In 2005 Tewksbury and Potter suggested that transgender prisoners (including jail and remand inmates) were an ignored group within correctional populations. That has since changed. Presently, in the United States, transgender prisoners and their unique issues are frequently featured in correctional conferences and national symposiums. This contribution takes up the developments in the legal status of transgender prisoners and their recognition by health providers from the 2005 period with a more international coverage. The role of the Prison Rape Elimination Act (PREA) and health equity movements in the United States and other nations is highlighted as areas that have spurred the attention paid to this previously hidden or ignored aspect of correctional administration. The chapter will cover the following topics: overview of the challenges of transgender inmates/prisoners for corrections; epidemiology of transgender person into correctional facilities; overview of the history of transgender issues in corrections; the impact of PREA on trans prisoners and the system; and the future of trans prisoners/inmates and the criminal justice system. While much of the information will be drawn from the United States, attention will be paid to similar developments in Commonwealth and other nations.