Alright,
@skylar160 , I'm sorry for taking so long to respond - I needed all night to write this post. Your situation is obviously horrific and barbaric and fucked, and no one should be subjected to the kind of dehumanization you're potentially going to experience. I'm heartbroken and livid on your behalf. With that said, the rest of this post is going to be legal information. If you are not in a place where legal advice feels safe to read, please skip the rest of my post, or angry react to it so that I'll know to delete it.
I'm going to provide you with a list of states and their likely policies regarding HRT in prison, but first, some disclaimers: I have legal training, but I am not a lawyer. I do not have access to the legal databases I would need to have access to in order to feel certain about any of the information I'm about to share. Adding additional complexity is the fact that I don't know what state you're in, which, given my finite time constraints, does limit how deep I can dive into the weeds of each state. (It is okay that I don't know what state you live in - I'm a stranger you've never met.) If you're looking for 100% certain legal advice, I would *highly* recommend reaching out to your local ACLU chapter (
link here). Their entire purpose is to provide legal advice to people whose civil liberties are under threat (i.e., you). Tell them you are a trans woman who will be incarcerated soon, and you want information about whether or not you will be permitted to continue hormone replacement therapy while in prison. Tell that to literally everyone you talk on the phone with, until you find yourself talking on the phone with someone who can provide you answers. If that seems like too much effort, then I would ask your personal lawyer the same question.
Now...what follows is an
approximation of which states will allow you to continue HRT while in prison and which states won't, based on publicly available information. Please feel free to ask me any clarifying questions you want, either in thread or via pm. I would err somewhat on the side of assuming that the reality on the ground is more transphobic than what I've provided here, and state bureaucrats may make things needlessly difficult, regardless of what the law says. Moreover, what follows
only applies to state prisons. If you are being sent to a federal prison, you will likely have to spend some or all of your time without access to HRT. If you don't know where you're being sent, your lawyer should. In the following list, the main bullets provide my topline conclusions, and subbullets provide rationale + sources. Without further ado:
- Alabama: Likely to provide you with HRT
- The Alabama Department of Corrections issued regulations in 2018 stating that incarcerated trans people "entering ADOC with...hormonal therapy procedures will continue to receive maintenance hormone therapy, if prescribed." 2024 regulations from the same source suggest that incarcerated trans people receiving hormone treatment is still a thing that happens. Moreover, because these regulations are numbered sequentially, that suggests to me that if there had been updates to the 2018 regulations, they would've been reflected in the policies I read. However, I wasn't able to find anything definitive from 2025. Note that this cuts both ways! While I wasn't able to find a concrete policy in 2025 providing HRT to incarcerated trans people, I also wasn't able to find a concrete policy, law, or news article saying that the state had banned such care, either.
- Alaska: Highly likely to provide you with HRT
- Arizona: Highly likely to provide you with HRT
- Arkansas: Somewhat likely to provide you with HRT
- Less certain about this one, as there's not great publicly available info. But there was an article in the Arkansas Advocate in 2025 detailing various cross-state efforts to prohibit gender affirming care, and it specifically mentioned Kentucky's attempts to prohibit hormone therapy for incarcerated trans people without saying anything about similar attempts in Arkansas. Moreover, according to the same article, Arkansas only bans Medicaid from covering gender affirming care for minors, not adults - usually states with prison bans also have Medicaid bans for adults. Finally, the Eighth Circuit has issued a preliminary injunction mandating that Arkansas allow minors access to gender affirming care (this is good! indicates a favorable court system), though that hearing is pending en banc review (which is less good).
- Florida: Almost certain not to provide you with HRT, especially if you suffer as a result.
- Georgia: Highly unlikely to provide you with HRT unless you sue
- Idaho: Highly likely to provide you with HRT
- Indiana: Highly likely to provide you with HRT
- Iowa: Likely to provide you with HRT
- Kansas: Likely to provide you with HRT
- Kentucky: Highly unlikely to provide you with HRT, unless you sue
- Louisiana: Highly unlikely to provide you with HRT, even if you sue
- According to the Jailhouse Lawyers Handbook, as of 2021, "Louisiana did not have an express policy on gender dysphoria treatment and care" for incarcerated trans people. Moreover, because of the increasingly barbaric political climate and because Louisiana falls within the ambit of the Fifth Circuit (see Texas below), your odds of receiving HRT if you live here are low.
- Mississippi: Highly unlikely to provide you with HRT, even if you sue
- According to the Jailhouse Lawyers Handbook, as of 2021, "Mississippi did not have an express policy on gender dysphoria treatment and care" for incarcerated trans people. Moreover, because of the increasingly barbaric political climate and because Louisiana falls within the ambit of the Fifth Circuit (see Texas below), your odds of receiving HRT if you live here are low.
