Where the Glass Ceiling Meets Iron Bars
“Did you ever notice that women can seem common while men never do? You won’t ever hear anyone describe a man’s appearance as common. The common man means the average man, a typical man, a decent hardworking person of modest dreams and resources. A common woman is a woman who looks cheap. A woman who looks cheap doesn’t have to be respected, and so she has a certain value, a certain cheap value.”
~ Rachel Kushner, The Mars Room
Thought prison was hard? Try being a woman.
Well-known is the statistic that the United States incarcerates ~21% of the world’s prisoners while comprising less than 5% of the world’s population. Lesser known is that while women comprise only around 5% of the world’s incarcerated, nearly one-third are in the U.S. The growth in female imprisonment (>700% aggregate growth in the past 40 years) has outpaced that of men by over 50% from 1980-2014. And despite appearing to taper off over the past two decades, The Sentencing Project reports these figures are still very much on the rise:
Simple figures like these are often overlooked because women are a numerically much smaller fraction of the prison population, but maybe even more so because the image of a woman doesn’t fit as neatly into the many layers of stereotyping that constitute what we commonly think of as a “prisoner” or “criminal”. Politicians speak of combating violent crime and cracking down on gangs. The media focuses our attention on events that look more like scenes from The Wire than the everyday injustices and compounding burdens that truly define prison life.
The non-media-friendly reality is that only ~38% of women in prison were incarcerated for non-violent offenses. But violent or non-violent, if the result is incarceration, lives are still overhauled. Guided purely by intuition, one might think that non-violent offenses result in milder sentences, a quicker return to society, and a smaller policy issue to tackle. Unfortunately, this line of reasoning doesn’t hold—and the reasons why take us deeper into the problem.
The vast majority of women are imprisoned for non-violent offenses, and it’s true that non-violent offenses have shorter-than-average stays in prison. The catch is that shorter stays lead to little or no support from correctional officers and program staff, whose programs are traditionally designed to help individuals serving for a longer set duration. If you’re only in prison for 3 months, and the best educational, employment or mental health services all have a 6-month minimum duration, you’ll almost always be denied access to those services (the argument being you can’t finish the program, so it’s waste of resources to start). This seems a directionally logical policy at first glance, though its consequences warrant a reinvestigation.
The issue is that shorter sentences have been consistently linked to higher rates of reoffense—which is expressly what programming (and prison time in general) is supposed to deter. Of all those in prison for short durations (i.e. serving <1 year in prison), BBC reported that women are actually more likely to re-offend than men. This vicious cycle of reoffense and poorly-spent time in prison only exacerbates the problems being dealt with beyond prison confines.
The mounting problems women face while incarcerated show why they’re particularly vulnerable to short stays, and why it should be unsurprising that rates of reoffense are so high (even among a largely non-violent population). They’re being hit with problems of every kind—simultaneously—just one of which might overwhelm any of us. The main body of this piece details the many layers that make women particularly susceptible to even short stays behind bars.
Women Aren’t More Fragile; They’re Just Dealing with More Problems
It’s commonly cited that twice as many women in prison grapple with mental health issues in prison…and frankly every incarcerated woman could probably make the case. But before looking at any facts or statistics, it’s worth noting that figures around women’s mental health are often misconstrued as a product of women being more “volatile” or “emotional”. I myself have heard correctional officers referring to women’s prisons as “crazy town” or “the real nuthouse”—a wonderful cocktail stigmatizing women and the incarcerated simultaneously.
The slight issue with that thinking is that it’s entirely wrong. Women in prison—even those incarcerated for just a few months—have greater mental health issues because many of their lives are proportionately more messed up. Their mental health is directly tied to real-world, physical hardships—and the numbers are nothing short of staggering. For anyone inspired to work on even one dimension in this field, the following is must-know:
Trauma (Pre-Incarceration)
~85% of women in prison say they have experienced some form of physical or sexual trauma in their lives.
During childhood, 53% say they experienced some form of physical, sexual or emotional abuse; a separate study on Illinois prisoners found 25% experienced physical trauma symptoms in childhood.
This same Illinois study found 60% could “potentially be diagnosed as having PTSD”, while 83% stated they were “bothered by a PTSD symptom in the past month.”
71% experienced “repeated, disturbing memories, thoughts, or images of a stressful experience from the past, and avoided thinking about or talking about a stressful past experience to avoid having feelings related to it.”
30% of women in custody reported a psychiatric admission prior to entering prison.
