Metro Weekly

Federal court: Missouri prisons must allow transgender inmates to access transition-related care

Judge Noelle Collins finds "freeze-frame" policy violates trans inmates' Eighth Amendment rights

Photo: opus2008 / Flickr

A federal court has struck down a Missouri Department of Corrections policy that bars transgender inmates from receiving transition-related health care treatments.

U.S. Magistrate Judge Noelle C. Collins declared the Department of Corrections’ “freeze-frame” policy unconstitutional, finding that it violates the Eighth Amendment’s prohibition on “cruel and unusual punishment” because it denies health care to transgender inmates unless they had previously been receiving treatment prior to their incarceration.

Jessica Hicklin, a transgender woman incarcerated at the Potosi Correctional Center in Mineral Point, Mo., sued over the policy, saying she was denied the right to receive hormones, body hair removal treatments, and access to “gender-affirming” canteen items.

In February, Collins issued a preliminary injunction to stop the prison from enforcing its “freeze-frame” policy and allow Hicklin to access those treatments, which are recommended as medically necessary to help treat Hicklin’s gender dysphoria.

Collins also issued an order permanently barring the Missouri Department of Corrections, and Corizon LLC, its contracted health care provider, from refusing medically necessary treatment like hormones to transgender inmates across the state.

Lambda Legal, which is representing Hicklin in the case, celebrated the court’s decision, noting that it would spare her significant “pain and anguish,” and would also protect other inmates from discrimination.

“To keep life-saving treatment from transgender people suffering needlessly in prison simply because they were not receiving that treatment before they entered the facility is cruel and unlawful,” Demoya Gordon, an attorney with Lambda Legal’s Transgender Rights Project, said in a statement. “This is the first court in the country that we know of to rule specifically that ‘freeze-frame policies’ are unconstitutional, but we are hopeful that other courts will see these discriminatory policies as deliberate indifference to incarcerated transgender people’s serious medical needs and follow suit.”

Hicklin also celebrated the victory, which ensures she’ll be treated according to her gender identity going forward.

“For years, I felt like I had been drowning,” she said in a statement. “But when the first decision came down in February, I could finally breathe knowing I would be able to start an important part of my transition that I had been waiting for desperately. This final decision makes it unquestionably clear that prisons cannot deny transgender people like me life-saving medical care and that MDOC and Corizon must continue to provide the gender dysphoria treatment I need.”

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

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