{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T12:26:20Z","timestamp":1793190380393,"version":"4.5.0"},"reference-count":16,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T00:00:00Z","timestamp":1769990400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychiatry"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Transgender and gender-diverse (TGD) individuals face high levels of stigma, discrimination, and psychological distress, which are amplified in carceral settings. Italian prisons have introduced specialized sections for TGD inmates; however, limited empirical evidence exists on their function and the psychiatric, social, and institutional challenges emerging within them.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A case-informed qualitative design was applied to four TGD inmates housed in a specialized prison section in Northern Italy. Data were derived from routine psychiatric and endocrinological assessments, administrative documentation, informal and semi-structured interviews, and multidisciplinary team observations. A thematic cross-case synthesis was conducted to identify institutional determinants of distress and barriers to gender-affirming care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Three themes emerged. (1) Context-dependent fluidity in gender identity recognition and categorization: institutional frameworks relied on static binary models, contributing to confusion and psychological strain. (2) Intra-group tensions within designated housing: discrepancies in transition pathways, administrative criteria, perceived authenticity, and the presence of sexual minority inmates generated conflict and social exclusion. (3) Gaps in gender-affirming and psychiatric care: logistical barriers, limited staff training, reliance on telemedicine, and inconsistent access to hormone therapy disrupted continuity of care and exacerbated distress.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>These findings illustrate how rigid systems and ambiguous housing policies may reinforce minority stress and undermine psychiatric well-being. Protective units can inadvertently reproduce exclusion when gender identity and sexual orientation are conflated or when criteria for placement remain unclear. Correctional systems should adopt flexible gender-recognition procedures, implement trauma-informed practices, develop distinct housing policies, establish standardized pathways for gender-affirming care, and provide specialized staff training to ensure dignity, safety, and improved mental health outcomes for TGD inmates.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpsyt.2026.1737418","type":"journal-article","created":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T06:31:45Z","timestamp":1770013905000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Transgender identity and psychiatric care in Italian prisons: a thematic analysis of systemic gaps and institutional challenges"],"prefix":"10.3389","volume":"17","author":[{"given":"Paolo","family":"Meneguzzo","sequence":"first","affiliation":[{"name":"Department of Neuroscience, University of Padova","place":["Padova, Italy"]},{"name":"Padova Neuroscience Center, University of Padova","place":["Padova, Italy"]},{"name":"Regional Reference Center for Gender Incongruence, Azienda Ospedale-Universit\u00e0 di Padova","place":["Padova, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniele","family":"Zuccaretti","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, University of Padova","place":["Padova, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matilde","family":"Obici","sequence":"additional","affiliation":[{"name":"AULSS 1 Dolomiti","place":["Belluno, Italy"]},{"name":"Hygiene and Public Health Unit, Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova","place":["Padova, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Cristoforetti","sequence":"additional","affiliation":[{"name":"AULSS 1 Dolomiti","place":["Belluno, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Scala","sequence":"additional","affiliation":[{"name":"Regional Reference Center for Gender Incongruence, Azienda Ospedale-Universit\u00e0 di Padova","place":["Padova, Italy"]},{"name":"Unit of Andrology and Reproductive Medicine, Department of Medicine, University of Padova","place":["Padova, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marina","family":"Bonato","sequence":"additional","affiliation":[{"name":"Regional Reference Center for Gender Incongruence, Azienda Ospedale-Universit\u00e0 di Padova","place":["Padova, Italy"]},{"name":"Department of Developmental Psychology and Socialization, University of Padova","place":["Padova, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marina","family":"Miscioscia","sequence":"additional","affiliation":[{"name":"Regional Reference Center for Gender Incongruence, Azienda Ospedale-Universit\u00e0 di Padova","place":["Padova, Italy"]},{"name":"Department of Developmental Psychology and Socialization, University of Padova","place":["Padova, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela","family":"Favaro","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, University of Padova","place":["Padova, Italy"]},{"name":"Padova Neuroscience Center, University of Padova","place":["Padova, Italy"]},{"name":"Regional Reference Center for Gender Incongruence, Azienda Ospedale-Universit\u00e0 di Padova","place":["Padova, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Garolla","sequence":"additional","affiliation":[{"name":"Regional