For perspective, these are the types of figures you’d expect to see from war veterans returning from overseas. In fact, a 2017 study of ~5,000 U.S. veterans found 13% were medically diagnosed with PTSD. That’s extremely high, given only ~3.6% of the U.S. population experiences symptoms of PTSD in a given year. But with 85 of every 100 female prisoners reporting they’ve been physically or sexually traumatized in their lives, it’s no wonder 60%—over 4x the rate of U.S. veterans—could be diagnosed with PTSD and 83% (at least 23x the general populace) have experienced PTSD symptoms in the past month. If nothing else, these numbers paint a picture of a population that is both extremely fragile and extremely resilient.
Childcare & Intimacy
60% of women have a child <18 years of age who depended on them prior to their incarceration; 25% are lone parents prior to imprisonment
Under 10% of children are cared for by their father if their mother goes to prison; only 5% of children will remain in the same home in which their mother originally cared for them.
Knowing how unreliable external support systems are (at least colloquially) adds a layer of deep helplessness to an already high-strung environment, and is one of the most commonly cited reasons women commit suicide in prison. Considering how short so many stays are, the fact that children are moved from location to location makes clear just how destabilizing any amount of prison time can be for a woman and her family.
Depression / Anhedonia
65% of women in prison identify as suffering from depression (compared to the still-alarming figure of 37% for men)
60% of women felt “distant or cut off from other people”, while 50% felt “emotionally numb or being unable to have loving feelings for those close to [them].”
46% of women prisoners said they had attempted suicide at some point in their lives; in prison, women commit 19% of all self-harm incidents while comprising only 5% of the prison population.
Exact numbers for suicide attempts among all U.S. women are hard to pin down but can be triangulated. Women on average commit 58 suicides per 100,000 people and have been reported to attempt suicide ~10x more than they commit suicide. This implies a .558% suicide attempt rate among U.S. women at large, meaning women who’ve been incarcerated are 8,243% more likely to attempt suicide (.46/.0058) than the average woman. The only thing to do after calculating a number like this is to hope you messed up the decimal place somehow. And to never forget it.
Addiction
Over half (52%) of female prisoners thought their drinking was out of control and the majority of those (41%) wished they could put a stop to their drinking habits.
Though some information on this is dated, treatment programming for substance abuse actually declined from 1991 to 1997 (40% to 18%)—a likely relic of the post-War-on-Drugs era.
A 2017 paper authored by the U.S.D.O.J. found that ~7 in 10 females in state prison (69%) or jail (72%) “met the DSM-IV criteria for dependence or abuse”, around 10% higher than males in analogous circumstances.
There are natural linkages to trauma-based coping, higher rates of self-harm and suicide here. But such high rates of addiction across the board reinforce the point that this is a population with such depleted resources at their disposal, and who are grappling with real pain on a day-to-day basis. We’re not even going to get into the physically harmful and life-shortening effects of regular substance dependence that follow these women into prison (ranging from withdrawal symptoms and mood fluctuations to problems sleeping and impulse control).
One Last Thing: Basic Healthcare
This section is split out because the trauma these women are bringing with them to prison, the stress of having their lives upended, and the loneliness of their incarceration are all raised to the power of not having basic necessities to take care of their bodies. Not to mention these women spend their days in a staff environment that’s >70% male (predominantly correctional officers), who are trained to prevent violence and run prison operations, not help with day-to-day women’s health needs. Here are some of the most important findings and gaps in women’s healthcare that need to be addressed for women in prison:
The National Commission on Correctional Healthcare found that access to menstrual hygiene products for incarcerated women was “inconsistent and often inadequate”, citing a study (Allsworth et al., 2007) that up to 40% of women report abnormal menstrual bleeding from extreme stress and poor access to healthcare products.
STI transmission rates for diseases like gonorrhea (up to 3%) and chlamydia (up to 14%) are extraordinarily high relative to the broader U.S. population (~.5% and .6%, respectively)
Women in prison have exceptionally high rates of unintended pregnancy prior to incarceration, with only 28% of those who were sexually active reporting to have used birth control consistently in the 3 months before they were incarcerated. 85% planned to be sexually active after prison and 60% wanted to start a contraceptive program in prison, yet only 38% reported access to contraceptive methods through their state or federally-run prison.
There is a massive nutritional gap for women, and it’s pronounced even relative to the inadequate dietary conditions for men in prison. Despite the heavy societal stigmas that lead women to nutrition and eating conditions on the opposite extreme, 37-43% of incarcerated women are obese (compared with men at 20-27%).
