Transgender, gender nonconforming, and intersex (TGNCI) youth are acutely vulnerable to poor mental health outcomes. Justice-involved TGNCI youth are at even greater risk of trauma, victimization, suicide, and self-harm (Markshamer & Tobin, 2014; Lydon et al., 2015; James et al., 2016; Hughto et al., 2018; Malkin & DeJong, 2019). TGNCI youth in juvenile detention facilities face additional challenges related to housing and medical care. Providing quality care for this vulnerable subpopulation is an important challenge for juvenile justice professionals.

Since 2000 California has passed successive legislation to protect TGNCI youth in public schools, state programs, and juvenile detention facilities. Among these was SB 518 (2007), the California Juvenile Justice Safety and Protection Act, which made California the first state to adopt a comprehensive bill of rights for young people confined in juvenile justice facilities. The law protected lesbian, bisexual, gay, and transgender (LBGT) youth from discrimination in the state's juvenile justice facilities and served as the foundation for subsequent legislation that provided specific protections for TGNCI youth. In 2019, Title 15 of the California Code of Regulations (CCR) was expanded to include definitions around gender and to provide specific protections for LGBQ and TGNCI youth in detention facilities. Title 15 section 1352.5, ‘Transgender and intersex youth’, requires the development of written policies and procedures ensuring respectful and equitable treatment of transgender and intersex youth. These requirements built on national legislation such as the 2003 Prison Rape Elimination Act (PREA), which intended to prevent sexual violence in all custodial correctional settings operated by federal, state, and local governments (juvenile, adult, community corrections, and immigration). According to Smith (2008), data collection resulting from PREA created visibility for the issue of sexual violence in custody. For example, in the first baseline survey in 2005, juvenile agencies reported rates of sexual violence three to seven times higher than adult facilities – both staff sexual misconduct and youthon-youth sexual abuse (see Beck & Harrison, 2006).

In California, probation departments are responsible for running youth detention facilities. As such, they are tasked with ensuring the physical safety and psychological well-being of incarcerated TGNCI youth. While legal protections from discrimination and sexual abuse are a critical step in safeguarding the physical and psychological well-being of TGNCI youth, legislation is not sufficient.