By Nassim Benchaabane
St. Louis Post-Dispatch
ST. LOUIS — A federal judge here ruled Friday that the Missouri prison system must provide hormone therapy for a transgender inmate serving a murder sentence.
The ruling came in a lawsuit challenging the system’s policy barring the treatment for inmates who weren’t receiving hormone therapy before they were incarcerated.
The suit, similar to others filed in other states, alleges the policy violates the Constitution’s ban on cruel and unusual punishment.
The ruling by U.S. Magistrate Judge Noelle Collins grants in part a preliminary injunction sought by Lambda Legal last year on behalf of Jessica Hicklin, 38, a transgender woman in the maximum-security Potosi Correctional Center. Lambda represents Hicklin in her suit challenging the state Department of Corrections’ policy.
“This decision is such a welcome relief,” said Demoya Gordon, an attorney for Hicklin and Transgender Rights Project attorney for Lambda Legal. “Jessica will finally have access to the potentially life-saving medical care she has waited so many years for.”
Hicklin was sentenced to life in prison at age 16 after she was convicted of fatally shooting a man during a drug-related crime in the western Missouri town of Clinton in 1995.
Corrections Department officials could not be reached for comment.
In a blog on Lambda Legal’s website, Hicklin wrote that she had felt she was a girl since she was very young and spent years in prison grappling with depression.
“I didn’t know what gender dysphoria was, or how to explain my feelings to my family or others in my small town. But I had felt I was a girl since I was very young, even though I was assigned the male sex at birth.”
She was diagnosed in 2015 with gender dysphoria, according to the lawsuit. The medical term, listed in the American Psychiatric Association’s diagnoses manual, refers to the distress a person feels because of a conflict and disconnect between their gender at birth and the gender with which they identify.
The ruling Friday orders the corrections agency and its contracted health care provider, Corizon Health LLC, to immediately provide Hicklin with the care her doctors had deemed medically necessary.
The ruling said there was sufficient evidence that Hicklin was at risk of irreparable harm, including emotional distress, suicide and self-castration, if she didn’t receive treatment.
That treatment includes hormone therapy, permanent body hair removal and access to “gender-affirming” hygienic products and other products from the prison commissary store. Those products are not typically available at the all-male Potosi prison, according to the lawsuit.
‘Freeze-frame policy’
Federal inmates can receive treatment for gender dysphoria if an evaluation determines they need it, based on a policy enacted in 2011, but state regulations vary.
The federal policy was enacted after the Bureau of Prisons settled a lawsuit brought by a transgender inmate in Missouri. It says officials must not only evaluate prisoners for gender dysphoria but also treat those who have it, whether therapy was prescribed before or after the inmate entered federal custody.
Hicklin’s challenge of the state’s so-called “freeze-frame” policy is similar to lawsuits filed elsewhere in the country, including an ongoing federal lawsuit filed in Southern Illinois by the American Civil Liberties Union and six transgender inmates alleging inadequate medical care at prisons across the state.
The ruling Friday follows a series of decisions in other states over the years that found policies similar to Missouri’s to be arbitrary and unconstitutional under the Eighth Amendment, which bans cruel and unusual punishment, Gordon said.
Hicklin said in a statement that the ruling “is like someone threw me a life preserver — it has saved my life.”
Hicklin’s lawsuit is set for trial in May.
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