The absence of basic women’s healthcare sits at the center of this crisis: minimal access to basic healthcare products, higher rates of disease, ignorance (willful or not) of basic issues around childcare and pregnancy, and total neglect of nutrition. What’s the material cost of all this? Today, average life expectancy among all women in the U.S. is ~81 years of age. The last time that U.S.-wide figure matched today’s life expectancy for incarcerated women was in 1912—when life expectancy was 54.
What should we do about this?
Naturally, just fix teen pregnancy, teach all correctional officers the nuances of women’s healthcare, change sentencing guidelines in every city across the country…
Just beginning to think through this type of problem can feel more like getting the bends than answering a policy question. A constructive way to approach this is to think through (a) the effort and stakeholders required to execute each potential intervention, (b) the discrete impact that any given intervention would have, and (c) the ripple effect, or the degree to which all initiatives to follow become easier to undertake. In short, find the low-hanging fruit—especially if that fruit brings other branches closer to ground. Two countervailing examples may help make this easier to see.
One place we likely should not start is homing in on rates of depression. If we first go at the problem of helping women in prison by instituting more mental health programming and hiring more social workers, we won’t be addressing the root causes of this population’s failing physical and mental health. And we’ll have to magically raise the supply of mental health workers and licensed social workers—who are already dissatisfied and overworked. While this work has the potential to be extremely impactful, the impact of focusing here first is likely to be capped. It’s like giving an endurance athlete the latest and greatest in shoewear while neglecting to ice her swollen ankle.
A place to start is raising the baseline nutritional requirements for every prison facility housing women today. We need to establish standardized nutritional requirements (using FDA or other guidelines), ship the most cost-effective, healthy options to state and federal facilities across the country, and ensure they’re distributed under sanitary conditions to incarcerated women. This is easy to comprehend and it’s been proposed before (e.g. in European prisons with, among other issues, extremely high sodium rates). To give an idea of what we’re dealing with today, here’s a sample breakfast from an article on Insider:
Now I don’t know what that is per se, but it’s definitely not breakfast for a full-grown adult. This is something you eat as a kid if the entire family forgot to go grocery shopping and you just needed something in your system. Nutritional deficits have become commonplace in correctional contexts, and these consistently poor meals add up quickly to create all sorts of serious health risks.
Some might still object that this would be too costly. But even if government bodies insist on absurdly low costs for arguably the most important element of healthcare (i.e. nutritious food), they can check out what some very regular people are coming up with for breakfast options under $2. Jokes aside, let’s do the math. With around 225,000 women incarcerated in the U.S. today, even at a cost of $5/meal (3 meals / day), that’s 225,000 x $5 x 3 = $3,375,000 / day to feed nearly a quarter-of-a-million people. Across a calendar year, that cost scales to $1.23 billion—again, to feed 225,000 human beings. Assuming shipping and storage is about as cumbersome as humanly possible, add another $250 million in cost (imagining it’s comparable to the dubiously-construed prison care package shipping rates) to get healthy fruits, vegetables and grains where they need to be. Surely 50 state budgets and a ballooning federal balance sheet can squeeze just under $1.5 billion into their forecasts to feed 225,000 women who are otherwise on track to lose a third (54/81) of their years on Earth. This doesn’t even net out the cost of feeding incarcerated women today.
Bottom line: this kind of investment would prove pennies on the dollar, and it incidentally might be one of the highest-ROI (return being longer life expectancy) initiatives towards which any entity, particularly our government, could put its time and resources. Along with the basic provisioning of women’s health products and contraceptives, we should start yesterday on the higher-impact, lower-effort interventions like nutrition that can make a huge dent in yet another of our world’s unsung human rights crises. There’s still so much more to discuss when it comes to what women are dealing with in the prison environment, but knowing the many added burdens they’re shouldering should give us a well of compassion for them—and a felt determination to do what we can to help.
To learn more, Vera’s Institue of Justice has a detailed blog series, Gender and Justice in America, and the Prison Policy Initiative has documented a great deal of what we know today (both sources are drawn from considerably here).
For a novel with about as much non-fiction as fiction, The Mars Room catalogues a woman’s harrowing journey from the streets of California's Central Valley to her new reality behind prison walls. Not for the faint of heart, but you made it this far and it’s a meaningful read.
To donate or contribute to work helping currently and formerly incarcerated women, here are a few places where your own dollars will be put to good use: