Secure settings are, in fact, queer spaces. This is not simply because LGBTQ+ people are found, disproportionately at that, in these settings.1 (“LGBTQ+” herein refers to people who are lesbian, gay, bisexual, transgender, queer, questioning, Two Spirit, and asexual.) Rather, these spaces are implicitly and explicitly domains for non-normative cultures, behaviors, as well as identities. Often that means various antisocial behaviors, those who have committed crimes, or those who live with severe mental illnesses; or a combination therein. In this review, while those may be operative, the case of those who hold minoritized sexualities and genders will be centralized and examined.2 It can be that LGBTQ+ people are in secure settings because they have committed crimes and/or live with severe and persistent mental illnesses. However, there are also structural and social forces that contribute to their disproportionate presence in these settings specifically due to existing as a person with a minoritized sexuality or gender, regardless of criminality or mental health. For this review, secure settings mean those locations that are extensions of justice systems; inherently they restrict liberties and rights and they can intersect with mental health and human service systems. These can include jails, prisons, state hospitals, juvenile detention, and immigration detention facilities, among others. Even more, these settings by their very nature of being secure punctuate the lived existences within them through the persistent specter of policing and discipline. The LGBTQ+ individuals, then, who do enter these spaces have a sharply impacted existence by multiple compounding factors, that is, they bring operating oppressive experiences by being a queer person into these settings and those experiences are compounded and even exacerbated by the oppressive nature of such secure settings. The net effect of this, too often, is that the health and mental health of LGBTQ+ people are negatively affected. This does not have to be the case, however.
The purpose of this review is to increase the competence, that is the knowledge and skills, of multidisciplinary practitioners in secure settings to better serve LGBTQ+ clients, albeit to increase equity and justice. In order to achieve this end, this review brings together archives of theoretical, cultural, and empirical research to architect knowledge and skills that are LGBTQ+ affirmative. The review begins with a discussion of critical terminology imperative for understanding and addressing LGBTQ+ existences. Next, the health, mental health, and social inequities that LGBTQ+ people experience are reviewed. From there, the social science paradigm to explain queer disparities, or the minority stress model, is diagrammed. Then, the review moves into more squarely deconstructing how LGBTQ+ people are criminalized and how their health is implicated in that process, moving from pre-detainment experiences, to existing in secure settings, and finally to re-entering the community. In response to this knowledge, applied strategies are offered that are LGBTQ+ affirmative for people and organizations, are promotive of wellbeing, and that are in resistance to criminalizing procedures, pathways, and approaches.