Victory! Federal Court Strikes Unlawful Policy That Denied Health Care to Incarcerated Missouri Transgender Woman

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May 23, 2018
Jessica Hicklin

A federal district court has struck down a Missouri Department of Corrections (MDOC) policy as cruel and unusual punishment because it denies vital health care to transgender people, including Lambda Legal client Jessica Hicklin, a transgender woman incarcerated at the Potosi Correctional Center in Mineral Point.

The court’s order requires Missouri Department of Corrections (MDOC) and its contracted healthcare provider, Corizon LLC, to provide Ms. Hicklin with medically necessary, doctor-recommended health care for the treatment of gender dysphoria.

The order also permanently bars MDOC and Corizon from enforcing the discriminatory “freeze-frame” policy that affects Ms. Hicklin and all transgender inmates in Missouri. The policy is a blanket ban on providing hormone treatment to any transgender person who was not receiving such treatment prior to incarceration.

A number of federal courts have held that such arbitrary and unfairly targeted policies violate the Eighth Amendment’s prohibition on cruel and unusual punishment.

“The court’s decision to strike down this policy will save Ms. Hicklin from pain and anguish and spare so many others from the same abuse. 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,” said Demoya Gordon, Transgender Rights Project Attorney for Lambda Legal. “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.”

In February 2018, a federal court granted Lambda Legal’s preliminary injunction motion and ordered MDOC to give Ms. Hicklin access to hormone therapy, permanent body hair removal, as well as access to gender-affirming canteen items – all recommended by her doctors as part of her treatment in accordance with the prevailing standards of care.

Today, in granting the permanent injunction motion, the court ruled that as long as Jessica Hicklin is in MDOC, she must be provided care in accordance with her doctors’ recommendations to treat her gender dysphoria. The court also ruled that MDOC’s freeze-frame policy that denied Jessica Hicklin medically necessary treatment is a violation of the Eighth Amendment and struck down the policy.      

“Today another court ruled that blanket bans on medically necessary gender dysphoria treatment are discriminatory and unconstitutional. The court’s ruling comes just one week after the Trump Administration released changes to the federal Bureau of Prisons Transgender Offender Manual. Despite the Trump Administration’s attempts to undermine important constitutional and federal protections– including the Prison Rape Elimination Act (PREA) – we will continue to fight for transgender people’s right to health care and safety,” said Richard Saenz, Lambda Legal Staff Attorney and Criminal Justice and Police Misconduct Strategist.

“For years, I felt like I had been drowning,” said Jessica Hicklin. “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.”