Missouri Becomes Latest State to Begin Medically Experimenting on Trans Prisoners, in Defiance of Longstanding Court Ruling

Missouri quietly passed a law that will immediately forcibly detransition every trans person in its prisons. According to its sponsor, they deserve it because “they’ve been convicted of a crime."

The Missouri State Capitol in Jefferson City | Image: Wikimedia Commons

Like in many other states, incarcerated trans people in Missouri have long struggled to access gender-affirming care. For many years, the state enforced a so-called ‘freeze frame’ policy, a common approach at the time that saw hormone therapy barred from anyone who hadn’t already begun receiving it prior to their arrest. Although this also meant trans people wouldn’t be detransitioned, it didn’t allow trans people to transition, either—making them wait until their release to get necessary care that the prison system is, at least in theory, legally required to provide.

That changed eight years ago. Unable to access the care she needed, a transgender woman in Missouri Department of Corrections custody fought back, and, in the ensuing case, secured a ruling that struck down the DOC’s policy as it applied to hormone therapy on Eighth Amendment grounds. However, that case, known as Hicklin v. Precythe, notably didn’t challenge the DOC’s categorical denial of gender-affirming surgery, and in 2023, the state legislature codified the surgery ban through Senate Bill 49.

Even as the state became more hostile to transgender Missourians, the Hicklin ruling was never appealed, and thus, for eight years, it has remained settled law. However, in March, one state representative took it upon himself to alter that status quo: Dirk Deaton. Being the sponsor of this year’s corrections appropriations bill, House Bill 2009, Deaton tacked on a provision barring the DOC from spending its appropriated funds on “any cross-sex hormones, or gender transition surgery undertaken for the purpose of any gender transition.”

Explaining his reasoning for tacking the provision onto the bill while speaking on the House floor in March, Deaton had this to say:

“A number of years ago, there was a court decision that indicated that certain gender transition sorts of measures, including specifically hormone therapies, [were] required under the Eighth Amendment of the US Constitution. This was a federal decision, and the Department of Corrections has been operating under that.

Now, since that time, the Eighth Circuit, you know, there’s been a lot of appointments there. There’s been a lot of change, I think, in the national conversation around this issue, and I think conditions have changed significantly, and so we’re trying to insert this language.”

Here, Deaton admits to knowing that his proposal has already been ruled unconstitutional, and yet, he is deciding to push it anyway, thinking that a more conservative judiciary will give him a favorable ruling. And if this feels familiar, that’s because it is: this is the same strategy that conservatives used to get Roe v. Wade overturned, except here, the move is much more aggressive.

While the law that led to Dobbs v. Jackson Women’s Health Organization banned abortions after 15 weeks—5 weeks shy of a legally permissible 20-week ban—Deaton’s provision goes even further than the ‘freeze frame’ policy that led to Hicklin, entirely barring gender-affirming care from those who have already begun medically transitioning as well. As such, under this provision, trans people in Missouri’s prisons will be forcibly detransitioned, and Deaton clearly knows this:

“We do provide healthcare for offenders and there are certain offenders currently receiving hormone therapy for the purposes, as I understand it, of a gender transition. And so this would speak to that, and in a manner of public policy, allow the general assembly to speak into this as to what we believe and deem is an appropriate use in expenditure of taxpayer dollars or not.

And as if that wasn’t enough, he concluded his tirade by dehumanizing those in prison and implying that the trans people in question deserve to have their healthcare stripped away:

“Because recall…these are people that have been adjudicated of a crime. They’ve been convicted of a crime. They have been sentenced to prison. They are incarcerated on the taxpayer’s dime, for their room and board and also for their healthcare—paid 100% by the taxpayer. And what is appropriate healthcare under those circumstances, that’s what this speaks to.”

In the end, HB 2009 ended up overwhelmingly passing both chambers, and on June 30th, it was signed into law by Governor Mike Kehoe. Effective as of yesterday, it now governs the Missouri Department of Corrections’ operations—as well as the lives of the trans people in its custody. It also makes Missouri only the 6th state (and the first this year) to pass a law entirely banning gender-affirming care within its prisons. Here’s what that map currently looks like:

Note that Georgia and Idaho have had their bans blocked in court. For sources, tables, and more maps, head to Transitics’ CATPALM page.

HB 2009’s passage comes amid a backdrop of an aggressive campaign by the Trump administration to deny trans prisoners access to healthcare—a campaign Deaton himself acknowledged when he first proposed the ban in committee earlier in March. As Transitics has extensively reported, that campaign essentially amounts to medical experimentation: trans inmates in federal custody are being forcibly ‘tapered’ off of hormone therapy, misgendered, deadnamed, and made to live as their assigned sex at birth. The Trump administration has admitted to implementing this despite being aware of the adverse mental health effects that it will have.

Thanks to HB 2009, Missouri is no different. While drafting the law, state legislators were explicitly told by the director of the DOC that similarly to the court in Hicklin, the Fifth, Seventh, and Ninth Circuit Courts ‘have been pretty consistent’ in ruling that gender-affirming hormone therapy is medically necessary and that denying it violates the Eighth Amendment. They were explicitly told that the litigation surrounding Trump’s policy was still ongoing. They were explicitly told by Deaton himself that there are people whose lives the law was going to affect, and that—unlike the Trump administration’s policy—the denial of care would be immediate. And they passed it anyway.

Now, starting today, trans people in Missouri DOC custody will start having the rug pulled out from under them. They will be forcibly detransitioned without even being given time to adjust. And if a court intervenes? Well, Missouri has clearly shown it’s more than willing to ignore a court ruling that still legally binds it to provide this care.

Who’s to say the state won’t do that again?