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8. Conditions and Conduct in the California Criminal Justice System, ICCPR Coalition Report

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Conditions and Conduct in the California Criminal Justice System
A Report on U.S. Government Compliance with the United Nations International Covenant
on Civil and Political Rights (ICCPR)

Table of Contents
Executive Summary — p. 2
Abuses of ImprisonedYouth — p.5
Sexual Misconduct and Abuse in Women’s Prisons — p.7
Abuses of Elder Women Prisoners — p.9
Abuses of Pregnant Prisoners — p.10
Abuses of Transgender Prisoners — p.12
Abusive Testing and Treatment of Hepatitis C — p.14
Conclusion — p.15
Recommendations for the U.S. Government — p.15
Contributors and Further Information — p. 18

Executive Summary
“Conditions and Conduct in the California Criminal Justice System: A Report on U.S.
Government Compliance with the United Nations International Covenant on Civil and
Political Rights (ICCPR)”

California-based WILD for Human Rights, Justice Now, Legal Services for Prisoners With
Children, and the Transgender Gender Variant and Intersex Justice Project welcome the opportunity
to comment on the 2nd and 3rd Periodic Report of the United States of America to the United
Nations Committee on Human Rights concerning its compliance with the International Covenant on
Civil and Political Rights (ICCPR), submitted in October 2005. This report will examine identitybased discrimination in the California prison system, the failures of medical care, sexual violence
and misconduct, and egregious conditions of confinement facing youth. It will highlight the gravity
of human rights concerns facing California’s imprisoned populations, as the mistreatment of
inmates has resulted in a spectrum of abuses that particularly impact marginalized populations
including transgender persons, women1, the elderly, youth, the disabled, and the mentally ill. This
report also demonstrates that prisoners face multiple forms of discrimination and subjection to
violence based on their gender and racial identities, economic status, age and sexual orientation.
California not only houses a prison population that is 1/10th that of the nation’s incarcerated, but
historically the state also has influenced the political landscape and social policies of the rest of the
Due to the increased imprisonment of drug offenders and other low-level offenders, the
dismantling of California’s mental health system as well as a trend toward imposing long prison
sentences, California’s inmate population has swelled to over 500 percent since 1980. The number
of institutions has nearly tripled from 12 to 33, currently holding 164,000 inmates. In addition, there
are marked racial disparities in sentencing and incarceration in California. The 2000 national census
reported that only 6.7% of California’s population was African Americani, but African Americans
account for more than 29% of California’s prison population.ii In contrast, white persons make up
59.5% of the population, but make up 28.4% of the state’s incarceratediii. California has also
implemented the Three Strikes Law, which incarcerates repeat offenders for a term of 25 years to
life for any third felony. Under Three Strikes, where sentencing is solely under the discretion of the
prosecutors, this has resulted in a disproportionate number of African Americans sentenced under
the law. Of the 7,736 men serving Three Strike 25 years to life sentences, 44% are African
American, while only 25% are white.iv
California prisons are approximately 195% over capacity.v Between 15 and 30% of the inmates in
the system suffer from mental illness. Another 15 to 30% suffer from substance addiction. And at
least another 2/3 are in custody for non-violent offenses. The numbers for women are even more
stark; more than 2/3 of women are imprisoned for nonviolent offenses and the majority are the
primary caretakers for children under 18. The system operates without the necessary management
structure, policy standardization, training and capacity of staff, information technology, health care
services and rehabilitative programming to comply with its obligations under the International
For the purposes of this report, "women" also includes transgender women, and all those persons who identify as women whether or not they are
biologically female while incarcerated.


Covenant on Civil and Political Rights (ICCPR). In addition, individual wardens wield extensive
independent authority to determine standards and operating procedures and often act without
impunity. This lack of accountability has created a health care system with a more than US$1
billion annual budget with widespread medical malpractice and neglect that results in, on average,
at least one needless inmate death every 6 to 7 days. Consequently, the medical system was taken
from state control by a federal court as of June 2005. Moreover, Federal courts, state legislators, the
Governor of California, auditors, and California Department of Corrections and Rehabilitation
(CDCR) officials all concur that the Juvenile Justice system is also broken beyond repair. The
system is plagued by excessive violence, overcrowding, and fails to provide imprisoned youth
adequate medical and mental health care, safety, or educational and rehabilitative programming.
Systemic Failures to Uphold Human Rights: Priority Concerns Under the ICCPR
The California Department of Corrections is unable to provide a minimum standard for the
humane and safe treatment of incarcerated persons. In California prisons, women, including
transgender women in men’s prisons, experience rape, sexual assault and abuse by both correctional
officers and other inmates, and often receive punitive treatment or administrative segregation for
filing a complaint. Staff fails to inform women prisoners of correctional policies on sexual
misconduct and the processes available to report abuse. In the provision of medical care, women
experience sexually inappropriate pat and strip searches, sexualized treatment and assault by
medical personnel, and unwarranted invasions of their privacy. Medical personnel delay treatment
and medication to elder women and transgender prisoners, thereby obstructing access to adequate
care. Incarcerated mothers experience substandard pre and post-natal care, including physically
violent treatment such as shackling during labor. Hepatitis C infected prisoners experience
negligence and inadequate medical treatment, which too often results in premature deaths.
California correctional facilities for youth are overcrowded and marked by excessive violence.
Safety concerns have contributed to increasing rates of teen suicides. Youth also lack access to
school programs and sufficient mental health treatment and rehabilitative programming, particularly
gender-specific programming for young women offenders.
We urge the Human Rights Committee to critically analyze the United States’ Periodic
Report concerning its compliance to the following articles under the ICCPR, as it pertains to areas
of concern in the California criminal justice system:
Article 6—the right to life—is implicated by the high rate of premature deaths of prisoners due to
medical neglect and malpractice, and overcrowding;
Article 7—the obligation to protect against torture or cruel, inhuman or degrading treatment
or punishment—is implicated by the failure to provide adequate medical care, or a safe
environment free of gang violence; the use of excessive force; sexual harassment and violence;
verbal degradation and abuse; and the excessive use of administrative segregation (isolation),
particularly as punishment for reporting cases of assault or abuse by correctional staff.
Article 9—the right to liberty and security of person—is implicated by the failure to provide due
process protections to offenders who are facing parole violations, arbitrary arrests and detentions,
and prolonged segregation and isolation.
Article 10—the requirement to treat persons deprived of their liberty with humanity and with
respect for their inherent dignity, including the aim to socially rehabilitate and reform

