(Editor’s note: Photo provided by Unsplash)
Transgenders in prison face a tide rising against them
By Olivia Estep
When the phone rings and a despondent voice repeats to me the monotonous “press one to accept this free call from . . .” I already know it’s Maddilyn Marcum.
Accepting this call won’t change much, but her story might.
We only have 15 minutes when we talk. That 15 minutes costs $2 a pop. I get 15 minutes per call to collect pieces of her life and weave them together until I can step back and tell a genuine story.
I get 15 minutes per call to try to understand what she tells me because the Kentucky Department of Corrections minions tell me little. Even getting the 15 minutes per call — made extremely difficult by myriad DOC protocols — required subterfuge.
But her story gets told, nevertheless.
Marcum came into the world near Cincinnati, Ohio, and grew up in Florence, Kentucky. She lived in Crescent Springs, Kentucky, her world ended.
Marcum stands at 5-foot-10 with piercing moss-green eyes and shoulder-length sandy-blonde hair. Her feminine presence permeates the space around her.
It reveals her unwavering confidence. It flows throughout her voice and rings in her soft laughter. Her tone is determined and self-assured, but an undertone lurks behind that. It ebbs and flows like an ocean’s tide. It’s dark and crashes against the surface. It does its best to reach anything it can hold on to.
But that feminine presence came at a price well beyond dollars and cents.
Transgenders pay deeply.
Marcum lives alone, despite living among a sea of inmates at the Northpoint Training Center in Danville, Kentucky. She longs for connections outside of a jail cell. Endless numbers of people roll in and out of the prison, but no one around looks like her or can imagine what that might be like.
“This is my life,” Marcum said. “My truth. There are no tribes, no communities. Just isolated individuals. Lone Amazons.”
This isolation increases because of the difficulty someone faces trying to speak or visit an inmate when you are not family.
For weeks, I tried to contact Marcum.
When direct outreach failed, I shifted my approach and worked to ensure I got her my contact information so she could contact me. Ultimately, we connected through Securus, an app designed to allow email communication with the incarcerated — for a fee paid by creating an account and putting my money into it.
Thus far, trying to meet Marcum in person presented numerous hurdles, including court rulings that make the process long and arduous. The Overton v. Bazzetta (2003) U.S. Supreme Court decision upheld certain restrictions on prison visitations. This includes friends facing more stringent requirements, such as needing pre-approval or showing a longstanding connection to the inmate.
In addition to rules about phone and mail restrictions, prisons may limit who inmates can call and with whom they can correspond, how often they can do that. And then here is the cost. The 1987 Turner v. Safley decision reinforced these restrictions.
Marcum has spent her time behind bars fighting alone for something that she believes no one should have the right to take away from her — her womanhood.
Marcum began hormone replacement therapy at age 19, a process that replenishes the estrogen supply in the body. By the time she reached 20, she had fully transitioned as a female with breasts.
Matthew Paul Smith became Maddilyn Isabella Marcum.
“My mother said Maddilyn would have been the name she would have chosen had I been born with female parts,” Marcum, 34, said. “So I felt like I was correcting the historical record.”
Marcum is one of the 10,519 female inmates incarcerated in the Federal Bureau of Prisons and is one among the approximately 2,291 transgender inmates, bureau data shows.
Marcum was convicted of murder on Aug. 3, 2015, and sentenced to 40 years in prison with the possibility of parole at 20 years. She was 25 at this time and had been receiving HRT for about six years.
She sleeps in an open dorm arranged in barracks-style and full of men. Rows of bunk beds, 10 sets in total, line up. If she spreads out her arms while in her bunk at night, she touches an inmate next to her.
She takes risks every day doing things that most take for granted. Changing clothes, showering and sleeping require calculated risks when you are a woman serving time at Northpoint Training Center, whose population is about 1,230 inmates, all males.
Except for Marcum, who landed in an all-male jail because she was born a biological male.
