 Attachment 6 - Transgender Care
11. LGBTI. The acronym for Lesbian, Gay, Bisexual, Transgender, and Intersex.
11 Sexual Orientation. A pattern of romantic, emotional, physical, and /or sexual attraction
towards members of the same, opposite, or both sexes. Includes homosexuality,
heterosexuality, and bisexuality,
11 Transgender. A person whose gender identity (i,e„ internal sense of feeling male or
female) Is different from the sex assigned to the person at birth.
14. Transgender Classification and Care Committee (TCCC). The detention facility
committee that gathers information and assesses the gender identity of tite detainee, and
produces and regularly assesses a Detention Plan for a transgender detainee.
15. Transgender man. An individual who is a biological female and has a gender identity as
a man,
16, Transgender woman. An individual who is a biological male and has a gender identity
as a woman.
17. Transition. The process by which an individual changes his /tier gender from that
assigned at birth to one with which he/she now identifies. This may include making
personal, legal, and medical changes to his /her gender, such as changing his /her name
and /or gender on legal documents undergoing hormone therapy; and/or undergoing
one or more forms of surgery,
10 s;!,ti
65A -57
65A -58