Menopause in incarceration is a social and policy campaigning issue in which people work to raise awareness of the gender specific impact menopause symptoms can have on people in prison. [1] Although women are a minority of those incarcerated, the age of women in the prison system is increasing across the world. As this happens it becomes necessary for inmates to be assessed for menopausal symptoms and offered the gender and age-specific services and support they need. [2] Researchers have identified this as a gap in prison healthcare which leaves the needs of many people unmet. [3] [4]
Menopausal women experience a range of medical and health issues whether or not they are in prison. Particular aspects of incarceration, however, may exacerbate the experience of menopause and these are the responsibility of organisations making health policy. [5] In the US, a third of older women prisoners say they are concerned about it. [3] Menopause is an inter-sectional issue in women's health as it combines gender and age. [6] Incarceration brings a complex combination of inequality factors for women's needs in terms of menstruation, pregnancy, contraception, post-natal health, mental health and menopause. In countries where prisons are privatized, women's health needs may be seen as low priority. [7]
In prisons access to hygiene and medical supplies are restricted, [8] [9] and it is difficult to regulate the temperature of rooms. Peri-menopause leads to erratic periods and many women experience frequent hot-flashes. [10] Many facilities do not provide access to locally controlled air conditioning or fans which are needed to regulate and relieve hot flashes, which are a common symptom of menopause. Additional layers of clothing may be needed for increased comfort during hot flashes and night sweating. [11] The symptoms of menopause may also include mental health issues such as feelings of shame, embarrassment, short-temper, loneliness and depression which are challenging to manage for well-being in prison. [12] [13] In the UK, 65% of women in prison suffer from depression. [14] Shame and embarrassment results from physical changes but also from societal norms in which menopause continues to be a 'taboo subject'. [15] Women inmates in prisons report that their concerns were often dismissed. [3]
There are additional physical complications as menopause often brings osteoporosis and in prisons the weight-bearing exercises and extra support may not be available to help in treatment. [11] In the UK the health of older prisoners is seen to be worse than that of the wider community and many have additional disabilities or long-standing illness. [16]
In the USA the fastest-growing segment of the prison population is women but health systems which have been designed for men fail to meet their needs. [17] The National Commission on Correctional Health Care recognize the need for standards in care in jails and prisons. [18]
The UK Government has set standards for care of women in prison which includes appropriate treatment and support for transition through the menopause and access to the similar standards of care as they would have in the community. Women are offered access to hormone replacement therapy and the option to change their sheets frequently if they suffer from night sweats. [19]
In 2009 the Kyiv Declaration on Women's Health in Prison reviewed issues affecting women's health in the criminal justice system. [20] The Declaration raises awareness of the differences in health needs between men and women prisoners. The World Health Organisation considers that prison health services contribute to the social well-being of all of society and suggests that prisons should have written policies showing the practices that are sensitive to women. [5] The United Nations 2010 Rules for the Treatment of Women Prisoners and Non-custodial Measures for Women Offenders are known as 'The Bangkok Rules'. The 70 Rules give guidance to cover healthcare and humane treatment . [12] [21]
Menopause, also known as the climacteric, is the time when menstrual periods permanently stop, marking the end of reproduction. It typically occurs between the ages of 45 and 55, although the exact timing can vary. Menopause is usually a natural change related to a decrease in circulating blood estrogen levels. It can occur earlier in those who smoke tobacco. Other causes include surgery that removes both ovaries, some types of chemotherapy, or anything that leads to a decrease in hormone levels. At the physiological level, menopause happens because of a decrease in the ovaries' production of the hormones estrogen and progesterone. While typically not needed, a diagnosis of menopause can be confirmed by measuring hormone levels in the blood or urine. Menopause is the opposite of menarche, the time when a girl's periods start.
Prison sexuality consists of sexual relationships between prisoners or between a prisoner and a prison employee or other persons to whom prisoners have access. Since prisons are usually separated by sex, most sexual activity is with a same-sex partner. Exceptions to this include sex with spouses/partners during conjugal visits and sex with a prison employee of the opposite sex.
A prison nursery is a section of a prison that houses incarcerated mothers and their very young children. Prison nurseries are not common in correctional facilities in the United States, although prior to the 1950s many states had them and they are widespread throughout the rest of the world.
Lesbian, gay, bisexual, transgender and queer (LGBTQ) people face difficulties in prison such as increased vulnerability to sexual assault, other kinds of violence, and trouble accessing necessary medical care. While much of the available data on LGBTQ inmates comes from the United States, Amnesty International maintains records of known incidents internationally in which LGBTQ prisoners and those perceived to be lesbian, gay, bisexual or transgender have suffered torture, ill-treatment and violence at the hands of fellow inmates as well as prison officials.
Prison healthcare is the medical specialty in which healthcare providers care for people in prisons and jails. Prison healthcare is a relatively new specialty that developed alongside the adaption of prisons into modern disciplinary institutions. Enclosed prison populations are particularly vulnerable to infectious diseases, including arthritis, asthma, hypertension, cervical cancer, hepatitis, tuberculosis, AIDS, and HIV, and mental health issues, such as Depression, mania, anxiety, and post-traumatic stress disorder. These conditions link prison healthcare to issues of public health, preventive healthcare, and hygiene. Prisoner dependency on provided healthcare raises unique problems in medical ethics.
Approximately 741,000 women are incarcerated in correctional facilities, a 17% increase since 2010 and the female prison population has been increasing across all continents. The list of countries by incarceration rate includes a main table with a column for the historical and current percentage of prisoners who are female.