“No matter how far along you are or how feminine you appear, the gender you are housed with will boil down to what’s between your legs,” Marcum said. “Other factors such as safety, mental health or well-being are nonfactors in the state’s eyes.”
Before her arrest, Marcum had an appointment scheduled for an orchiectomy — removal of the testes — a long-time goal that never came to fruition.
“(It’s) like breaking your legs within eyeshot of the finish line,” Marcum said. “It’s bitter tasting even still.”
Audrey Anton is a political science professor at Western Kentucky University. She teaches at WKU and leads a philosophy class in a men’s maximum security prison at the Riverbend Maximum Security Institution in Nashville, Tennessee.
Anton teaches a transgender woman in her class who told Anton that a person is incarcerated under the sex on their birth certificate and housed based on the certificate.
Anton hears both sides of the debate about “trans” issues, she said. Trans inmates tell her that it is impossible to live a transgender life in jail. But jail administrations say that they are “mindful of transgender rights and that they work hard to make everyone feel comfortable,” Anton said.
“Honestly, it’s possible that both are telling me the truth,” Anton said. “Even if an administration is mindful of transgender needs, they don’t want to isolate anyone (unless it’s solitary confinement, which is a punishment). And statistically, transgender folks are outnumbered in prison. So, they will be vulnerable to interactions with the ‘general population.’”
Anton said going into a prison is like “traveling through time.” She watches some prison employees behave toward trans inmates with disregard for the gender change.
Marcum attempted to mutilate her genitalia to align her body on the outside what she feels on the inside, she said. Outside of HRT, she has not had access to medical care that affirms her gender dysphoria, a listed medical condition defined as a marked difference between a person’s expressed gender and the gender assigned at birth.
Her three attempts to mutilate prompted emergency medical treatment but failed to get her reassignment surgery. Even though Marcum uses hormones, getting access to them posed challenges.
When incarcerated, the DOC denied her hormones. It took three years before the DOC would allow them.
“While that might seem fast, I ask you to consider what it would be like for a diabetic to go without insulin for three years,” Marcum said. “Hormones literally control everything in your body — how to process foods, how your hair and nails grow, how your skin absorbs sunlight.”
Choosing who and what you want to become is like artist mixing colors to get the perfect shade. The paint reveals an image.
Marcum didn’t get the chance to create the perfect shade.
Her life seems more like a Jackson Pollock painting, paint hastily splattered across the canvas. She lost her family, friends, freedom and future all in one brush stroke.
Without the hormones, her female identity began to fade like a watercolor painting caught in the rain. Her breasts shrank, her body hair returned, and her muscle and fat melted off her body.
Marcum became ill quickly. She believes the only reason she was allowed HRT after three years resulted from her sickly state.
“It was cheaper to just give them to me rather than mitigate the effects of not giving them to me,” Marcum said. “I was a line item on a budget, not a human.”
Gender affirming care has been absent in five prisons where she stayed: the Roederer Correctional Complex (also known as “the Farm”), the Kentucky State Reformatory, the Little Sandy Correctional Complex, the Lee Adjustment Center and Northpoint.
Prison staff forcibly made changes to Marcum’s appearance upon her arrival at the Roederer Correctional Complex.
“When I reached the Farm, they cut off all my hair,” she said. “It felt as though my identity had been stripped clean. Those were the dark days.”
While politicians and the public debate the rights and identities of transgenders, what happens to them in jail remains largely overlooked.
The systemic biases within the U.S. criminal justice system, the long history of mistreatment and the human cost of stripping people of their identities in prison go largely undiscussed, especially in Kentucky.
Kentucky has no documented research on what the prison population looks like regarding transgender people in any of its 12 state prisons, five federal prisons and 84 jails.
Andrew Ritzel, Kentucky’s criminal justice statistical analysis director, declined an interview.
Ritzel wrote in an email: “My office does not currently conduct research in the topic area of transgender housing.”
