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The Missouri court case that expanded trans health care in prisons

Jessica Hicklin sits on a couch with a pool table in the background.
Courtesy of Jessica Hicklin

Jessica Hicklin entered Potosi Correctional Center at the age of 18.

During her time there as an inmate, she came out as trans and wanted to medically transition with hormone therapy. But at the time, the Missouri Department of Corrections wouldn’t allow her access to the health care she needed.

Prior to the Hicklin v. Precythe ruling, only inmates who had started their transition before entering the DOC were allowed to continue treatment.

In 2018, Hicklin won her case and expanded trans health care in prisons across the state.

A restriction of this type of care is currently being considered in the Missouri State Legislature.

"Reach out. There are plenty of organizations out in the world that actually still care... there are very good people in this world who care about your right to exist."
Jessica Hicklin

Jessica Hicklin: I had no references for what it meant to be trans. Like, there was nobody around. I didn't know any trans folks. I'd never seen an image of one.

Around the time I was 20, I saw my first images of trans women and first began to gain an understanding of hormone therapy and transitional medicine, and that there was an option of living my life. But I was in Missouri’s death row prison, which was scary as hell.

So, in 2018, I took my first dose of estrogen and it was – it’s funny, I can still see it like it was yesterday. I was there in my cell holding this tiny little green pill and just looking at it and going, “Is this really happening?”

I mean, it was – I was there for the whole process and still couldn't believe that I was standing there and myself holding on this little green pill, which to me was like my birthday. It's the day I started living my true life.

And for those who are still incarcerated – simply don't give up. That's the hardest thing. It's a real struggle, especially when you're fighting for care, and you're misgendered and not recognized by anybody. You are isolated, and alone and in danger in a lot of ways.

And just don't give up. There are people still fighting. There are people who still care. You have to hold on to who you are.

Updated on April 27 at 10:00 a.m.: A St. Louis County judge has temporarily blocked attorney general Andrew Bailey’s emergency rule. Now, the rule is set to go into effect on Monday at 5 p.m.The ACLU, Lambda Legal and Bryan Cave Leighton Paisner filed a temporary restraining order on Monday to prevent the implementation of the restrictive trans health care rule.

Beyond that – like when it comes down to practical advice – reach out. There are plenty of organizations out in the world that actually still care. They just don't know you're there, and if you start reaching out into the world, you will find people that will come and help.

They will make the calls for you. They will, if necessary, fight the legal battles. But there are very good people in this world who care about your right to exist.

For folks that have come home – don't forget about what it was like.

Like I said, I'm the vice president of the Metro Trans Umbrella Group. Missouri only has two trans specific organizations, so we serve a large population of Missourians, and I do it because I remember what it was like finding that help, and a lot of times giving is how you get yourself.

You know, as you help take care of the rest of your community, they take care of you.

My experience in Missouri Department of Corrections was – I was treated with respect as a trans woman, and it's hard to say that because people like to say corrections is always bad.

I was properly gendered.

Spread that. Make sure that all your staff is doing that - they’re respecting trans folks and LGBTQ+ folks in general, because there is a culture of it. It's just not large enough. There are still the people from the old culture who don't do that.

Because the administrators from the top down have been good. It's the ground level staff, the people that inmates interact with every day that are generally causing the problems. And if they can just enforce the policies they have in place and spread that culture of respect that they have at the top – honestly, that goes a long ways. Goes a very long ways.

Katie Quinn works for Missouri Business Alert. She studied radio journalism and political science at the University of Missouri- Columbia, and previously worked at KBIA.
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