Missouri Transgender Inmate Can Get Hormone Therapy, Judge Rules

ST. LOUIS, MO — A federal court in St. Louis has ruled that the Missouri Department of Corrections must provide hormone therapy for Jessica Hicklin, a 39-year-old transgender inmate currently serving life without parole at Potosi Correctional Center in Washington County, Missouri, for a drug-related murder that happened in 1995.

Hicklin was 16 years old and went by the name James when she was convicted of shooting a man who refused to pay for methamphetamines.

Missouri policy is currently to deny hormone treatment to inmates who were not receiving it when they went to prison, but the temporary injunction will reverse that for now, and also allow Hicklin access to "gender affirming canteen items" until the lawsuit goes to trial next year. Those items are typically not available at the all-male prison.

Hicklin testified that she has feelings of hopelessness arising from gender dysphoria, and that she has attempted to take her own life while in prison. Ignoring serious medical needs violates the Eight Amendment, magistrate judge Noelle Collins wrote, saying that Hicklin had demonstrated such a need.

"Two separate psychiatrists diagnosed Ms. Hicklin with gender dysphoria and noted that she required specific treatment in order to treat her disorder," Collins continued. "Further, upon review of Ms. Hicklin's medical records, the Court finds that her gender dysphoria disorder is especially severe."

Gender dysphoria is characterized by a contradiction between a person's gender identity and the sex they were assigned at birth. It is recognized by the American Psychiatric Association and is included in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, commonly called the DSM-5.

Hicklin said she has "languished in the closet" for many years, and has been sexually assaulted three times while in prison.

"I spent many years this way, grappling with these questions, eventually telling myself that I could not continue to live in a body that does not reflect who I really am. For me, the fear of living the rest of my life like that was worse than the fear of sexual assault and people knowing the truth," Hicklin writes on the website of Lamba Legal, an LGBTQ legal advocacy group. "Although I have struggled for years to name what I was experiencing, and I sought treatment for depression and anxiety, it wasn’t until several years later that I realized that I am a woman who is transgender."

"Potosi Correctional Center is a place people go to die, but ironically I feel like I was born here," she said.

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