Evaluating correctional health care. The lessons of New York City.

New York City's correctional health care system is a complicated one, with many component parts. Correspondingly, the task of developing an evaluation process to assess this system turned out to be complex as well. The major responsibility for developing such a process and for keeping it in motion lies with the Contract Evaluation Unit of the Department of Health. Our experiences in meeting these challenges, as well as the historical and institutional factors that have influenced our efforts, should be of interest to professional groups facing similar tasks in other localities and to readers curious about how particular health service evaluation approaches take form. This article describes our method, how it emerged, and that it entails, with an eye toward identifying what might usefully be applied to the study of other correctional health care services and settings.     

Transsexuals and European human rights law

Sexual identity is a legal status, and as such it is as much dependent on public policy as on self-identification. However, because this status can be crucial to one's role in society, a conflict between the legal status and an individual's perceptions or aspirations creates a dilemma if society is committed to individual freedom. This difficulty can become particularly acute where it is technically possible for an individual to alter some of the factors used socially or legally to determine sexual identity. This paper analyses these difficulties, both from the situation of endocrine disorder and with respect to gender identity. It argues that this distinction in approach may not be a valid basis for different legal treatment. It considers four major issues: the stage at which a change of gender should be recognised; any preconditions to which a legal change of gender should be made subject; whether legal recognition should be made for all purposes or only for specific areas of the law; and the confidentiality of a person's previous sexual identity. The paper particularly analyses the law in the United Kingdom and then considers other jurisdictions before focusing on the treatment of transsexuals under the European Convention on Human Rights.