incarcerated youth—is implicated by negligence and insensitivity in medical care; sexualized
and/or degrading verbal humiliation of transgender people, women, and elder women prisoners; and
the failure to ensure incarcerated youth are in a safe and nonviolent environment.
Article 17—the right to privacy—is implicated when women are subjected to inappropriate pat
and strip searches, and sexualized treatment and assault by medical personnel, and unwarranted
invasions of privacy; and
Article 19—the right to information—is implicated when prisoners are not informed of the
available remedies and/or processes to report abuse; the deprivation of medical information; and the
failure to train staff in the special needs of prisoners, particularly youth, the elderly, and transgender
Limitations of Domestic Remedies to Address ICCPR Obligations
The United States has ratified the ICCPR in a way that precludes the treaty from having any
real effect domestically. Under the “federalism understanding,” the U.S. government pledges that it
will implement the ICCPR to the extent that it has legislative and judicial jurisdiction, and allow
state and local governments to implement the treaty where they have respective jurisdiction.
However, the federal government has yet to name the types of matters where state and local
governments have unique jurisdiction and therefore specific obligations under the ICCPR treaty.
Nor has the federal government taken steps to pass implementing legislation to ensure that all
branches of government understand their human rights obligations. Finally, should states and local
governments fail to uphold their obligations under the ICCPR, the federal government has not
clarified its authority to ensure the treaty is upheld and enforced.
In direct opposition to its obligations under the ICCPR, U.S. legislation such as the Prison
Litigation Reform Act (“PLRA”) effectively prevents many prisoners from seeking redress in
federal court. Under the PLRA, federal court supervision over prison systems failing to maintain
humane conditions in their facilities automatically terminates unless the court can make detailed
factual findings of a current and on-going constitutional violation. This drastically reduces the
ability of the courts to remedy human rights violations in prisons. In addition, the PLRA caps the
attorney fees that can be recovered in cases filed by prisoners and limits the tasks for which fees can
be awarded. In effect, this discourages attorneys from representing even prisoners with strong cases.
Congressional legislation like the Prison Rape Elimination Act (PREA) of 2003 exists to address
sexual violence, however the State of California has not taken action to implement PREA-based
recommendations to provide safety in its correctional complex or to hold perpetrators accountable
for custodial sexual misconduct.
General Recommendations
This report seeks to support the State of California to take affirmative steps to fulfill its
obligations under the ICCPR. Towards that end, this report sets forth the following opportunities for
Implement decarceration strategies to address excessive burdening of the correctional
system, including but not limited to, the creation of local treatment alternatives and early
release for all low risk, disabled and nonviolent prisoners.
Take steps to effectively improve the correctional medical care system, with specific
attention to providing appropriate and non-discriminatory care for HCV-positive,
transgender, elder and pregnant women prisoners, and rehabilitative treatment for youth.

Improve administrative oversight, employee training and response procedures to effectively
address sexual misconduct, violence and abuse in the correctional system.
Establish minimum standards for correctional operations compliant with international
obligations by which all prison officials must abide.
Create effective oversight mechanisms to ensure compliance with international obligations.

Abuses of Imprisoned Youth
Violations of ICCPR Articles 6, 7, 9, 10 and 19
“I have spent the last four years watching [my son] appear in the visiting room with cuts, choke
marks and bruises. He has been attacked by other youth or staff more than 40 times. I have seen
him lose confidence in himself, become cold and depressed and fearful for his life.”

California’s juvenile justice system has approximately 14,000 children and young adults between
the ages of 11 and 23 imprisoned at youth prisonsvi, camps, and detention facilities, which is 17% of
the nation’s incarcerated youth. Youth corrections in California is an antiquated system and
warehouse model plagued by excessive violence, the use of long term isolation of youths,
inadequate medical and mental health care, and a failed system of educational and rehabilitation
programming. The federal courtsvii, state legislatorsviii, California’ governor, auditors, and prison
officials all agree, that the system is “broken” and has completely failed in its mission to rehabilitate
Overcrowding: California’s juvenile justice system is systematically overcrowded, from local
detention centers to youth prisons.
Familial Alienation: Prisons are often hundreds of miles away from the youth’s home and family.
Families, particularly lower income families, are unable to travel the great distances to see their
children, leaving the youth alone and vulnerable.
Insufficient Programming, Treatment and Education: California’s Youth Prisons fail to provide
even rudimentary education, treatment for substance abuse, mental disorders, or the effects from the
sexual and/or physical abuse the child had previously suffered. This, coupled with familial
alienation, leaves youth completely vulnerable.
Extreme brutality, suicides, and sub-standard physical conditions are reported as
commonplace.x As a result of the extreme levels of violence and gang control, the staff places
youth in the position of either renouncing gangs and facing violent retribution, or living in isolation
indefinitely. During lockdown, aside from brief showers about three times per week, youth receive
virtually no exercise, education, mental health treatment or other basic and mandated services.
Because of the fear of violence and of the depraved environment of administrative segregation, too
many youth choose suicide.xi
Court-appointed experts and monitors filed a report in March 2006, which found that the
constant and pervasive violence remains "stunning", and an unchanged environment since 2003.xii
In May 2004, an officer was caught on video letting his German shepherd bite a 20-year-old prisoner on