Ritzel suggested contacting Morgan Hall, communications director for the Justice & Public Safety Cabinet and Kentucky’s Public Information Officer.
Hall requested that I send “specific questions” and that she would “work to get” the information. After sending these questions on Nov. 21, Hall wrote in an email on Dec 2, “Hi. What is your deadline?”
There has been no follow-up with any information.
Transgender individuals housed under their biological sex can be traced back hundreds of years, said Joss Greene, a professor in sociology and a qualitative researcher at the University of California-Davis, who studies transgender people’s experiences with prisons.
He said that “transgender” is a fairly recent category of identification and expression. Before the 1970s, when the term transsexual came into use, people who would now identify as transgender simply saw themselves as not easily fitting into the category of men or women.
“People didn’t identify as transgender in the 1910s,” Greene said. “That word didn’t exist. But there is a long history of people who have presented and expressed their gender in ways that would differ from what one might anticipate based on their sex assigned at birth. We can see historical evidence of people wearing dresses in California men’s prisons in the early 1900s and pictures of very masculine presenting people in California women’s prisons around that time.”
It wasn’t until the early 20th century that prison facilities and administrations became concerned about gender nonconformity being associated with same-sex relations.
In the 1910s, the New York prison system established segregated units of housing for what they described as “effeminate homosexuals.” The California prison system created “Queens Row” in 1941, which was a segregated part of a prison for inmates deemed “queens.”
“The 1970s was really when we start to see advocacy by incarcerated people to access things like hormone therapy, gendered property items or clothing that would accord with their gender regardless of the facility they’re in,” said Greene.
The effort to change that started with Dee Farmer, the first transgender petitioner to have a case accepted by the U.S. Supreme Court. Farmer was arrested on federal criminal charges and was generally kept separate from the male population. However, when Farmer was transferred to the U.S. Penitentiary Terre Haute (Indiana), she was housed with the male population based on the prison’s policy.
At this time, she had already received silicone breast implants, estrogen therapy and an unsuccessful sex reassignment surgery.
Within two weeks, a cellmate beat and raped Farmer, reported the website Oyez.com and Just Detention International. The Oyez site archives the business of the Supreme Court, including rulings and audio recordings of oral arguments.
Farmer sued in the federal district court on the grounds that prison officials deliberately and indifferently failed to protect a prisoner, violating her constitutional rights under the Eighth Amendment’s cruel and unusual punishment standard.
The district court granted summary judgment in favor of the prison official, meaning it allowed one party to win the case without a full trial.
The U.S. Court of Appeals for the Seventh Circuit affirmed, but Farmer appealed to the Supreme Court, which agreed to hear the case.
The question the Supreme Court needed to decide in 1994 was: “Is Farmer entitled to damages or an injunction against various federal prison officials responsible for transferring her to, or assigning Farmer within, a prison facility where Farmer was sexually assaulted by another inmate?”
The court unanimously backed Farmer, who now serves as an expert witness and legal consultant for Fight 4 Justice.
This case set the precedent for many transgender cases today and is a foundational layer for the installation of the Prison Rape Elimination Act of 2003. The purpose of this act is to “provide for the analysis of the incidence and effects of prison rape in federal, state, and local institutions and to provide information, resources, recommendations and funding to protect individuals from prison rape,” the law states.
A report from the National Prison Rape Elimination Commission in 2011 estimated that 1 in 200 prisoners in the U.S. was transgender, which translates to around 2,000 transgender inmates.
This population only continues to grow as seen the 2016 Bureau of Justice Statistics report that showed 2,500 prisoners identifying as transgender.
The law includes 13 protections for transgender inmates to keep them safe from victimization. The Kentucky Department of Corrections (DOC) enforces several of these protections.
For example, standard overview § 115.42 provides guidelines for the use of screening information and placement of residents in order “to reduce the risk of inmate-on-inmate sexual abuse and sexual harassment.”
