Jail and prison health care systems have largely been defined and operated by men for a nearly exclusive male clientele. However, the dramatic rise in recent years in the number of incarcerated women has been accompanied by demands for specialized health services. Women as a group have been immersed in the illicit drug culture as alcoholics, addicts or the domestic partners of alcoholics or addicts. Medical problems associated with women inmates may include high-risk pregnancies, premature deliveries and other reproduction-related conditions, and conditions related to sex-for-drugs exchanges, such as HIV/AIDS and tuberculosis. In addition, their mental health service needs exceed those of men. Reproductive health care access notwithstanding, the systematic denial to women of parity of services readily and routinely available to incarcerated men is the most widespread and invidious impediment to adequate health care for women offenders. The article describes a California model of improved care for women. Figure, notes