Metro Weekly

Federal judge rules Missouri transgender inmate is entitled to hormone therapy

Court finds that denying Jessica Hicklin gender-affirming treatments violates her Eighth Amendment rights

Jessica Hicklin – Photo: Lambda Legal, via Facebook.

A federal judge has ruled that a transgender inmate in Missouri prison who is serving a life sentence for murder must be allowed to receive hormone therapy, permanent body hair removal, and be guaranteed access to “gender-affirming” canteen items. 

U.S. District Judge Noelle C. Collins issued a preliminary injunction in the case that allows Jessica Hicklin, 38, to receive treatment for gender dysphoria, which includes both hormone therapy and being treated according to her gender identity. The injunction prevents the state from attempting to deny Hicklin access to those treatments while her ongoing lawsuit against the Missouri Department of Corrections, and its contracted healthcare provider, Corizon LLC, works its way through the courts.

“The denial of hormone therapy based on a blanket rule, rather than an individualized medical determination, constitutes deliberate indifference in violation of the Eighth Amendment,” Collins wrote in her opinion.

Hicklin, 38, is serving a life sentence after being convicted of first-degree murder for killing a man during a crystal meth drug deal-gone-wrong in 1995. When she arrived at the Potosi Correctional Center, in Mineral Point, Mo., Hicklin ran afoul of the Missouri Department of Corrections’ “freeze-frame” policy, which prohibits transgender inmates from receiving hormones and other therapy if they were not receiving them prior to their incarceration.

Due to Hicklin’s gender dysphoria, she suffers from depression, panic attacks, and has even attempted suicide. She has a fear of male pattern baldness, and has tried to amputate her own testicles with a tourniquet “to remove offensive testosterone.” All of these factors play into why Hicklin’s medical provider has classified the hormones and other treatments as “medically necessary.”

Enlisting the help of Lambda Legal, Hicklin, an inmate at the Potosi Corectional Center in Mineral Point, Mo., sued the Department of Corrections and Corizon in 2017, alleging that the denial of hormone therapy and other gender-affirming treatments for her dysphoria constituted cruel and unusual punishment that violated her Eighth Amendment rights.

Meanwhile, the Missouri Department of Corrections argued that its “freeze-frame” policy should stay in place. However, the state was forced to acknowledge in court that it has provided hormones to other inmates, meaning that their refusal to provide them to Hicklin was not due to a lack of resources or unfamiliarity with providing hormone treatment. Instead, the Department of Corrections maintained that it was doing enough by providing Hicklin with psychiatric care and counseling — something that Collins ruled was insufficient in helping treat Hicklin’s gender dysphoria.

“Merely providing counseling and/or psychotropic medication to a severely gender dysphoric patient is a gross departure from medically accepted practice,” Collins wrote for the court. “Inadequate treatment of this disorder puts an individual at serious risk of psychological and physical harm.”

Lambda Legal and Hicklin both cheered the court’s decision to issue the injunction and allow Hicklin to access the medical care she needs.

“This decision is such a welcome relief. Jessica will finally have access to the potentially life-saving medical care she has waited so many years for,” Demoya Gordon, an attorney for Lambda Legal’s Transgender Rights Project, said in a statement. “Forcing her to go without medically necessary treatment was unnecessarily cruel and the source of a lot of pain and anguish for her. Furthermore, this makes clear that the Eighth Amendment requires that prisons provide all forms of medically necessary treatment for gender dysphoria. Ensuring that Ms. Hicklin receives constitutionally adequate medical care while the lawsuit proceeds was the humane thing to do.”

“For years, I felt like I had been drowning,” Hicklin said in a statement. “But today, I can finally breathe because I will be able to start an important part of my transition that I had been waiting for desperately. Today’s decision is like someone threw me a life preserver — it has saved my life.”

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John Riley is the local news reporter for Metro Weekly. He can be reached at jriley@metroweekly.com