It is noted that there should be “additional protections for transgender and intersex inmates, based on the unique risks these populations face while incarcerated.”
But the primary law that exists to protect imprisoned transgenders does not specify what protections should be in place.
The U.S. Department of Justice Federal Bureau of Prisons requires annual prison staff training on “working with unique issues when managing transgender inmates,” states the Transgender Offender Manual provided by Chad Webb, the director of Education for the U.S. penitentiary in Kentucky called “Big Sandy.”
Webb offered a straightforward, no-nonsense response when asked why there are transgender women in Kentucky being housed with men:
“If you still have the male genitalia, you’re going to a male institution,” Webb said. “If you have gone through the change and have female genitalia, then they will send you to a female institution because you have made a complete change.”
The purpose of the manual is to “ensure the Bureau of Prisons properly identifies, tracks and provides services to the transgender population.”
The manual has a section on housing and programming assignments, where it is made clear that unit management staff will review an inmate’s current housing unit status.
These reviews will consider on a case-by-case basis that the inmate placement does not jeopardize the inmate’s well-being or create security concerns. They will also seriously consider a transgender or intersex inmate’s own views concerning their safety.
There is also a section on visual searches.
It states: “The visual search shall be made in a manner designed to ensure as much privacy to the inmate as practicable. Staff should consider the physical layout of the institution, and the characteristics of an inmate with a transgender CMA assignment, to adjust conditions of the visual search as needed for the inmate’s privacy.”
CMA stands for Case Management Activity. This was not granted to Marcum.
Recently, Marcum had been required to conform to a strip search. After removing her shirt, Marcum “shook out her bra” to show the man conducting the search that she had nothing to hide. The man said that he needed her to take it off. She was forced to remove the last item of clothing blocking her bare breasts, Marcum said.
Marcum is a C-cup and is very uncomfortable being naked around men, but she complied with the search.
She felt embarrassment and helplessness.
“This guy has seen my breasts and my nipples, and I can tell that he’s talking about that, almost like ‘Look at the knockers on that one,’” Marcum said.
Kentucky Administrative Regulations, Chapter 7, section 501, specifies searching policies under Section 3. Point “d” states: “A strip search shall be conducted by jail personnel of the same sex of the prisoner.”
Marcum has failed to be accommodated by two different regulations, one under Kentucky law and one under federal law. Despite policies in place for staff, nothing seems to be done to prevent transgender mistreatment in Kentucky.
Federal data shows transgender people nearly 10 times more likely to face sexual assault than the general prison population with an estimated 40% of transgender people in state and federal prisons reporting a sexual assault in the previous year.
Marcum’s worst day in prison involved her sexual assault by three inmates brandishing weapons at the Lee Adjustment Center in Lee County, Kentucky. Marcum fought them off, but the incident left her with mental and physical scars.
The incident led to Marcum’s hospitalization, but no government authorities filed charges. Prison officials later labeled her as a “problem inmate” and transferred her.
“I suppose my ‘problem’ was being trans?” Marcum said. “Being attractive? Having breasts? It was a dark chapter. One that still haunts me — still affects my daily life. There are no pretty metaphors. Just trauma.”
A request to Hall, communications director for the Justice & Public Safety Cabinet and Kentucky’s Public Information Officer, to verify the incident and outcomes got no response.
The Federal Bureau of Prisons Inmate statistics show that sex offenses are the third most common type of offense among inmates as of November 2024. Some 13% of inmates have committed sexual offenses, the most recent data shows.
However, this data is “limited due to the availability of offense-specific information,” suggesting that offenses occurring in prison are not always reported accurately or in general.
Officials transferred Marcum four to five months after the attack. This was her move to Northpoint Training Center, tossing her into a sea of men. Housing decisions are still solely based on genitalia status rather than physical and mental health and safety.