Gender-biased diagnosing is the idea that medical and psychological diagnosis are influenced by the patient's gender. Several studies have found evidence of differential diagnosis for patients with similar ailments but of different sexes. Female patients face discrimination through the denial of treatment or miss-classification of diagnosis as a result of not being taken seriously due to stereotypes and gender bias. According to traditional medical studies, most of these medical studies were done on men thus overlooking many issues that were related to women's health. This topic alone sparked controversy and questions about the medical standard of our time. Popular media has illuminated the issue of gender bias in recent years. Research that was done on diseases that affected women more were less funded than those diseases that affected men and women equally.
Postmenopausal confusion, also commonly referred to as postmenopausal brain fog, is a group of symptoms of menopause in which women report problems with cognition at a higher frequency during postmenopause than before.
Atrophic vaginitis is inflammation of the vagina as a result of tissue thinning due to low estrogen levels. Symptoms may include pain with sex, vaginal itchiness or dryness, and an urge to urinate or burning with urination. It generally does not resolve without ongoing treatment. Complications may include urinary tract infections. Atrophic vaginitis as well as vulvovaginal atrophy, bladder and urethral dysfunctions are a group of conditions that constitute genitourinary syndrome of menopause (GSM). Diagnosis is typically based on symptoms.
The incarceration of women in the United States refers to the imprisonment of women in both prisons and jails in the United States. There are approximately 219,000 incarcerated women in the US according to a November 2018 report by the Prison Policy Initiative, and the rate of incarceration of women in the United States is at a historic and global high, with 133 women in correctional facilities per every 100,000 female citizens. The United States is home to just 4% of the world's female population, yet the US is responsible for 33% of the entire world's incarcerated female population. The steep rise in the population of incarcerated women in the US is linked to the complex history of the war on drugs and the US's prison–industrial complex, which lead to mass incarceration among many demographics, but had particularly dramatic impacts on women and especially women of color. However, women made up only 10.4% of the US prison and jail population, as of 2015.
Transgender health care includes the prevention, diagnosis and treatment of physical and mental health conditions for transgender individuals. A major component of transgender health care is gender-affirming care, the medical aspect of gender transition. Questions implicated in transgender health care include gender variance, sex reassignment therapy, health risks, and access to healthcare for trans people in different countries around the world. Gender affirming health care can include psychological, medical, physical, and social behavioral care. The purpose of gender affirming care is to help a transgender individual conform to their desired gender identity.
People with mental illnesses are over-represented in jail and prison populations in the United States relative to the general population.
Gender-responsive prisons are prisons constructed to provide gender-specific care to incarcerated women. Contemporary sex-based prison programs were presented as a solution to the rapidly increasing number of women in the prison industrial complex and the overcrowding of California's prisons. These programs vary in intent and implementation and are based on the idea that female offenders differ from their male counterparts in their personal histories and pathways to crime. Multi-dimensional programs oriented toward female behaviors are considered by many to be effective in curbing recidivism.
Women in American prisons encounter numerous difficulties that often involve mental health problems, drug and alcohol issues, and trauma. These challenges not only make navigating the criminal justice system more difficult for women but also highlights broader societal issues such as, gender-based violence, economic inequalities, and lack of mental health support. People in prison are more likely than the general United States population to have received a mental disorder diagnosis, and women in prison have higher rates of mental illness and mental health treatment than do men in prison. Furthermore, women in prisons are three times more likely than the general population to report poor physical and mental health. Women are the fastest growing demographic of the United States prison population. As of 2019, there are about 222,500 women incarcerated in state and federal prisons in the United States. Women comprise roughly 8% of all inmates in the United States. This surge is largely attributed to the rising use of imprisonment for drug-related offenses rather than violent crimes. A considerable portion of incarcerated women are serving time for drug-related offenses, with the proportion increasing significantly between 1986 and 1991. Even among those in maximum security facilities, a majority are not imprisoned for violent felonies. The data also reveal that in states like New York, a substantial proportion of incarcerated women are serving time for drug-related offenses, with a smaller percentage incarcerated for violent crimes or property offenses.
In the United States, prisons are obligated to provide health care to prisoners. Such health care is sometimes called correctional medicine. In women's prisons, correctional medicine includes attention to reproductive health.
Prisoner reentry is the process by which prisoners who have been released return to the community. Many types of programs have been implemented with the goal of reducing recidivism and have been found to be effective for this purpose. Consideration for the conditions of the communities formerly incarcerated individuals are re-entering, which are often disadvantaged, is a fundamental part of successful re-entry.
Women with disabilities have the same health issues as any other women, such as the need for routine breast and cervical cancer screening. However, women with impaired mobility are often not given basic tests, such as weight monitoring, due to the lack of accessible equipment.
Mass incarceration is a major problem in the United States. People who have been incarcerated or are currently incarcerated face many challenges including challenges with their health. This wikipedia post studies the health problems that can come with incarceration by looking at the relationship between children being incarcerated and the health outcomes they have as adults, the health effects of incarcerated people with HIV, the effect of aging on people with a history of incarceration, and the effect that the Affordable Care Act has on the health insurance status of people who have been incarcerated.
Alongside the general opioid epidemic in the United States, there has been an increase in the number of incarcerated people in the United States experiencing opioid use disorder. Over half of the estimated 7 million incarcerated people in the United States meet the Diagnostic and Statistical Manual for Mental Disorders (DSM) criteria for substance use disorder, and only 20% receive treatment. To alleviate this problem, the United States Department of Corrections has implemented various treatment plans and programs for inmates.
Menopause in the workplace is a social and human resources campaigning issue in which people work to raise awareness of the impact menopause symptoms can have on attendance and performance in the workplace.
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