the leg, even though the inmate was following orders and lying on the floor. This was the second such
episode in four months.xiii Data shows that in 2002, there were more than 4,000 ward-on-ward fights
for an agency that houses about 4,000 youth. With the overcrowding conditions and lack of
programming or training, staff are overwhelmed, leading to harsh treatment such as forcing youths
to spend considerable time on their knees with their hands bound behind them or forcing them to
sleep on concrete slabs in chilled rooms wearing only underwear. The California Youth Authority
(CYA) is the only youth penal system in the country that houses youth in cagesxiv, even though it is
recognized to be a practice that is "degrading and antithetical to the mission and goals of (the
department)”. Investigators reported that state correctional facilities have no set criteria for who is
put in cages, but that a higher percentage of African American and Latino wards are placed in the
cages.xv Administrators and experts agree that the high level of violence undermines the
department's control of its facilities and impedes any rehabilitative programming.
Overuse of Isolation Cells: The prison overuses Isolation Cells to punish, and “protect” youth.
Youth stay in isolation for months without contact with counselors, family, friends, and the little
education that is afforded youth is either done in the isolation cell, or they are caged in the
classroom. Edward Jermaine Brown was locked in a filthy isolation cell for 23 hours a day for
seven months. The toilet in the cell often did not function and Brown was fed “blender meals,” a
whipped mix of food groups, through a straw pushed through his cell door.xvi One young man, at
age 19, sits in a cell by himself for 23 hours a day. He can’t go to church, school or vocational
classes because he is in protective custody. Meanwhile, he has been jumped and beaten up four
times while he has been in protective custody.xvii
Inhumane Conditions in Juvenile Detention Facilities: California counties house more than
10,800 youths in juvenile halls and camps. These youths are generally pre-trial detainees, or lowlevel offenders who range in age from 11 to 19. The conditions inside these detention facilities, like
the Youth Authority, include severe overcrowding, lack of access to school programs, endemic
violence, excessive use of force by staff, and virtually non-existent mental health care. xviii
Denial of Due Process: Youth who have been released on parole are reincarcerated for lengthy
terms for technical violations such as drug or alcohol use. These same parolees may spend months
in custody before having a violation hearing. Furthermore, parole authorities have steadfastly
resisted giving simple due process protections, such as counsel and a timely hearing.xix
Female Offenders are Committed at Higher Rates for Property and Drug Offenses than their Male
Counterparts: Young women and girls in the CYA parole population comprise 6% of the total
parole population. Female offenders are committed at higher rates for property and drug offenses
than their male counterpart. The only CYA facility that accepts girls is located in Southern
California. With over 50% of girls committed from the Northern region, this distant location,
inaccessible by public transportation, presents a barrier to an increasing number of families.xx
Juvenile Girls Denied Access to Education, Programming, Treatment and Information: Staff
and educators are not specifically trained in the needs of pre-adolescent and adolescent girls.
Therefore, in violation of Article 19, young women are denied information on issues particular to
their special needs such as safe sex, menstruation, child-care, and basic life skills. Additionally, the
general educational needs are not met as the teachers are substandard and often fail to attend
classes. There are very few treatment programs; most are run by other prisoners. There is also no
sexual or child abuse counseling provided.

Juvenile Girls Subjected to Sexual Abuse in Youth Authority: Juvenile Girls are guarded by
both male and female staff. Male staff are allowed to roam freely throughout the facility. As a
result, sexual abuse is a common occurrence. In California, correctional staff sexual abuse is
chargeable as either a misdemeanor or felony, as determined by the local prosecutor. A
misdemeanor conviction will not hinder future employment at the youth authorityxxi. Nevertheless,
the local District Attorney’s office has repeatedly refused to prosecute the staff members even with
the lesser offenses.
Many states in the U.S. have started to implement their juvenile justice systems through state
departments of human services.xxii California needs to move in that direction. California’s
admission for the need for change xxiii is in accordance with its own domestic laws against torture
and cruel and inhumane treatment of prisonersxxiv. However the state continues in its failure to
implement the changes necessary to meet its domestic and international obligations. It fails to have
the political will to change.
Questions for the U.S. Government
What steps is the U.S. government taking to educate the individual states concerning their
obligations to incarcerated juveniles under the ICCPR?
What steps is the U.S. government taking to ensure that California’s and other individual
states’ juvenile justice systems comply with the international obligations under the ICCPR?

Sexual Misconduct and Abuse of Women Prisoners
Violations of ICCPR Articles 7, 10, 17, and 19
“Some of the women who get strip searches and touched in certain ways, it causes them flashbacks [of
sexual assault]. I’ve seen it make women depressed for a while or sad. We can’t stand them. They are
degrading, humiliating. It makes us angry at them, the officers. We feel helpless, we’re just helpless.”

Women prisoners in the California Correctional system are regularly subjected to sexual
misconduct and violations of their human rights. Hundreds of women have reported sexual
misconduct ranging from rape, inappropriate pat and strip searches, sexual assault by medical
personnel, sexualized and degrading verbal harassment, and unwarranted invasions of their privacy.
Sexual Abuse in Medical Care: Reported assault by medical personnel includes sexual violence or
excessive force by male doctors during routine Pap, pelvic or breast exams; unnecessary or
unwanted pelvic exams; and appropriate medical care given only on the condition that the
individual not file a sexual misconduct complaint. According to one woman’s report:
“There was one doctor who required pap smears every time you went, no matter what you went
for. Sometimes he wouldn’t have gloves on or sometimes you couldn’t tell because you couldn’t
see the way he was positioned. Or he’d give a breast exam and be playing with your breasts
instead of examining them.”xxv


