Transgender Prisoners Transition in Lockup: 'Becoming More and More of Me'

Reader advisory: Some accounts of violence in this story contain explicit details and strong language that some may find upsetting. This story is part of a larger piece on transgender prisoners. 

In 2015, Yekaterina Wesa Patience found herself in a prison crisis bed. She said she could no longer play the tough guy — or any guy.

"I couldn't do it no more. I kind of started having a little mental breakdown. ... It was too painful," she said.

Patience, 44, an inmate at the California Medical Facility in Vacaville, said she’d known she was a girl since her childhood in North Carolina.

At 14, she moved to California. There, she said she found herself on the streets of Los Angeles, a victim of child sex trafficking.

Patience said she had been homeless for nearly four years when she committed the crimes — first-degree murder, attempted first-degree murder and cruelty to a child — that sent her to prison at 20.

"I really have a hard time reconciling that I did something like that,” she said. “It seemed like I could have stopped everything and I didn't — like my heart was too cold to do it."

She’d do anything she could to change the past: "That was a damaging tragedy that ruined a whole lot of lives, and I was directly responsible."

Prison was no place to be openly transgender. Two rapes in less than two years forced her into the closet, she said. There she stayed until about four years ago, when she found herself in the crisis bed.

"Despite knowing myself, the world told me different, and if I wanted to avoid problems I had to give the world what it wanted to see — and the world wanted to see a boy," Patience said.

She finally confided her secret to a nurse: "I have to admit, I'm a girl. ... It's the first time I'm really just admitting it and saying that this is who I'm going to be."

Though it seemed like she had it together, "I would cry almost every night. ... Because I never felt like I would ever get a chance to be me," she said.

With the help of other transgender inmates, Patience began to come out.

"Now I'm becoming more and more of me, and the more I am, the less angry I am, the more able I am to just kind of love myself and be gentler to other people."

Patience, known as Kat, wrote about her struggles and transition over decades in prison, from her teen years to her 40s, in a short story she called "Platinum Linings" for the LGBTQ writing group at CMF.

" ... my decisions, born and died in rage, put me so far away from where I started from. I never heard I'm proud of you as a child. In pain, my anger rose as I struggled to stand. To be more than I was ever allowed to imagine. Forced to live as a man ...

... I desperately needed to be locked away — jailed and be moved for the safety of all involved. It provided me time to reflect and change. To be a better person, grow and evolve. ...

If only those thoughts would have molded me as a child I may now be reading a better page. But then I wouldn't be me, the woman, the Kat, that my transformation has made."

‘I Just Jumped In’

As a child growing up in West Covina, Ava Fey knew she was different. In private, she would dress up in her mother’s and then stepmother’s clothing.

"I had a pretty good idea I wasn't like the other little boys," she said.

Like Patience, Fey, 58, ended up homeless and a victim of child sex trafficking on the streets around L.A., she said.

Fey said she first went to federal prison at age 20 for robbing banks. After a few years, she came out as transgender. After she was released, Fey lived as a woman until she landed in California state prison in 1995 for the arson death of her adopted father. His death haunts her to this day.

"Worst thing I've ever done in my life," she said. "I didn't mean for him to come to any harm. So when he did, it was even worse. ... I'm not complaining about being in prison. I deserve to have come here."

While in maximum security lockup in California, she tried to keep her gender identity under the radar.

"I didn't want to get used and abused," Fey said. "Once I got out of there, then I kind of loosened up. It took me a minute. And I just jumped in."

Fey shaved her beard and ordered makeup. In January 2019, a month after she transferred to the state prison in Vacaville, she started taking hormones. Still, it wasn’t easy going.

“Prison is not the optimal place to go through a transition, especially the beginning. People are thinking you're one thing and then all of a sudden you're not,” she said. “Some people get pissed off and it's like, ‘Oh, you've been tricking me or lying to me.’ On the streets that might break friendships. Here, it might get you stabbed.”

In July, Fey said she could feel a difference from the hormones even if she wasn’t sure it showed all that much.

During a transgender support group meeting at the California Medical Facility, Fey asked officials from the California Department of Corrections and Rehabilitation, who were accompanying reporters on a media visit, to provide transgender inmates with treatments like electrolysis and voice therapy.

"It is more than hormones and getting a vagina,” Fey said. "If you do just a part, what are you going to do, create a bearded lady? ... That's a circus freak show."

CDCR said medical interventions for transgender people don’t include wigs, facial or neck hair removal or voice therapy.

The state has provided hormone therapy to prisoners for years, CDCR said. Many of the transgender women at CMF said they’re receiving hormones; CDCR said shots were the most common method though pills are also administered.

"I need this because for decades ... it's almost like somebody dressed me up in the wrong skin. It is not being yourself," Fey said of the medical treatments. "I'm a woman but somebody walking by might not catch that. How can you live if you're not what you are?"