THE RIGHT TO HEALTH IN PRISON: RESULTS OF A NATIONWIDE SURVEY AND REPORT 4.63 The Prisons Department should therefore provide support for persons with disabilities in order for them to enjoy all the rights on an equal basis with other prisoners as the lack of such support in a prison environment can amount to torture or cruel and degrading treatment.137 4.64 The Commission accordingly recommends that all prisons make their services, programmes, and activities accessible to people with disabilities. Prisoners with Gender Dysphoria (transgender prisoners) On combatting discrimination based on sexual orientation and gender identity: “Some say that sexual orientation and gender identity are sensitive issues. I understand. Like many of my generation, I did not grow up talking about these issues. But I learned to speak out because lives are at stake, and because it is our duty under the United Nations Charter and the Universal Declaration of Human Rights to protect the rights of everyone, everywhere.” — UN Secretary-General Ban Ki-moon to the Human Rights Council, 7 March 2012 4.65 The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) which is the 2013 update to the American Psychiatric Association’s classification and diagnostic tool defines ‘gender dysphoria’ (formerly Gender Identity Disorder) by “strong, persistent feelings of identification with the opposite gender and discomfort with one’s own assigned sex that results in significant distress or impairment.” Observations on the Standard Minimum Rules for the Treatment of Prisoners prepared by the Committee on the Rights of Persons with Disabilities, 20 November 2013. 137 78