Missouri Trans Inmate Allegedly Denied Health Care

August 22nd 2016

A Missouri inmate's story is shedding light on the obstacles transgender women face to obtain healthcare within the prison system.

The LGBT legal advocacy organization Lambda Legal filed a federal lawsuit Monday on behalf of 37-year-old Jessica Hicklin, a transgender inmate at Potosi Correctional Center (a facility for male inmates) in Missouri, who was allegedly denied access to hormone therapy, permanent hair removal and "gender-affirming canteen items" by the Missouri Department of Corrections.

Jessica HicklinJessica Hicklin/Lambda Legal - lambdalegal.org

The lawsuit claims that Hicklin's diagnosis of gender dysphoria — when a person identifies with the opposite gender than the one they were assigned at birth — was confirmed by numerous medical professionals, whose treatment recommendations were repeatedly ignored by the MDOC due to a “freeze-frame” policy banning inmates from beginning or expanding treatment.

"'Freeze-frame' policies prohibit incarcerated transgender people from receiving care for gender dysphoria unless they were receiving such care before incarceration," Lambda Legal Transgender Rights Project attorney Demoya Gordon explained in an email to ATTN:.

"Not only do these policies violate accepted medical standards by prohibiting individualized assessment and treatment of people with gender dysphoria they also violate the Eighth Amendment’s prohibition against cruel and unusual punishment," Gordon added.

The Federal Bureau of Prisons did away with its "freeze-frame" policy in 2011, "when it adopted a policy requiring an individualized assessment of the health needs of transgender people in federal prisons, pursuant to a settlement arising out of another lawsuit called Adams v. Federal Bureau of Prisons," Gordon said. "Unfortunately, several states’ prison systems still maintain similar policies."

“Without care, I feel as though I am resentenced each day, further locked in a prison within a prison—my body,” Hicklin said when the lawsuit was filed, according to a Lambda news release. “This personal prison is much crueler, and without a change in policy, I’m not sure I will survive it.”

potosi correctional centerFlickr/KomuNews - flickr.com

Lambda Legal is suing both the MDOC and Corizon Health, Inc., the MDOC's contracted health provider, for putting Hicklin's mental health and life at risk by denying her treatment, the Washington, D.C. LGBT news outlet Metro Weekly reported.

In 2015, the Department of Justice published a statement asserting that it was unconstitutional for state correctional facilities to institute "freeze-frame" policies after trans inmate Ashley Diamond brought a federal lawsuit against the Georgia Department of Corrections for repeatedly denying her hormone therapy, the Advocate reports. The court ruled in favor of Diamond.

Diamond's case was brought by the Southern Poverty Law Center, Gordon explained.

"The brief DOJ filed in the Ashley Diamond case was very important because it had the weight of the federal government saying that these policies are not just harmful, but they violate the U.S. Constitution," she told ATTN:. "The advocacy community have been making that argument for years, citing the case law that DOJ highlighted so well in its brief. But having a federal law enforcement agency formally and affirmatively say so in a legal document was a very powerful and important step."

In August 2011, the ACLU and Lambda Legal successfully overturned a Wisconsin statute that kept incarcerated transgender people with gender dysphoria from having access to hormone therapy and surgery, according to the Harvard Law Review.

"Freeze-frame" policies are dangerous and illegal.

"There is no legal basis for these types of policies," Gordon explained. "They are harmful, arbitrary, out of step with accepted medical standards, and unconstitutional. They make it impossible for transgender people to get the medical care they need even when—as is the case with Ms. Hicklin—mental health and medical professionals recommend such care. This poses serious harm to people like Ms. Hicklin including debilitating depression and anxiety, the impulse to engage in self-surgery and self-harm, and even suicidal thoughts or acts."

Hicklin was sentenced to life without parole for first degree murder and armed criminal action when she was 16, and she has been incarcerated for 21 years.

Due to recent Supreme Court rulings on inmates serving life sentences for crimes convicted as juveniles, her sentence will be revisited, according to Lambda Legal.

When reached for comment, Missouri Department of Corrections Communications Director David Owen told ATTN: the department does not comment on pending litigation.

The story, first published 8/22/16, was updated on 8/23/16 to include the MDOC's response to a request for comment.

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