Liza Rash is a volunteer for the Voices Inside program at Northpoint. Rash, an actress, performed a script that Marcum wrote about the goddess Calypso. Rash’s volunteer work connected her with three transgender women at Northpoint.
Rash said the sheer resilience of incarcerated people surprised her. She held preconceived notions when she entered the prison.
She thought she would find inmates apathetic and defeated.
“I’ve been shocked at how a system so cruel has not been able to break many of their spirits,” Rash said. “Their ability to find beauty, meaning, hope, humor, understanding, connection and redemption under such a heinous system is remarkable.”
For Marcum, hope is a dangerous thing.
It can lift her or cut her down.
Her hope took another hit when the Commonwealth of Kentucky’s 2025 legislative session began.
Senate Bill 2 — introduced on Feb. 18 — targets transgenders by prohibiting gender-affirming care for them. An amendment to the bill states that administering cross-sex hormones to an inmate would continue “if the inmate was undergoing this treatment upon admission to the correctional facility.”
Marcum heard about the bill and sent this message via email:
“Inside the fence girls are in full panic, unsure what will happen next,” Marcum wrote. “Staff are telling us they will rip us off meds and prevent us from buying bras and gender affirming clothing.”
Marcum said that she has been on hormones since age 18 and that her body no longer produces its own hormones.
“Taking me off hormones will physically harm me, not to mention deform my body in irreversible ways,” she wrote.
But she regenerates her spirit with the arts.
Marcum writes novels and dramas. She plays piano, reads a lot and loves the best parts of womanhood. Hope comes with just thinking about the life that society often takes for granted, she said.
“I think of writing a New York Times Best Seller,” Marcum said. “I think of going to a salon, buying a chic little black dress, dancing in heels until my hair is damp with sweat. Lingerie. A bra that fits. I picture moving West, going somewhere far away from here. A little farm. A quiet life. Baby goats. And when all that doesn’t work: Matthew McConnahay and Vin Diesel.”
She takes pleasure in the small things that she can do to reflect her femininity.
Leaving her hair down and wearing the one or two shades of makeup she is provided is a weak replacement for her love for “being beautiful, being confident, and wearing her womanhood proudly,” Marcum said.
She sees her female life slipping away as people become more hateful toward the LGBTQ+ community.
“Do I think things will improve in the criminal justice system?” Marcum said. “No, I do not. I expect it to get worse, not just (at Northpoint) but everywhere. We will be branded as witches. We will burn and people will cheer.”
Hate causes people to act cruelly. Anxiety and loneliness generated by hate become multiplied tenfold in prison.
“A third of my peers want to act cruelly or even violently toward me based on some insecurity, ignorance or blatant transphobia,” Marcum said. “While the other two-thirds view me as some sort of sexual object and their intentions range from harmless flirting to stalking and even outright assault.”
She is alone, afraid, tired of being behind bars and tired of not knowing what might happen to her, she said.
“There are very few I can trust or even safely spend time with,” Marcum said. “Anxiety is a natural state. The bottling of emotions an assembly line. It’s lonely. I am a unicorn among horses.”
Talking to outsiders offers her great relief.
So when that 15 minutes rolls around, I will always answer.
Resources:
https://apps.legislature.ky.gov/record/25RS/sb2.html
https://apps.legislature.ky.gov/recorddocuments/bill/25RS/SB2/SFA1.pdf
https://corrections.ky.gov/Facilities/AI/ntc/Pages/default.aspx
https://www.journals.uchicago.edu/doi/10.1086/724237
https://www.journals.uchicago.edu/doi/abs/10.1086/723433
https://www.nclrights.org/about-us/press-release/dee-farmer-the-first-transgender-plaintiff-in-a-supreme-court-case-mourns-the-passing-of-aimee-stephens/
https://supreme.justia.com/cases/federal/us/511/825
https://www.bop.gov/about/statistics/statistics_inmate_offenses.jsp
https://www.prearesourcecenter.org/about/prison-rape-elimination-act