Reference Center for Gender Incongruence, Azienda Ospedale-Universit\u00e0 di Padova","place":["Padova, Italy"]},{"name":"Unit of Andrology and Reproductive Medicine, Department of Medicine, University of Padova","place":["Padova, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,2,2]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1080\/19419899.2020.1729844","article-title":"What is gender, anyway: a review of the options for operationalising gender","volume":"12","author":"Lindqvist","year":"2021","journal-title":"Psychol Sexual"},{"key":"B2","doi-asserted-by":"publisher","first-page":"S1","DOI":"10.1080\/26895269.2022.2100644","article-title":"Standards of care for the health of transgender and gender diverse people, version 8","volume":"23","author":"Coleman","year":"2022","journal-title":"Int J Transgender Health"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1016\/j.chc.2023.05.011","article-title":"Complex Psychiatric histories and transgender and gender diverse youth","volume":"32","author":"Curtis","year":"2023","journal-title":"Child Adolesc Psychiatr Clinics"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph18179335","article-title":"Views and experiences of lgbtq+ people in prison regarding their psychosocial needs: A systematic review of the qualitative research evidence","volume":"18","author":"Donohue","year":"2021","journal-title":"Int J Environ Res Public Health"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1080\/09540261.2023.2287680","article-title":"Mental health of transgender people in prison: a systematic review and meta-analysis","volume":"36","author":"Marchi","year":"2024","journal-title":"Int Rev Psychiatry"},{"key":"B6","doi-asserted-by":"publisher","first-page":"258","DOI":"10.1080\/26895269.2020.1772937","article-title":"Contemporary transgender health experience and health situation in prisons: A scoping review of extant published literature, (2000\u20132019)","volume":"21","author":"Van Hout","year":"2020","journal-title":"Int J Transgender Health"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1111\/hojo.12567","article-title":"Trans and gender diverse offenders\u2019 experiences of custody: A systematic review of empirical evidence","volume":"63","author":"Evans","year":"2024","journal-title":"Howard J Crime Justice"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1080\/15532739.2019.1651684","article-title":"Whole-incarceration-setting approaches to supporting and upholding the rights and health of incarcerated transgender people","volume":"20","author":"Br\u00f6mdal","year":"2019","journal-title":"Int J Transgenderism"},{"key":"B9","article-title":"How queer \u2019pack rats\u2019 and activist archivists saved our history: an overview of lesbian, gay, bisexual, transgender, and queer (LGBTQ) archives 1970\u20132008","author":"Brown","year":"2010","journal-title":"Serv LGBTIQ Library Arch Users: Essays Outreach Serv Collect Access"},{"key":"B10","volume-title":"Qualitative inquiry and research design: Choosing among five approaches","author":"Creswell","year":"2016"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2017.09.052","article-title":"What\u2019s the right thing to do?\u201d Correctional healthcare providers\u2019 knowledge, attitudes and experiences caring for transgender inmates","volume":"193","author":"Clark","year":"2017","journal-title":"Soc Sci Med"},{"key":"B12","doi-asserted-by":"crossref","DOI":"10.1016\/j.socscimed.2015.11.010","article-title":"Transgender stigma and health: A critical review of stigma determinants, mechanisms, and interventions","volume-title":"Social science and medicine","author":"White Hughto","year":"2015"},{"key":"B13","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1080\/27703371.2025.2483742","article-title":"Navigating normative narratives: understanding familial communicative behaviors and practices about trans young people\u2019s embodiment","author":"Arora","year":"2025","journal-title":"LGBTQ+ Family: Interdiscip J"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2024.116876","article-title":"Provision of gender affirming care among medical and allied health practitioners: The influence of transnormative beliefs in working with gender diverse patients","volume":"348","author":"Speechley","year":"2024","journal-title":"Soc Sci Med"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1177\/14624745221087058","article-title":"Trans architecture and the prison as archive: \u201cdon\u2019t be a queen and you won\u2019t be arrested","volume":"25","author":"Sanders","year":"2023","journal-title":"Punishment Soc"},{"key":"B16","first-page":"26","article-title":"Fundamental principles inherent in the comprehensive care of transgender inmates","volume":"42","author":"Simopoulos","year":"2014","journal-title":"J Am Acad Psychiatry Law Online"}],"container-title":["Frontiers in Psychiatry"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyt.2026.1737418\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T06:31:47Z","timestamp":1770013907000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpsyt.2026.1737418\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,2]]},"references-count":16,"alternative-id":["10.3389\/fpsyt.2026.1737418"],"URL":"https:\/\/doi.org\/10.3389\/fpsyt.2026.1737418","relation":{},"ISSN":["1664-0640"],"issn-type":[{"value":"1664-0640","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,2]]},"article-number":"1737418"}}