Custodial Sexual Misconduct: Reports of sexual misconduct in recent years demonstrate an
uncoordinated response to abusive and illegal penal management and a failure of the California
Department of Corrections and Rehabilitation (CDCR) to effectively take steps to prevent sexual
violence and rape in its facilities. Hundreds of allegations identify correctional staff, ranging from
parole agents, guards, contract employees, or Medical Technical Assistants as responsible for
coercing inmates into sexual activity in return for medical attention, early relief from house arrest,
or as a threat to negatively influence parole hearings. Of these allegations, “there are at least 400
separate incidents, 200 of these are serious and prosecutable.”xxvi It should also be noted that the
State of California did not criminalize sexual misconduct in custody until 1994, and procedures and
policies to effectively respond to patterns of abuse stand yet to be institutionalized.
Abuses of Transgender Prisoners: Transgender and gender variant people in men’s prisons are
either sexually assaulted and/or raped by prison staff, or prison staff actively encourage other
prisoners to harm them. It is not uncommon for transgender and gender variant prisoners to be used
as human sexual “currency” to be traded among prisoners and staff alike, nor is it unusual for many
to be forced into sexual slavery in exchange for protection.
Unwarranted Violations of the Right to Privacy: Many prisoners experience inappropriate and
unnecessarily invasive violations of their right to privacy. On her trip to California women’s
prisons, the U.N. Special Rapporteur on Violence Against Women remarked that the presence of
male corrections officers in women’s showers and toilets and the restriction of women’s use of
towels is “intolerable, unacceptable and unnecessarily intimidating and humiliating.”xxvii To date,
the CDCR has not developed any policy to address female inmate privacy.xxviii California has made
important advances, for instance discontinuing, effective in September 2005, the practice in
women’s prisons of male custodial staff conducting pat searches on women inmates. However, male
corrections officers continue to have the authority to enter prisoners' cells and living areas.xxix And
the larger issue of inappropriate and abusive pat and strip searches by staff of both genders remains
unaddressed. The unrestricted access of male correctional staff into a prisoner's cell and living area
only creates greater opportunities for inappropriate, sexualized interactions or abuse to occur.
Impacts of Sexual Abuse on Survivors of Trauma: 50% of women prisoners have experienced
physical, sexual and emotional abuse prior to incarceration, so they are often retraumatized by
experiences of sexual harassment and abuse in prison. Survivors of sexual abuse in prison often
return to their communities with sexually transmitted diseases and learned violent behavior. This
only contributes to higher rates of recidivism and return back into the criminal justice system.
Institutional Failures to Respond to Sexual Misconduct: CDCR procedures on reporting and
investigating allegations of sexual abuse are not comprehensive. Concerns include failure to ensure
confidentiality for the individual filing a complaint, correctional staff focusing on the consent of the
victim, and retaliatory action taken in response to complaints of sexual misconduct, including
forcing inmates into administrative segregation and denying basic privileges. Reports increasingly
demonstrate a failure to provide adequate remedy to victims and general inconsistency in how cases
are treated. In one instance, a parole agent was arrested and accused of sexually abusing a female
parolee. He was then released and received paid administrative Investigations of sexual
misconduct are prolonged and disciplinary action is often taken on inmates for filing a complaint
process. One woman was denied her personal belongings, transferred to another facility (which
obstructed her husband’s visitation rights for an 8-week period), and was forced to sit for eight
hours a day with no staff and no work in an office that was the exact layout of where she’d been

repeatedly raped. The staff accused of sexual assault continues to work at the California
Correctional Women’s Facility (CCWF).xxxi
Questions for the U.S. Government
What steps has the U.S. government taken to ensure that the California Department of
Corrections and Rehabilitation (CDCR) keeps adequate statistics on sexual misconduct and
abuse of detainees, including the number of reported incidents, whether the abuse was
perpetrated by a staff member or another inmate, the outcome of the investigation, and
whether there was resolution of the complaint?
What substantive steps has the U.S. government taken to ensure that states implement the
federal Prison Rape Elimination Act of 2003, mandating the prevention of sexual violence
and rape in prisons, including administrative action and the development of systems to hold
perpetrators accountable for custodial sexual misconduct?

Abuses of Elder Women Prisoners
Violations of ICCPR Articles 7, 10
“If we get sick…it might be a month or two months before they call us down. Once in a while it’s
faster but as a rule it takes three, four or five weeks to get in to see a doctor.”
Elder prisoners, ages 55 and older, are particularly at risk of violations of their human rights due to their
age, physical limitations, and unique needs relating to health, safety, and social support. California
incarcerates approximately 7,550 elder prisoners, 7% of which are women.xxxii Elder prisoners warrant
unique consideration given that most are nonviolent and often pose little threat to themselves or other
inmates. Research demonstrates that as persons age in the criminal justice system, rates of recidivism
decrease and that elder prisoners are the least likely to return to prison.xxxiii In the California Department
of Corrections and Rehabilitation (CDCR), elder women prisoners report that they are at greater risk of
physical and verbal abuse, insensitivity by medical technicians and delays in providing treatment, and
obstructed access to adequate and preventative medical care. Such reported practices demonstrate a
systematic failure of the CDCR to prevent, address and respond to egregious violations of elder women
prisoner’s rights.
Abuse and Failures to Address Special Needs: Reported abuses of elder women prisoners include
verbal and physical abuse from correctional staff or other prisoners, neglect and insensitivity, and
retaliation or punitive action taken on prisoners that file a complaint. Many elder women prisoners
report the inaction of correctional staff and the failure of the CDCR to prevent abuses. Staff are
reluctant to address the specific needs of elder women prisoners thereby providing “special
treatment”, even though many claim a fear of abuse from younger inmates and an inability to
protect themselves. In 2004, of a respondent group of female prisoners over the age of 55, two out
of three reported to have been verbally abused by correctional staff; one out of three reported
physical abuse by another prisoner; and 83% reported that prison staff do not take adequate action
to protect against physical abuse by other prisoners.xxxiv


Obstructed and Sub-Standard Medical Care: Reported obstacles to the enjoyment of adequate
and preventative medical care include 1-2 month delays before receiving medical treatment, poor
monitoring of chronic illnesses, delays in refilling medication, a reluctance to provide mental health
care that doesn’t involve prescribing medication, lack of access to an age-appropriate diet
(particularly for those persons with an inability to chew or digest certain foods), and substandard
preventative care.xxxv The latter is of particular concern for elder women prisoners due to weakened
immune systems, greater susceptibility to life-threatening illnesses and the need for vaccines, and
the specific need for preventative screenings to address the risks of breast, cervical, colon or uterine
cancer. Additionally, the California co-pay system which requires most prisoners to pay $5 to
access medical services, is an obstacle for many elder prisoners and forces a choice between
medical care and the purchase of needed goods such as hygiene items and food.
Questions for the U.S. Government
What steps has the U.S. government taken to ensure that the CDCR keeps adequate statistics
on misconduct and abuse of elder women prisoners, including the number of reported
incidents, whether the abuse was perpetrated by a staff member or another inmate, the
outcome of the investigation, and whether there was resolution of the complaint?
What steps has the U.S. government taken to ensure the humane treatment of elder women
prisoners, including the training of correctional staff on policy toward protecting vulnerable
persons against abuse, and the provision of preventative and curative medical care that is
both timely and age-appropriate?

