King County Jail Whistleblower Comes Forward

An interview with a former nurse who worked for five years at Jail Health, a division of King County Public Health in Seattle, about cross-sex housing and safety concerns for female inmates

(Greg Gilbert / The Seattle Times)

America's prison system is grappling with a growing challenge that threatens the safety and well-being of its most vulnerable inmates. As the number of trans-identifying prisoners increases, correctional facilities across the nation are struggling to balance the needs of these individuals with the safety concerns of the general prison population. Decisions made by institutions housing trans-identifying inmates pose risks to the safety of all incarcerated individuals, especially females.

Despite government attempts to create guidelines, intake procedures, and evaluations for individuals identifying as the opposite sex are highly variable in federal, state, local, and private institutions. Some places use self-reporting, while others may have a lengthier evaluation process, but it is not known how many include a procedure for communication with inmates’ community health professionals. Institutional guidelines for ongoing evaluations, monitoring, therapies, sexualizing hormone prescribing, tapering, and post-surgical care are also not uniform. This lack of standardization leaves inmates vulnerable to potential medical harm and creates an environment ripe for abuse.

To make matters worse, prisons and jails have housing policies that raise safety concerns, especially for incarcerated females who already experience four times the rate of sexual violence than their male counterparts. The Council on Criminal Justice reports that a large majority of these women enter prison having a history of mental health disorders and a prior history of trauma, including sexual and physical violence, making them uniquely vulnerable to repeat trauma and violence.

Traditionally, incarcerated males are housed separately from females for safety and privacy concerns, but some institutions are housing females with males identifying as females. In some cases, such as in the recently publicized story about violent males identifying as females being housed at the Washington Corrections Center for Women (WCCW), the needs of the female-identifying males are prioritized over the health and safety of the females. This story inspired FAIR to advocate for the safety of females in Washington state prisons.

Unfortunately, the WCCW is not the only institution where imprisoned females are at risk.

Olivia* is a nurse who worked for five years at Jail Health, a division of King County Public Health in Seattle, Washington, that services King County Jail (KCJ). KCJ houses male and female adults charged with violent and non-violent crimes.

After facing roadblocks in her advocacy for the safety and care of incarcerated individuals, Olivia resigned as a charge nurse at KCJ and brought her story to FAIR. She agreed to an interview with me to enlighten the public about the effects of gender policies on the safety of female inmates in the Washington jail system.

Through Olivia’s story, we gain a troubling insider's perspective on these issues. Her account reveals a system ill-equipped to handle the nuances of gender identity in a carceral setting, and the devastating consequences this can have for all involved.

As we examine this complex issue, it becomes clear that a more balanced approach is needed—one that safeguards the dignity and security of all inmates, especially women. The time has come for a frank discussion about how we can create a more just and safe environment within our prison walls.

How are transgender inmates initially evaluated at KCJ? Who does this evaluation, and is there any communication with the inmate's community doctors and therapists?

Olivia: When an inmate declared transgender status, outside health records were reviewed by the medical team to continue prescriptions and care plans started in the community. But regardless of health history, inmates were free to declare a new identity and meet with health staff to initiate gender-affirming care at any point during incarceration.

When you were there, was there a process requiring a health professional’s verification of transgender status?

Olivia: No. Neither actual transition nor intention to transition was required for inmates to be honored as “transgender.” A person could identify as male in the community but female in jail. Per policy, this was irrelevant.

Did you witness any safety events related to medical or surgical treatments prescribed or not prescribed to trans-identifying inmates? If not, do you have concerns about the potential for medical harm because of the policies at KCJ?

Olivia: Because I was not a prescriber, I did not witness any safety events related to gender-affirming therapy. I was not aware of the language in KCJ’s policies describing the treatment of gender dysphoria.

Who decided housing placement for inmates, and were there any psychological or medical considerations for determining the housing placement of trans-identifying individuals?

Olivia: Inmates declaring transgender status would meet with the Transgender Review Committee (TRC) within 24 hours. On paper, this was an interdisciplinary meeting between a medical professional, a mental health professional, and representatives from the King County Department of Adult and Juvenile Detention (DAJD). The health staff would determine if the inmate needed medical or psych housing, but whether that placement was in male or female housing was entirely up to DAJD.

So, was there no trans-identification verification process, even for housing purposes?

Olivia: No. Approval for cross-sex housing was granted regardless of pre-existing diagnoses, physical presentation, or participation in gender-affirming care. This absence of a verification process created an unsafe situation for women and for transwomen, both of whom were at risk when nearly any male could qualify for female housing.

Did you have reason to suspect a male inmate might be falsely identifying as a female to gain access to female housing?

Olivia: Yes, staff were very concerned about this. Some health staff said that males were asking them: “How do I get over to the women’s section?” Some of these males had histories of sexually harassing female staff.

What did the policy say about suspected false reports?

Olivia: King County policy does not require staff to honor gender identities if there is “specific evidence that a person has asserted a gender identity falsely.” However, “specific evidence” is not something that is sought; it’s something one trips over. One man was observed telling family members of his plan to deceive staff by demanding recognition as a woman. Another casually admitted to a mental health counselor that he routinely falsifies a transgender identity in the community. Without these chance reveals, both would qualify for female housing at King County Jail.

Did female inmates have an opportunity to voice concerns over their safety?

Olivia: Complaints could be submitted, but I was told by leadership that they were not being retained or tracked. I’d like to stress that the consent of female inmates was not sought prior to housing them with males. Additionally, they had no opportunity to request a “female only” space and risked placement in isolation if they refused their housing location.

