Missouri Gov. Kehoe signed law cutting off gender-affirming care for trans inmates despite binding 2018 Eighth Amendment ruling

On June 30, 2026, Missouri Gov. Mike Kehoe signed House Bill 2009, the Department of Corrections appropriations bill, which contains a rider — inserted on the bill's final page — declaring that "no funds shall be expended for any cross-sex hormones, or gender transition surgery undertaken for the purpose of any gender transition." The law took effect July 1-2, 2026, immediately cutting off hormone therapy for transgender inmates already receiving it, with no plan to taper the medication. Medical providers have warned that abruptly stopping hormone therapy, particularly for people who have undergone gender-affirming surgery, can cause severe cardiac, metabolic, bone-density, and mental-health harm.

The provision was inserted by state Rep. Dirk Deaton, sponsor of the appropriations bill, who told the House floor in March that he added it because there had "been a lot of appointments" to the Eighth Circuit and "a lot of change" in the national conversation, not because the underlying law had changed. A 2018 federal ruling, Hicklin v. Precythe, found that Missouri's prior categorical denial of hormone therapy to a transgender inmate violated the Eighth Amendment, and the Missouri Department of Corrections had operated under that ruling since. During drafting, DOC leadership told legislators that the Fifth, Seventh, and Ninth Circuits have been consistent in finding hormone therapy medically necessary and that related federal litigation was still ongoing. Deaton also told the House floor that incarcerated people's healthcare is "paid 100% by the taxpayer" and that the funding restriction reflects what "is appropriate healthcare under those circumstances." Missouri becomes the seventh state, and the second in 2026 after Oklahoma, to categorically ban gender-affirming care in its prisons, according to Transitics' tracking.