Abuses of Pregnant Women Prisoners
Violations of ICCPR Articles 6, 7 and 10
"There's a [guard] in there the whole time. The whole experience is
horrible. I freaked out—it's scary and they're yelling at you. They treat
you like an animal."
Pregnant women in California prisons, many of whom are high risk due to past histories of poverty
or malnutrition, face rampant violations of their human rights. Doctor visits for pregnant women
are infrequent and erratic. In some cases, prison medical staff has ignored obvious warning signs of
complications, such as extensive bleeding. Special dietary requirements are not fully met and
despite recent changes in the state law, some, if not many, women are still shackled during labor
and post-delivery. And post-natal care is virtually nonexistent. Underlying all of these abuses is a
complete lack of respect for the humanity of pregnant women in prison. When interviewing women
in prison about their doctor-patient relationship, all responded that they did not have a relationship
with their doctor. One woman was told, “If you wanted better care, you shouldn’t have gone to
prison.” The following overview of pregnancy-related abuses experienced in women’s prisons
comes from first person testimonials.
Abysmal Pre-natal Care: One woman was told when she went to the doctor with complaints of
bleeding heavily that it was pulled ligaments and sent home. Her premature daughter died shortly
after birth. This same woman had been forced over her strong objections to have a Pap smear when

four months pregnant. Despite clear medical advice, there is no special diet for pregnant women.
Every woman we spoke to raised concerns about her prenatal diet. They do not receive extra food;
the fruits and vegetables are often inedible; they get an extra 4 oz. carton of milk; and occasionally,
folic acid/iron supplements.
Slow Transport to the Hospital: It took prison staff an hour and a half of screaming before they
transported a laboring woman to the hospital, “they don’t rush, they never rush.” One woman was
told, “Shut the fuck up, you’re not a baby stop screaming.” A nurse made another woman check her
own vagina for amniotic fluid and then sent her to the hospital in her underwear, which her
ambulance attendant said was “ridiculous.”
Shackling During Labor: During labor and after giving birth, in all cases we have investigated,
women are shackled. Thus, they cannot walk around, although walking has been shown to promote
labor and post-birth healing, and they have to request permission from prison staff to use the
bathroom. In one case, a woman urinated in her bed because the sergeant would not unshackle her.
In October 2005, California passed AB478 which requires the California Department of Corrections
to establish minimum standards of care for pregnant women and to transport pregnant women in the
least restrictive way possible, including a presumption against shackling. Nonetheless, we have
seen little, if any, change in the care and treatment that pregnant women receive. In fact, in April
2006 while on a hospital visit one of our staff attorneys saw an official notation that a laboring
woman was in shackles.
Substandard Post-natal Care: We spoke to one woman who did not have the staples from her csection removed until several weeks later. Women also routinely have their hospital-prescribed
pain medications taken from them when they return to prison and are often unable to receive any
more, even through the dispensary. Most of the women we spoke to, including a woman in
remission from cancer, never received the customary 6-week post natal appointment.
Questions for the U.S. Government
What steps has the U.S. government taken to monitor the rate of stillbirths and miscarriages,
disaggregated by race, in state and federal prisons compared to the country as a whole?
What steps has the U.S. government taken to ensure that pregnant women are treated
humanely including, but not limited to, receiving adequate medical care and sufficient
nutrition, and not being shackled during labor and after giving birth?


Abuses of Transgender Prisoners
Violations of ICCPR Articles 7, 10, and 17
"I felt scared, ashamed, hurt, betrayed, sick and [that] I deserved [to be raped] for being a
Transgender. I had learned in San Quentin [State Prison]...not to tell staff if I got raped. This was
not by another inmate but by a custody staff member. A sergeant said if I did, I would go to
Administrative Segregation, lose my job, my program, [and] be labeled a rat."
Transgender and gender variant peoplexxxvi are disproportionately incarcerated in the United
States today.xxxvii Because transgender and gender variant people are discriminated against in
housing, education, health care, and employment, most transgender people are unemployed or
underemployedxxxviii and forced to commit “survival crime” like prostitution and selling illegal
drugs to generate income.xxxix Furthermore, transgender and gender variant people of color are
especially affected – racism, sexism, homophobia and transphobia combine with other forms of
discrimination in society and in the criminal justice system to create a complex web that too
frequently ensnares transgender and gender variant people.
Transgender and gender variant people constitute a particularly vulnerable prison
population. While no official numbers exist, we estimate there are several thousand to tens of
thousands of transgender and gender variant people incarcerated in prisons and jails around the
country. Because transgender and gender variant people do not conform to social expectations
surrounding sex and gender, they face severe discrimination and are susceptible to torture and cruel,
inhumane and degrading treatment. Prison staff members either commit these acts themselves, or
allow or encourage other prisoners to harm transgender and gender variant prisoners. The following
overview of abuses experienced by transgender and gender variant prisoners originate from firsthand testimonials from transgender and gender variant people in prison:
Verbal degradation: Staff routinely subject transgender and gender variant people in prison
to profanities and racial and homophobic slurs, and threaten them with physical violence.
Sexual humiliation & invasion of privacy: Staff members perform needless strip searches
to view the genitalia of transgender prisoners, force post-transition male-to-female transgender
people to parade naked in front of or shower with male prisoners, and make sexually demeaning
comments about their bodies.
Institutional discrimination: Transgender people are disproportionately placed into
punitive administrative segregation (isolation) solely because prison administration does not
know where to place them. In other cases, transgender people defending themselves against
attack have been given disproportionately harsh punishments and placed in isolation because
they are seen as co-combatants rather than as survivors of violence. Finally, prison staff
stereotype transgender and gender variant prisoners as homosexual “predators”, and assume
casual physical contact with others as violates prison policies against “homosexual conduct.”
Sexual assault and rape: Transgender and gender variant people in prison report rampant
sexual harassment, sexual assault, and even rape. Both staff and other prisoners commit these
incidents. Additionally, all prisoners are discouraged from reporting these incidents because
institutional policies mandate that survivors be placed in punitive isolation pending internal
investigations that may or may not take place.

