A Transgender Woman In A Missouri Prison Will Be Allowed Life-Saving Health Care

"It’s like you’re drowning and somebody throws you the life vest."

Jessica Hicklin, a trans woman serving time in Missouri's Potosi Correctional Center, will receive access to hormone therapy and gender-affirming treatments after a federal court granted her requests in a preliminary injunction on Friday.

"I kept going, like, Are you kidding me? I get to be the woman I am? Even just trying to explain it my eyes are fogging up," Hicklin, 38, told BuzzFeed News in a phone call from the Mineral Point prison on Saturday. "I have so much hope for the future now."

The Missouri Department of Corrections had denied the transition-related care recommended by Hicklin's doctors, including hormone therapy, access to women's commissary items, and regular hair removal, because she wasn't diagnosed with gender dysphoria before she was sent to prison — what's known as a "freeze frame" policy.

Hicklin was sentenced to life in prison without parole in 1995 after she was convicted of first-degree murder and armed criminal action for shooting and killing a man during a drug-related incident.

She was 16 years old when she began serving time. Her doctors and psychologists testified that she has severe anxiety and depression, and has at times been suicidal, as a result of being denied treatment and access to commissary items that align with her gender.

"I wanted to have hope that it was going to happen and when it didn’t I had to convince myself every night when I went to bed, how am I going to go on, how am I going to keep doing this?" Hicklin said. "I was just explaining to my therapist the other day, I can’t even take myself in the mirror anymore. And to think I’ll actually be happy to look in the mirror, that’s actually going to be me, not this other person."

Judge Noelle C. Collins wrote in the preliminary injunction that Hicklin has shown that she would suffer "irreparable harm" if she had to continue living without hormone treatment, hair removal, and women's commissary items, while waiting for the case to be finalized.

"Ms. Hicklin has established that she suffers from and will continue to suffer from severe emotional distress as well as a substantial risk of self-harm and that she has been deprived of her constitutional rights," Collins wrote, referring to the Eighth Amendment constitutional right to be protected from "cruel and unusual punishments."

The Missouri DOC did not immediately respond to a request for comment. A spokesperson for Corizon Health, the private company contracted to provide health care in the prison, said they would provide the treatments and access to women's items as ordered by the court, but noted that a final decision has not yet been handed down.

"We’re going to comply with whatever the court says but the final order has not been done in this case," said Corizon spokesperson Martha Harbin.

The preliminary injunction doesn't order the state of Missouri to rescind its "freeze frame" policy, but Hicklin's lawyer, Demoya Gordon of Lambda Legal, said she's hopeful this will be a significant blow to the policy.

"This kind of policy is unconstitutional," Gordon told BuzzFeed News. "If they can't justify not doing this for her, how that can they justify not doing this for anybody else. This should be the knife to the heart of the policy."

Hicklin legally changed her name to Jessica in 2015, and has since been appealing the Missouri DOC's refusal to grant her hormone therapy, hair removal, and women's commissary items. She filed the lawsuit, working with attorneys from Lambda Legal, in August 2016.

She said waiting for the case to progress for the past year and a half has been painful.

"It's like you’re out in the middle of the ocean, your boat capsized, and you’re just hoping that you’ll see a boat on the horizon, and that you’re not going to drown, but how do you keep treading water?" she said.

"It's like this lawsuit was a flare," she added. "That’s really how I’ve felt, like we filed this lawsuit and it's in the courts, there's no indication of whether anybody saw it and I’m just drowning, and wondering why I'm still treading water. So obviously the feeling is, the boat showed up. There is life now."

She said she's looking forward to things like mascara, women's underwear, and curling irons and straighteners for her hair, which she's grown out to reach past her waist.

"All my life it’s been the only expression of womanhood I had was my hair," she said. "And I’m looking forward to having [women's] underwear that's me ... I will be the only one who knows that I have it but it’s a sign of me. And just to be able to say I dress like a woman, because I am one."

And she's been thinking about the other two dozen or so trans and gender nonconforming people she's in touch with in other correctional centers around Missouri, some of whom have been denied treatment for decades while they've been in prison.

"They’re not going to believe it. For me this is life-saving, and I know for sure if I’m talking to someone, it’s going to be life-saving for them. It’s like you’re drowning and somebody throws you the life vest," she said.

After a 2011 lawsuit, Adams v. Bureau of Prisons, trans and gender-nonconforming people who are serving time in federal prisons must be given access to the health care they need even if they weren't getting that treatment before being incarcerated. Several state prisons have "freeze frame" policies, but Gordon says it's unclear exactly how many.

"In a lot of these prisons they don't have an official written policy, it’s just how they operate, so it’s hard to know the exact number of the ones that are still dong it but what I can tell you is that it is antiquated. They don’t adhere to either modern medical practice or standards of human decency," she said.

Hicklin's is the latest in a series of cases over the past few years in which courts have granted transgender prisoners access to trans-specific health care, including the high-profile case of Chelsea Manning, whose lawsuit against the US military eventually led to them agreeing to give her access to hormone therapy and gender affirmation surgery.

In another high-profile case another trans woman, Ashley Diamond, was serving time in a state prison in Georgia — she challenged the state's refusal to provide trans-specific health care in 2015, which led to that state's Department of Corrections changing its policies. During Diamond's case, the federal Department of Justice filed a brief supporting trans prisoners' rights to have trans-specific health care in prisons.