A transgender woman serving a life sentence in a Missouri prison for murder must be allowed access to hormone therapy, a federal judge ruled.
Jessica Hicklin, born James, must also be allowed to have permanent body hair removal and access to “gender affirming” toiletries, according to the temporary injunction, which will be in effect until a lawsuit goes to trial in the spring.
Hicklin, 38, is serving a life sentence for a 1995 murder in Cass County that occurred during a meth transaction.
According to testimony, Hicklin has feelings of hopelessness, has attempted suicide and has tried to amputate her own testicles with a tourniquet “to remove offensive testosterone.” She stopped because that would deprive her of the necessary tissue for future surgical treatment, according to the court ruling. She has panic attacks and a fear of male pattern baldness.
The Missouri Department of Corrections said its policy is to deny hormone to inmates who were not receiving it at the time of their incarceration. But the state also acknowledged that hormone therapy has been provided to other transgender inmates. The Department of Corrections says Hicklin continues to receive psychiatric care and counseling.
U.S. District Judge Noelle C. Collins on Friday ordered the state to provide the therapy to Hicklin, who filed a civil lawsuit in 2016, alleging that deprivation of hormone therapy was unconstitutional.
“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,” which prohibits cruel and unusual punishments, the court order said.
The state argued “there is an important distinction to be made between what medical professionals recommend and what the federal constitution requires.”
Hicklin changed her name in 2015 and wears women’s prison-issued clothing at Missouri’s Potosi Correctional Center.
Hicklin was convicted of first-degree murder and armed criminal action in the shooting death of Sean Smith, who lived in a trailer in East Lynne, Mo. Hicklin, of Clinton, Mo., shot Smith in the face and the back when he could not pay for a crystal meth transaction. He was 16 when he was convicted and sentenced to life in prison without parole.
According to the judge’s ruling, a clinical and forensic psychologist found that untreated gender dysphoria can lead to depression, anxiety, suicidal thoughts and “the compulsion to engage in self-castration and self harm.” Hormone therapy leads to breast development and reduction of body hair.
“Merely providing counseling and/or psychotropic medication to a severely gender dysphoric patient is a gross departure from medically accepted practice,” the court order said. “Inadequate treatment of this disorder puts an individual at serious risk of psychological and physical harm.”