Medical neglect: As prisoners, transgender and gender variant people suffer the same
medical neglect as is typical for all prisoners. While transgender-specific health care is widely
accepted by the medical community, many prison medical staff members are either unfamiliar
with these treatments, or willfully withhold such treatment out of personal bias. Refusal of
prescribed treatments can cause long-term psychological and physical harm. Follow-up care
when treatment is issued – such as counseling, monitoring hormone levels, and breast cancer
screening – are nearly non-existent.
Retaliation: Prisoners are routinely retaliated against for filing complaints and seeking legal
help regarding the above issues.
There is little to no difference between prison conditions in different states, or between state
and federal prisons, suggesting these problems are widespread and ingrained in the culture of U.S.
Questions for the U.S. Government
What steps has the U.S. government taken to recognize the specific needs of transgender
persons in prisons, including taking steps to train existing and incoming staff members on
basic transgender cultural competency and the medical necessity of transgender-related
health care. Additionally, what enforcement mechanisms have been developed to prevent
verbal, physical and sexual harassment from staff?
What has the U.S. government done to ensure transgender and gender variant people have
increased access to health care, education, drug rehabilitation, low-income housing, and
other services that alleviate poverty and reduce recidivism?
1. “Transgender” broadly describes people who do not conform to traditional societal gender roles.
This term includes transsexuals, transvestites and cross-dressers, as well as masculine women and
feminine men. This term describes a person’s deeply felt sense of gender, and is therefore distinct
from sexual orientation.
2. “Gender variant” describes people who also transgress traditional gender roles and expressions,
but for personal or cultural reasons do not call themselves “transgender.”
4. “Gender Identity Disorder” (GID) is the psychological term used in the Diagnostic and
Statistical Manual of Mental Disorders (DSM IV) to describe the condition whereby a person
strongly identifies with the other sex and may experience serious discomfort with their biologically
assigned birth sex. Adults who have GID sometimes request reassignment of their sex, or sexreassignment surgery. Prior to or in alternative to this kind of surgery, it is common to undergo
hormone therapy which attempts to suppress same sex characteristics and accentuate other sex
characteristics. For instance, biological males that have GID are given the female hormone
estrogen. Biological females with GID are given the male hormone testosterone, to help them
develop a lower voice, facial hair and greater muscle mass.


Abusive Testing and Treatment of Hepatitis C
Violations to Articles 6, 7, 10 and 19
“I’m so frustrated; I don’t want to see doctors anymore since they won’t do anything. I can feel my
health drifting away and there’s nothing I can do about it. I’m getting weaker and weaker here.”
The pervasiveness of Hepatitis C in California prisons is astounding. Studies show that over 41% of
all California prisoners are infected with Hepatitis C.xl Yet, despite those numbers, to our
knowledge the CDCR does not have an effective and coherent HCV testing and treatment policy.
The Department of Corrections fails to offer non-mandatory, confidential HCV testing to all women
prisoners who are at risk for infection, fail to attain informed consent for such testing, and
additionally fail to report test results to women in a timely fashion. Hepatitis C is a blood-borne
illness caused by the Hepatitis C virus (or “HCV”). First discovered in 1988, Hepatitis C
chronically infects an estimated 170 million people worldwide, or approximately 3 percent of the
world’s population, with as many as 180,000 cases occurring each year.xli Without adequate care
and treatment it will lead to liver failure and death. The following overview of HCV-related abuses
experienced by people in women’s prisons come from first person testimonials.
Egregious Testing Policies: In some cases women are tested without their knowledge and or
consent. On the other hand, many women prisoners must specifically request a test and are being
asked to provide a co-pay of five dollars for a HCV test and/or results. This is an excessive charge
for a woman making 7-10 cents per hour, often forcing them to forego basic necessities such as
toiletries. Moreover, this charge directly contravenes California state law. In all cases, they may or
may not get their results.
No Information Provided on Results or Disease: One woman learned of her HCV status when
she went to her yard doctor for a thyroid test in 2001. At that time, he casually told her that she was
HCV positive. Prior to that she did not even know that she had been tested. HCV-positive women
prisoners often are not informed of treatment options or provided with education materials about
this highly contagious and deadly disease. The specifics of testing, diagnosis, and treatment—such
as the importance of fasting before an ultrasound, which one woman discovered after the
examination—remain largely unknown to them. Very few are told of the potential risks for those
who are HIV-Hepatitis C co-infected, as many women prisoners are.
Inadequate Medical Care: The main source of HCV treatment in California women’s prisons is a
telemed doctor available every 90 days over a TV screen, which falls far short of an adequate
standard of care. One woman notes, “The system of Telemed, where the doctor doesn’t have the
patient’s medical history in front of him, doesn’t seem like proper care.” We heard woman after
woman tell us about having to fight to see a specialist. According to Abigail C, “I have to fight for
each pill. My kidney’s going down into renal failure. Took me eight months to see a kidney
specialist and I still haven’t seen him.”
Negligent Provision of Medication: One woman has observed other women overdose on the
medication used to treat HCV because they were not prescribed appropriate, height and weightrelative, amounts. Another woman reported being treated with Bengay and ibuprofen for pain

associated with HCV—a grossly insufficient treatment. Many other women reported reluctance to
prescribe adequate pain medication to mitigate HCV-related symptoms.
Premature Death: Some women receive Tylenol or Motrin for pain, drugs that are contraindicated
for persons with liver disorders. In 1999, Rosemary Willoughby, a Justice Now client, was given
TB medications with no attention to the fact that she had active liver disease. The medications
killed her. In 2003, according to Cynthia Chandler, co-Director of Justice Now “I just had another
client this past summer who was given contraindicated meds, she had liver disease but not endstage, and she died within a month.”
Questions for the U.S. Government
What steps has the U.S. government taken to accurately assess the prevalence of HCV,
disaggregated by race, in state and federal prisons and jails, and the rate of premature death
due to HCV compared to non-imprisoned population?
What steps has the U.S. government taken to ensure that state and federal prisons and jails
provide medical care that adheres to the standard of care outside prison and that people are
not dying prematurely or becoming HCV positive due to deficient care?

We strongly urge the Human Rights Committee to critically review the Periodic Report of the
United States of America in terms of its compliance to ICCPR articles 6, 7, 9, 10, 17 and 19. As
demonstrated by the case example of the State of California, we urge the Committee to pay specific
attention to human rights concerns within the U.S. criminal justice system, including the failures of
medical care, sexual abuse and misconduct, violence, neglect, and the unique discrimination
impacting imprisoned populations of women, transgender persons, the elderly, youth, the disabled,
and the mentally ill. The following are recommendations which we urge the Committee to consider
in its review of the U.S. report.

