Amber Akemi Piatt criminal justice human rights women's rights

New Report Reveals Systemic Medical Neglect and Violence in CA Women’s Prisons

New public health research on women’s prisons exposes medical neglect, sexual violence and inhumane living conditions.
An incarcerated woman walks back into the main facility after undergoing a laser tattoo removal procedure at the Folsom state prison in Folsom, California, on September 13, 2019. 

By Amber Akemi Piatt / Truthout

The COVID-19 pandemic brought to the fore the public health crises unfolding in carceral settings across the United States. In California, the California Department of Corrections and Rehabilitation (CDCR) has documented more than 90,000 cases in state prisons, with more than 3,500 of those cases in women’s prisons.

People incarcerated in women’s prisons have reported alarming neglect in CDCR’s handling of the pandemic, including months spent in quarantine units and the denial of toilet paper, phone calls, cleaning supplies and showers. But the health harms of incarceration existed long before COVID-19 and continue to exist now.

My work as a public health researcher and advocate explores the sometimes hidden public health crises of gender-based harm and incarceration. My team recently released new research, From Crisis to Care: Ending the Health Harm of Women’s Prisonsdetailing the severe individual-, family-, and community-level health impacts of incarceration on cisgender women and transgender, gender nonconforming and intersex (TGI) people in California. Our research affirmed the urgent need to close women’s prisons in California.

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Our research included interviewing and surveying people who are currently incarcerated in California’s two remaining women’s prisons, Central California Women’s Facility (CCWF) and California Institution for Women (CIW). Our findings paint a dire picture of people facing medical neglect, sexual violence, transphobic discrimination and inhumane living conditions while incarcerated.

In some ways, California’s incarcerated population mirrors national social patterns. Due to the racism of the criminal legal system, 929 people in California’s women’s prisons were Black in 2022. This is 25 percent of the prison population, while Black people make up only 6.5 percent of California’s total population. Transphobia creates the conditions for TGI people to be disproportionately criminalized as well, and 67 percent of our TGI survey respondents reported experiencing discrimination or violence for their gender identity while imprisoned in California women’s prisons.

Furthermore, 83 percent of our survey respondents reported having an illness, injury or disability, and 55 percent reported having three or more health conditions needing care. Ableism shapes how disabled people are policed, socioeconomically marginalized, and discriminated against in both the medical and legal sectors, leading disabled people to be disproportionately incarcerated.

Indeed, studies show an estimated 66 percent of the incarcerated population in the U.S. is disabled: an estimated 40.4 percent with a psychiatric disability and an estimated 56.0 percent with a non-psychiatric disability. Specifically, estimations show that a higher percentage of people incarcerated in women’s prisons reported disability (79.5 percent) compared with people incarcerated in men’s prisons (64.6 percent). This is particularly troubling considering medical neglect is characteristic of incarceration. We found 66 percent of our survey respondents reported that medical staff did not properly treat them; 60 percent reported that medical staff did not investigate the cause of their medical condition; and 51 percent reported that medical staff did not order diagnostic tests.

Additionally, an alarming 40 percent of our survey respondents reported experiencing reproductive abuse, such as coerced sterilization or an untreated reproductive health issue while imprisoned. Several respondents shared that they woke up from unrelated surgeries to find that their ovaries or uterus had been removed. One woman said that she was waiting for paperwork from a surgery two years prior to find out if she was sterilized.

This is part of a long and sordid history of marginalized Californians facing reproductive abuse. Last year, Gov. Gavin Newsom allocated funds for a new program to compensate survivors of state-sponsored sterilization, acknowledging the state’s shameful past. Our research found that such injustices still occur today, and the governor has the opportunity and obligation to address them further.

CDCR’s censorship of information about what’s going on inside the state’s prisons adds another layer to the problem. Early in our data collection, we noticed we had received dozens of survey responses from people in CCWF and none from people in CIW. Upon investigation, we learned that prison staff had not delivered the mail due to an unspecified CDCR mail protocol violation. Given this, volunteers then hand delivered surveys to people inside CIW. They received and completed our surveys, but the prison staff refused to mail them back to us. Why? Apparently, CDCR staff were concerned the data was being gathered for a possible class-action lawsuit.

Despite this, there are reasons for hope. Though “women’s incarceration has grown at twice the pace of men’s incarceration in recent decades,” California is actually one of the few places in the U.S. where the number of people incarcerated in women’s prisons is significantly decreasing. The number of people incarcerated in California women’s prisons dropped from 12,668 in 2010 to 3,699 in 2022 — a 70.8 percent reduction. This shift is thanks to commonsense policy changes demanded by community organizations and enacted by our state legislators in recent years that have shrunk the footprint of incarceration in our state. Yet, much work remains to be done.

California has the chance to redirect the $405 million spent yearly on women’s prisons toward community-based support systems, such as safe housing, job opportunities and affordable health care. Such investments would advance public health and gender justice and set an example for other states to follow. We urge policymakers, advocates, and the public to engage with our research findings on the health impacts of women’s prisons and to join us in calling for an end to this unjust system of punishment.

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Amber Akemi Piatt

Amber Akemi Piatt is the director of the Health Instead of Punishment Program at Human Impact Partners, a national public health organization headquartered in the San Francisco Bay area of California.

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