Caring for Women in Prison: Sexual Assault and Family Groups

kids girlfriends sharing a secret isolated

Cheryl is a petite inmate in her twenties who just entered a federal prison to serve out her drug trafficking sentence. She is quiet and withdrawn during her intake screening and admits to the nurse that she was sexually abused by an uncle when she was 12. Her family and friends are over 200 miles away and will be rarely able to visit. Several weeks into her stay she is seen almost exclusively in the company of an older woman who orders her around and often shouts profanity at her. The nurse wonders if this is a sexually abusive relationship.

Sexual assault is a real concern for incarcerated women. Although all inmates are at risk for sexual assault, female inmates are twice as likely as their male counterparts to be coerced by a fellow inmate according to a recently published Bureau of Justice report. The authoritarian structure of the prison system also contributes to sexual victimization by staff. Like Cheryl, a high number of women in prison have sexual abuse histories, some as children.

All forms of sexual contact are prohibited by the Prison Rape Elimination Act (PREA) of 2003. This federal mandate requires jails and prisons to prevent, detect, and respond to indications of sexual victimization within their facilities. Correctional nurses need to be aware of the prevalence of abuse histories and vigilant for sexual assault in the female patient population.

Risk factors for sexual assault: The following classes of individuals are more vulnerable for sexual assault while incarcerated.

  • Mental, physical, or developmental disability
  • Age
  • Physical build
  • Gay, lesbian, bisexual, transgender, intersex, or gender nonconforming
  • Previously experienced sexual victimization

With her slight build, young age, and past abuse history, Cheryl has a potential for sexual victimization while in the prison system.

The smaller size of the female inmate population and the special needs of this group mean there are few female prisons in the federal and state systems. Therefore, many female inmates are sent to facilities far from home with little opportunity to have contact with family and friends. The relational nature of this gender and the desire for belonging and group identity leads to the emergence of family groups within female prisons. The pseudo-family distinction in female prisons parallels gangs in male prisons. This can blur the relationship boundaries and make it difficult to determine if an intimate relationship is consensual or coerced.

How do you think a correctional nurse should respond to Cheryl’s situation? Should this nurse intervene? Would you? Share your thoughts in the comments section of this post.

To read more about the unique aspects of women’s health care in the correctional setting see Chapter 9 in the Essentials of Correctional Nursing. The text can be ordered directly from the publisher and if you use Promo Code AF1209 the price is discounted by $15 and shipping is free.

Photo Credit: © Oksana Kuzmina –

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