International Obligations of the U.S. Government
Pass implementing legislation to give effect to the ICCPR, including the identification of
the unique obligations of states and all branches of government under the treaty, and the
obligation of the federal government to enforce compliance.
Ratify the Convention on the Elimination of all forms of Discrimination Against
Women (CEDAW), the Convention on the Rights of the Child (CRC) and the
International Covenant on Economic, Social and Cultural Rights (ICESCR), thereby
fulfilling the minimum standard for the respect of human rights asked of all nations.
Ensure that the United Nations Standard Minimum Rules for the Treatment of
Prisoners are implemented at U.S. state levels as the basis for adequate practice in the
treatment of prisoners and in managing correctional institutions.


Ensure the federal and state-level implementation of the recommendations of the U.N.
Special Rapporteur on Violence Against Women to the United States on upholding
women’s human rights and protecting against violence within criminal justice.
U.S. Government Obligations to Ensure California State Compliance with the ICCPR
Reform current parole policies to ensure the early release of all elder prisoners who
have completed their minimum eligible release date and do not pose a threat to public
safety. Implement the recommendation of the Legislative Analyst’s Office to release all low
risk and nonviolent prisoners over 55 on parole.xlii
Repeal the “Three Strikes” law in California. Under the Three Strikes law, individuals
who have committed three felonies, many of which are for nonviolent offenses, receive a
minimum of 25 years to life sentence. Unless California reforms its sentencing laws, an
estimated 30,000 “Three Strikes” prisoners, a majority of which are disproportionately
African-American and Latino, will be incarcerated by 2007.xliii
Move children from state-run facilities to community-based safe placements that
promote rehabilitation, including providing access to medical and mental health care,
education, vocational training, life skills training, drug-treatment, etc.
Reinvest resources saved from closing state-run facilities for youth into violence and
poverty prevention mechanisms that identify and address systemic failures at the
community level (such as lack of substance abuse treatment programs, lack of housing, child
poverty, etc.) that contribute to the reoccurrence of serious harms, combined with the
implementation of decarceration strategies.
Properly screen correctional staff. Ensure non-eligibility for employment of CDCR staff
previously convicted of rape or sexual assault of either inmates or parolees, those who have
a history of anti-gay and anti-transgender bias, or those individuals who have been fired or
resigned as a correctional employee pursuant to an allegation of sexual abuse.
Reform and expand annual trainings for correctional staff beyond “overfamiliarity
issues”xliv to effectively address sexual misconduct and sexual violence in all forms.
Clarify the obligation of staff to report on all observed incidents of custodial sexual
misconduct and take action in a timely and professional manner to address allegations of
sexual assault.
Ensure that inmates who report abuse are not automatically segregated, unless
requested by a victim for their own protection, and that segregation is non-punitive and
does not result in a loss of rights or privileges. Also ensure that victims of sexual assault
or rape in women and men’s prisons receive appropriate acute-trauma care, including
treatment of injuries, medical examination, testing for sexually-transmitted diseases, and
emergency mental health counseling.
Release all pregnant prisoners with 12 months or less left on their sentences so that they
may receive appropriate medical care and give birth within their communities.


Prohibit the shackling of pregnant women during all stages of labor and delivery and
through the post-birth recovery process.
Allow transgender and gender variant people to choose to serve their sentences in
either women’s or men’s prisons, regardless of genitalia. Gender identity, gender
presentation, and the overall safety of the prisoner – not genitalia – should determine
placement. Prison officials in Spain have decided to allow qualifying prisoners to choose
whether to serve their sentences in women’s prisons or men’s prisons. xlv
Increase funding for transgender-inclusive drug rehabilitation (including harm
reduction strategies), medical care, job training, and low-income housing at local
levels. The state should also produce and distribute educational materials for employers and
landlords on the transgender protections in the state’s anti-discrimination statutes.
Provide mandatory, confidential HCV testing free of charge to any person being
detained in the United States who requests it.
Ensure that HCV-positive persons in state and federal prisons and jails receive medical
care, that conforms to the professionally accepted standard of care, either inside or outside
of prison.


For more information on the content of this report, please contact:
Maria Catoline
Advocacy Coordinator
WILD for Human Rights
3543 18th Street, Suite 11
San Francisco, CA 94117
Tel: (415) 355-4744, x.405

Alexander Lee
Transgender, Gender Variant and Intersex
Justice Project
1322 Webster Street, Suite 210
Oakland, CA 94612
Tel: (510) 677-5500

Geri Lynn Green, Esq.
Attorney; Board Member,
Legal Services for Prisoners With Children
Tel: (415) 575-3235

Robin Levi
Human Rights Director
Justice Now
1322 Webster Street, Suite 210
Oakland, CA 94612
Tel: (510) 839-7654, x.5


See 2000, US Census.
See, Summary Statistics On Adult Felon Prisoners and Parolees, Civil Narcotic Addicts and Outpatients and Other Populations, 2004, supra.
Second and Third Strikers in the Adult Institution Population. December 31, 2005. Department of Corrections and Rehabilitation Offender
Information Services Branch Estimates and Statistical Analysis Section Data Analysis Unit.
Summary Statistics On Adult Felon Prisoners and Parolees, Civil Narcotic Addicts and Outpatients and Other Populations, 2004 Department of
Corrections and Rehabilitation, Offender Information Services Estimates and Statistical Analysis Section.
California’s Department of Juvenile Justice (DJJ) is one of the few states to retain jurisdiction over incarcerated youth until the age 24. Available at
See Ferrel v. Harper complaint filed January 16, 2003. http:/ and Waters v. Woodford complaint filed April
19, 2006.
Bell, J. and J. Stauring (2004). “Serious Problems Festering in Juvenile Justice System Require Serious Reforms.” Los Angeles Times (May 2).
Report on Disability Access and Programming; Report on Mental Health Care and Substance Abuse Treatment; Report on Health Care Services;
Report on Education Programs; Report on Sex Offender Treatment Programs; Report on General Conditions (Safety, Use of Force, Segregation),
Cannon, A. (2004). “Special Report: Juvenile Injustice.” US News and World Report
(August 3).
Office of the California Inspector General Report. December 2005. “Special Review into the Death of a Ward on August 31, 2005 at the N.A.
Chaderjian Youth Correctional Facility.”
First Report of Special Master - Compliance with Interim Measures Provisions of Consent Decree and January 31, 2005 Stipulation. Farrell v.
Warren, J. (2004). “Attack by Prison Dog Revealed.” Los Angeles Times (May 7). Bell, J. and J. Stauring (2004). “Serious Problems Festering in
Juvenile Justice System Require Serious Reforms.” Los Angeles Times (May 2).
Bell, J. and J. Stauring (2004). “Serious Problems Festering in Juvenile Justice System Require Serious Reforms.” Los Angeles Times (May 2).
See, id. Farrell v. Harper complaint.
Talkington, Laura; Pacific News Service, May 23, 2004
April 19, 2006 -- A statewide drive to end illegal and inhumane conditions in California county juvenile halls has started with the filing of a
complaint in San Francisco County Superior Court. The lawsuit seeks court orders requiring the state authority responsible for being a watchdog over
juvenile halls -- the Corrections Standards Authority (CSA) -- to fulfill its duties and take action to correct intolerable conditions. Waters v. Woodford
available at (Attached hereto). The following week a second suit was filed against one
California County alleging pervasive violence and use of excessive force, overcrowding, small food portions, failure to provide safe temperatures in
the rooms, failure to provide hot running water, broken and dilapidated plumbing, pervasive use of isolation cells, denial of medical and mental health
care, inadequate education system and grievance procedures. Hixon v. Hope.