Did you witness a situation where the DAJD officials ignored the advice of the medical professionals?

Olivia: Yes. DAJD management made the decision to house in a female unit a male charged with extreme sexual violence against female adolescents. Multiple health staff strongly pushed back against it, but DAJD defended its decision. In another case, an aggressive male engaged in sexually inappropriate behavior in a female unit, after which psychiatric staff recommended his relocation to male housing. This too was dismissed. But the dilemma is that if the facility moved a male back to male housing, it would dishonor his “gender identity” [and] open the facility up to lawsuits.

What happened after those placements?

Olivia: When I was there, security staffing would frequently be so low that some units had no direct supervision. Even when in “isolation,” inmates can still talk to each other, peek into each other’s cells, [and] pass notes. I was also told by an officer that some of her colleagues had stopped writing infractions for bad behavior because they had lost faith that leadership would do anything about it. This is why this policy is so risky. Not only were there not enough eyes on the situation, there was likely insufficient record keeping. Under these circumstances, how can a policy be evaluated for safety?

Did you witness any violent interactions between trans-identifying inmates and other inmates?

Olivia: I did not personally witness any of these events, but there were documented accounts of sexual intercourse, sexual harassment, voyeurism, and hypersexual behavior (including open masturbation) by male inmates in female units.

Regarding the instances of sexual intercourse between male and female inmates, the administration has labeled one, if not all, of these as “consensual.” Labeling sexual intercourse as “consensual” in a jail or prison is extremely controversial, given the power dynamics and ever-present threat of retaliation in these facilities.

One female-to-male transgender person with an androgynous appearance was significantly harassed in male housing and requested, unhappily, to be moved back to female housing. This was an example of our suspicion that females identifying as transgender were not benefiting from the transgender housing policies like males were.

You resigned from your position as Charge Nurse in 2023. Why did you resign?

I resigned when my efforts to advocate for a safer policy were shut down by the administration.

What is the primary reason that prompted you to become a whistleblower?

Olivia: I never wanted to be a whistleblower. I thought that routing the shared concerns of my colleagues through the appropriate channels would open up dialogue and lead to a more inclusive policy. I was wrong. After nearly two years of advocacy, I was told by an official that King County had “no interest” in a project to balance the safety of women and transwomen. I was told there was “no avenue” for staff to continue reporting additional housing concerns. I was told by multiple leaders to “let the women advocate for themselves.” I was told, “It is not your role to advocate for change,” a surprising admonishment considering that one of the core duties of a nurse is to advocate for vulnerable populations. It was devastating to learn that the County’s constant messaging about Diversity, Equity, and Inclusion was just that—messaging.

I’ve been told by legislators that the only route to achieving better policy on this front is through a shift in public opinion. This is why I’m speaking out. The public has a right to know more about the policies carried out in facilities funded by their tax dollars.

What kinds of policies for transgender inmates would you like to see in this institution and others?

Olivia: We need policies that balance the safety of multiple vulnerable groups within the carceral context. This distinction from the community environment cannot be understated. In community spaces, such as a workplace where people are free to define their own boundaries, a person’s sex and gender identity have less relevance. In a jail or prison, people are forced to share bunk beds and toilets, to dress and bathe in front of one another. They cannot leave. They have no access to self-defense measures. This situation demands policies that are sensitive to this reality.

I think that authenticity verification is necessary to ensure that transgender people are benefiting from services and protections designed for them while reducing the incentives for anyone to falsely report a transgender status. We need formal recognition that females may be injured, traumatized, and experience a loss of dignity while being forced to share intimate living spaces with male strangers, no matter how each identifies. Females must be granted the right with impunity to refuse placement with males.

Unfortunately, the only way to reliably prevent unwanted pregnancies in jail is to house males and females separately. Given that females of reproductive age—and this includes female-to-male transmen—are the only sex that experiences the social and bodily impacts of unwanted pregnancy, we ought to treat this as the health disparity that it is.

What else do you want us to know?

Olivia: In my experience, many members of the public genuinely care about transgender people and want to know that prisons and jails have policies that protect them. I want them to know that the staff at my facility shared this concern, and at the same time felt deep moral distress over the ways in which this policy was being applied. It is perfectly logical to care about the safety and dignity of genuine trans people and women at the same time.

Olivia now volunteers with FAIR and Sovereign Women Speak (SWS) to bring about changes for inmates in Washington State. Her work includes direct communication with incarcerated females, engaging state officials, and building a volunteer base.

By sharing this story, we aim to raise awareness among Americans about the potential risks and safety concerns faced by inmates in our prisons and jails. Olivia’s description of events in the KCJ should raise concerns about what inmates experience throughout the country.

These challenges faced by our prison system demand immediate attention and thoughtful reform. The experiences shared by Olivia and others like her reveal a deeply flawed system that prioritizes ideology over safety, putting vulnerable populations at risk. As a society, we must recognize the imperative to protect the rights and safety of female inmates. This requires a thorough reevaluation of current policies, implementation of standardized, evidence-based procedures, and a commitment to ongoing dialogue between correctional facilities, healthcare professionals, advocates, and the inmates themselves.

Only through such comprehensive reform can we hope to create a prison system that truly serves justice while safeguarding the well-being of all those within its walls. Every incarcerated individual deserves access to quality medical care, adequate housing, and safe living conditions. No group should have preferential access that supersedes the rights of others.

*A pseudonym was used in this article to protect the whistleblower’s identity.