In August of 2021, Gus, a prisoner in Georgia, found himself entangled in red tape when seeking vital medical care for his Hepatitis C. His decision to begin the treatment would cost him dearly. Despite having no choice but to go to the doctor, Gus says the move rendered him ineligible for transfer to a transitional center (TC)—a sort of state-run “halfway house.” The decision extended his time behind bars by roughly a year, as those in transitional housing can receive extra credit toward their sentences.
Since the Georgia Department of Corrections (GDC) would not continue his treatment if he moved to a transitional center, Gus says he had to choose between his freedom and life.
Gus was released from prison on August 4. And, without spending the last year or two in a TC, he left his institution unprepared, unhoused, scared, and destitute—except for the $25 the state gives imprisoned people upon release.
In Georgia, some incarcerated people seeking transfers to transitional centers may face a troubling predicament: they may need to choose between access to vital medical treatments and the opportunity for successful rehabilitation. Transitional centers are pivotal for individuals reintegrating from incarceration into society. There are only 12 transitional centers in Georgia, which contain roughly 2,300 TC beds. Only two of those centers are accessible to women. These reentry centers provide a structured environment that offers steady employment, educational programs, and opportunities to develop necessary life skills. In addition, those participating in transitional center programs have an easier time getting driver’s licenses, securing community resources, and obtaining housing before their release.
Denying medical care to incarcerated people with chronic medical needs, who also need placement at these centers, can significantly reduce their chances of successful reintegration. This practice has raised concerns among both incarcerated people and advocates, who argue that denying necessary healthcare services undermines reentry efforts and perpetuates a cycle of incarceration.
Numerous written policies govern TC placement, leading to confusion about how the state determines eligibility. In an emailed statement to The Appeal, GDC spokespeople confirmed that the agency can deny people placement at a TC “dependent on the level of disability,” but that the agency continuously works “to try and find accommodations so that they may participate in the work release program.” The state says people denied TC transfers are instead offered reentry services inside prison.
“We focus on the skills needed to be successful upon release, as well as assisting with vital documents such as birth certificates, Social Security cards and, if eligible, state issued identification cards/driver’s license,” the state said.
GDC also stated that medical services “up to and including hormone therapy” are offered at transitional centers but added that “if the level of care exceeds the capabilities at center the resident will be transported to a nearby state prison to receive treatment” or may use their own provider.
“If offenders are currently receiving treatment, their transfer may be put on hold until treatment is completed; however the inmate is not required to sign a waiver unless they would like to opt-out of the treatment. Patients have a right to refuse treatment,” GDC said.
Emily Shelton, co-founder and director of Ignite Justice, a nonprofit organization working for humane prison conditions, parole reform, and more robust rehabilitation efforts, emphasized the importance of what she called “comprehensive, rehabilitation driven care,” in an interview with The Appeal. She said GDC ought to develop programs that address prisoners’ medical and reentry needs rather than enforce a system that makes incarcerated people broker deals for either.
“The denial of medical care as a prerequisite for transitional center placement is deeply unfair and counterproductive,” she said. “Access to healthcare, including mental health services, disease treatment, and transgender-related medical care, is crucial for successful reentry and rehabilitation. Denying prisoners these services perpetuates a cycle of marginalization and deprives them of a chance to reintegrate into society as a whole person.”
The Appeal spoke to three imprisoned individuals who say they have been denied placement at transitional centers due to their medical needs, including Susy (a transgender woman), John (who has a hernia), and Gus. The Appeal is not publishing their full legal names to prevent retaliation by prison and parole officials.
Transitional centers can serve as a crucial bridge between incarceration and stable housing, offering support and resources to help individuals secure a fresh start.
Georgia’s approach to rehabilitation has been debated and scrutinized in recent years. While the state has made efforts to improve programs and services within the correctional system, access to medical care remains a significant concern. As Georgia strives to reform its penal system amid a federal investigation, the state has largely failed to address this issue.
Gus, 40, said he was effectively told that he could only go to a transitional center if he agreed to delay treatment for hepatitis until after release. He said he agreed to receive treatment while still incarcerated and waived his right to all transfers—including to a transitional center.
“I was over a year out from my time to put in for a transfer to the TC,” Gus said. “I didn’t realize that signing up did not mean I’d start treatment that week.”
Due to the poor quality of medical care in prison, Gus said he did not start treatments for almost a year and, during that period, lost the time that he could have spent at the TC. When he would ask about his care, he says officials typically told him it would begin “soon.” But Gus says appointments were repeatedly canceled due to understaffing.
“The treatment already seems begrudgingly provided, as if it’s cutting into profit sharing or something,” he said. “It’s like they’re making me choose between my health and my freedom and not promising either. What’s the logic in that?”
Susy, 30, is a transgender woman who has been incarcerated with men for several years. With few resources, little family, and years left in prison, Susy said she was anxious and concerned for her future. She was devastated to learn she’d been rejected for placement in a transitional center—first in January and then again in June of this year—despite meeting the requirements for transfer: parole or max release date approaching, no serious disciplinary record, and no post-release residency plan submitted.
Susy said the problem was that GDC would not allow her to continue her regular endocrinology appointments (or any recurring medical consultations) or other gender-affirming care.
“It was really shocking for me, and I had them repeat it multiple times when they told me I had to waive access to my treatments,” she said. “They were essentially asking me to detransition.”
John, 58, a prisoner suffering from a hernia, said he was denied placement at a transitional center due to what he described as “not being the perfect physically fit prisoner.” John said prison officials told him that, despite his three decades in prison and having no family or resources, there were concerns about his ability to perform at the transitional center. He’d been sentenced to life in prison but said he qualified for long-term placement at the transitional center while his parole date was pending.
“I’m dealing with a bureaucracy, and it only sees things one way,” he said. “It doesn’t understand. They don’t individualize this. The reality is I need, not ‘want’ the TC. I’m not seriously incapacitated. But yes, there are some limits on what I can do. But that doesn’t remove my need for the TC. There are a lot of jobs I can do.”