LGBTQ+ organisations, healthcare professionals, religious leaders and state lawmakers are urging Missouri prison officials to continue providing medically prescribed gender-affirming care to transgender inmates.
Missouri LGBTQ+ advocacy organisation PROMO held a press conference alongside transgender and non-binary state Representative Wick Thomas, members of the LGBTQ+ Faith Alliance of Greater St Louis, healthcare professionals and representatives from Black & Pink.
The groups said they had received reports that at least two transgender inmates had been taken off prescribed gender-affirming medication by 8 July. PROMO described the treatment as medically necessary and called on Missouri Department of Corrections director Trevor Foley to intervene.
Budget Restricts Funding for Hormones and Surgery
The dispute follows the passage of Missouri’s Department of Corrections appropriations measure, House Bill 2009, which took effect on 1 July 2026.
Section 9.3000 of the bill states: “No funds shall be expended for any cross-sex hormones, or gender transition surgery undertaken for the purpose of any gender transition.”
According to PROMO, Foley told several state senators on 29 April — including Senators Tracy McCreery and Patty Lewis — that the restriction would not be enforced because it was “unenforceable and illegal”.
Despite that reported assurance, PROMO says at least two transgender prisoners have since had their medication discontinued.
The organisation has called on Foley to direct prison healthcare providers to continue prescribing gender-affirming treatment. It also warned that withholding care could prompt further legal action and increase costs for Missouri taxpayers.
Jessica Hicklin Joins Calls for Treatment to Continue
Transgender advocate Jessica Hicklin also participated in the press conference.
While incarcerated at the Potosi Correctional Center, Hicklin was denied hormone therapy under a former Missouri Department of Corrections policy that prevented prisoners from beginning certain gender-affirming treatments unless they had already been receiving them before entering prison.
In 2018, a federal court struck down that policy and ordered the department to provide Hicklin with medically necessary care, including hormone therapy, permanent body-hair removal and access to gender-affirming canteen items. Hicklin was released in 2022.
Her case has become an important precedent in challenges against blanket restrictions on gender-affirming healthcare in prisons.
PROMO Condemns Removal of Medication
In a letter to Foley, PROMO accused the department of placing transgender prisoners’ health at risk for political purposes.
“We implore you to stop using the health and lives of transgender inmates as pawns in fabricated culture wars,” the organisation wrote.
PROMO argued that denying medically necessary treatment could violate the Eighth Amendment’s prohibition against cruel and unusual punishment.
“Your actions are both cruel and unusual, and thus unconstitutional, but even more so your actions are a death wish for transgender inmates as gender-affirming care for transgender inmates is life saving healthcare.”
The organisation also accused Foley of attempting to implement the restriction quietly “because you know that it is a violent weaponisation of our state budget against an already vulnerable population”.
Senator Patty Lewis Warns of Legal Costs
Missouri Senator Patty Lewis said prisoners should not be denied treatment prescribed by qualified medical professionals.
“No one should be denied the care and treatment prescribed to them by their physician. The administration’s attempt to legislate through the budget is also unconstitutional, as the Missouri Supreme Court ruled as recently as 2024 that doing so violates article III, section 23 of Missouri’s Constitution. The administration’s actions are unethical, illegal, and will certainly cost taxpayers through expensive litigation once again.”
Opponents of the restriction argue that placing major policy changes inside a state budget prevents the full scrutiny and debate that would accompany standalone legislation.
Faith Leaders Cite Religious Duty to Prisoners
Members of the LGBTQ+ Faith Alliance of Greater St Louis also wrote to Foley “with profound grief, moral urgency, and unwavering conviction”.
The group said withdrawing healthcare would cause serious harm to transgender prisoners.
“This decision will inflict physical, emotional, and spiritual harm on some of Missouri’s most vulnerable people. Gender-affirming care is not only medically recognised and evidence based, but for many, lifesaving healthcare.”
Its letter cited several passages from the Bible, including Hebrews 13:3: “Remember those who are in prison as though you were in prison with them.”
The faith organisation argued that religious values should encourage compassion and care for incarcerated people rather than support the removal of necessary medical treatment.
Advocates Demand Immediate Action
PROMO and the organisations supporting its campaign are calling for the Department of Corrections to confirm that transgender prisoners will continue receiving treatment based on individual medical assessments.
They argue that prison officials cannot abruptly discontinue prescribed medication without exposing incarcerated people to physical and psychological harm.
The groups have warned that failing to restore treatment could lead to another costly legal battle over Missouri’s constitutional obligation to provide adequate healthcare to people in its custody.