Field Code Changed

Burrell and Laba , Violence-Prone Youth Authority Still Fails Its Children, Its Taxpayers, 4/26/06 San Francisco Daily Journal
Michele Byrnes, Daniel Macallair, MPA, Andrea D. Shorter, August 2002, Aftercare as afterthought: Reentry and the California Youth Authority
Prepared for the California State Senate Joint committee on Prison and Construction Operations.
California Penal Code Section 289.6.
Sele Nadel-Hayes, Goldman School of Public Policy, University of California at Berkeley & Daniel Macallair, MPA, Executive Director Center
on Juvenile and Criminal Justice, Report to the State Legislature on Restructuring Juvenile Corrections in California. September 2005.
In November 2004, a state court judge approved a consent decree, under which state officials agreed to remedy the serious on-going problems
with conditions in the state's juvenile correctional facilities. The decree requires the state to provide wards with adequate and effective care, treatment
and rehabilitation services, including reducing violence and the use of force, improving medical and mental health care, reducing the use of lock-ups
and providing better education programs. While it is of note, that the Governor and California correctional officials have acceded to the need for
remedial action, it is unlikely that this will result in significant changes.
The United States has incorporated international prohibitions against torture and mistreatment of persons in custody into its domestic law. The
United States has reported to the Committee Against Torture that: “Every act of torture within the meaning of the Convention is illegal under existing
federal and state law, and any individual who commits such an act is subject to penal sanctions as specified in criminal statutes. Such prosecutions do
in fact occur in appropriate circumstances. Torture cannot be justified by exceptional circumstances, nor can it be excused on the basis of an order
from a superior officer.”
Monica. Valley State Prison for Women. July 15, 2005.
Telephone call between Amnesty International USA and Ellen Barry on February 6, 2001.
United Nations Special Rapporteur on Violence Against Women report on the issue of Violence Against Women in U.S. State and Federal Prisons
(January 4, 1999, E/CN.4/1999/68/Add.2).
Senate Concurrent Resolution 33, Commission Report on Female Inmates and Parolee Issues, June 1994, p. 37.
15 California Administrative Code, Section 3287(4)(b)(1), "Cell, Property and Body Inspections."
Ventura County Star. May 26, 2000. “Officer Allegedly Forces Sex Act.”
Amnesty International Report “Abuse of Women in Custody: A State-by-State Survey of Polices and Practices in the USA.” 2006. Available at
Department of Corrections and Rehabilitation. (2005) “Summary Statistics On Adult Felon Prisoners and Parolees, Civil Narcotic Addicts and
Outpatients and Other Populations.”
Jonathan Turley. Statement of Professor Jonathan Turley: California’s Aging Prison Population, before a Joint Hearing of the Senate
Subcommittee on Aging and Long Term Care, Senate Committee of Public Safety, and the Senate Select Committee on the California Correctional
System, February 25, 2003.
Heidi Strupp and Donna Willmott. Dignity Denied: The Price of Imprisoning Older Women in California. (2005) Legal Services for Prisoners
with Children, at 38.
Dignity Denied. (2005)
See Appendix for terms and definitions used in this report.
A 1997 San Francisco Public Health survey showed an astounding 65% of transgender women and 29% of transgender men respondents had
been incarcerated. San Francisco Department of Public Health, Transgender Community Health Project, February 18, 1999, at Hereinafter “SFDPH.”
A 2006 employment survey of the San Francisco transgender community revealed that 75% of respondents did not have a full-time job, and over
half of the transgender community lived below the poverty line. Tali Woodward, “Transjobless,” San Francisco Bay Guardian, March 16-21, 2006.
J.D. Ruiz & J. Mikanda, “Seroprevalence of HIV, Hepatitis B, Hepatitis C, and Risk Behaviors Among Inmates Entering the California Correctional
System,” California Department of Health Services, Office of AIDS, HIV/AIDS Epidemiology Office (Mar. 1996).
American Civil Liberties Union of Michigan, “Hepatitis C in Michigan Prisons,” available at (Feb. 24, 2003).
Legislative Analyst’s Office, Analysis of the 2003-4 Budget Bill, Judiciary and Criminal Justice, Department of Corrections, February 2003.
Ryan S. King and Marc Mauer. Aging Behind Bars: “Three Strikes” Seven Years Later, The Sentencing Project, 2001 at 4; and California
Department of Corrections, Data Analysis Unit, Prison Census Data as of December 31, 2004, Ref. No. CEN-SUS1, February 2005, Table 4.
The report on the mission to California women’s prisons by the U.N. Special Rapporteur on Violence Against Women (January 4, 1999,
E/CN.4/1999/68/Add.2) showed that the use of the term “overfamiliarity” in correctional staff training was insufficient to refer to acts of sexual abuse,
harassment and assault, and thereby “obscured the serious nature of the acts concerned.”
“Transsexuals can choose jails,” May 3. 2006, at,,2-10-1462_1892464,00.html.




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