- Missouri: Likely to provide you with HRT
- Governor signed a law in 2023 that states that "the MO HealthNet program shall not cover gender transition surgeries, cross-sex hormones, or puberty-blocking drugs for the purpose of a gender transition and health care services provided in prisons, jails, and correctional centers shall not include gender transition surgeries." In other words, it sounds like you can't get hormones through Missouri Medicaid, but you can get hormones through the prison system - and the healthcare provided therein is indeed funded separately, in most cases. However, I wasn't able to find anything definitive from 2025.
- Montana: Highly likely to provide you with HRT
- Nebraska: Uncertain - lack of publicly available info.
- North Dakota: Somewhat likely to provide you with HRT
- Less certain about this one, as there's not great publicly available info. But as of May 2025, North Dakota Medicaid covers hormone replacement therapy for trans people - usually if a state had banned coverage for incarcerated trans people, it would have banned similar coverage via Medicaid first or concurrently. Unfortunately, I wasn't able to find anything that squarely addresses the issue of hormone replacement therapy in North Dakota prisons.
- North Carolina: Likely to provide you with HRT
- Per the North Carolina Department of Public Safety circa 2018, if you were prescribed HRT prior to incarceration, and unless "clinically contraindicated", "hormone therapy will be continued." While it was the most recent transgender regulations on their website, and I found no other news articles or court cases to the contrary, I wasn't able to find anything definitive from 2025.
- Ohio: Likely to provide you with HRT
- Couldn't find much, but this court filing with the Ohio Supreme Court in 2024 indicates that at least one trans person in an Ohio prison was receiving HRT within the past 12 months, which almost certainly means that there was a policy in place to allow it when deemed medically necessary. However, I wasn't able to find anything definitive from 2025.
- Oklahoma: Likely to provide you with HRT
- The Oklahoma Department of Corrections issued regulations in 2025 that state that incarcerated trans people "who are received with hormone therapy prescriptions, will have that therapy continued without interruption while the diagnosis is verified", and that the therapy will be continued after (i) verification of the diagnosis of gender dysphoria, (ii) a consult for with an OUMC Endocrine Specialist, and (iii) completion of "the non-formulary approval review process." (And then there may be other steps too. It's not ideal, but at least there's a formal process that loops in the comparatively more liberal OUMC).
- South Carolina: Likely to provide you with HRT
- As of December 2024 (basically 2025), the ACLU of South Carolina reported that the South Carolina Department of Corrections "does not purchase or prescribe medications for hormone replacement therapy to treat gender dysphoria unless the incarcerated person was using the medication prior to incarceration" - that's you. But I don't know the exact wording of the policy, so I don't know exactly how much of a hassle it'll be.
- South Dakota: Uncertain - lack of publicly available info.
- Tennessee: Highly unlikely to provide you with HRT unless you sue
- State passed a law in 2024 that "generally prohibits the [D]epartment [of Corrections] from using state funds to administer hormone replacement therapy to state inmates incarcerated in a state penitentiary or a county jail or workhouse."
- Texas: Highly unlikely to provide you with HRT, even if you sue
- In 2005, the Fifth Circuit ruled that it's constitutional to arbitrarily deprive incarcerated trans people of HRT in Texas, and then spoke glowingly of that opinion in 2019, when they ruled that it was similarly constitutional to arbitrarily deprive incarcerated trans people of gender affirming surgery in Texas. And given that Texas is second only to Florida in terms of abject cruelty towards trans people, the odds of a policy coming in place to supplant the courts is basically zero.
- Utah: Highly unlikely to provide you with HRT unless you sue
- West Virginia: Likely to provide you with HRT
- As of December 2024 (basically 2025), the West Virginia Department of Corrections and Rehabilitation issued regulations which state that "An inmate/resident who is receiving hormonal medication at the time of DCR intake may be continued on hormonal medication, provided the following conditions are met: 1. The hormones represent an established treatment that has been prescribed under the supervision of a qualified physician. 2. The inmate/resident cooperates in obtaining written records or other necessary confirmation of his or her previous treatment. 3. The agency's contractual medical provider will determine if the hormones are medically necessary and not contraindicated for any reason." Condition 3, in particular, is a little spooky, but the existence of such a policy is better than not.
- Wisconsin: Highly likely to provide you with HRT
- In 2011, the Seventh Circuit struck down Wisconsin's Inmate Sex Change Prevention Act, which bans publicly funded hormone therapy for incarcerated trans people, finding that denying the treatment constitutes torture under the US constitution. Then, in 2019, the Seventh Circuit ruled that Indiana prisons must provide trans prisoners with gender affirming surgery when deemed medically necessary. They ruled this in a case where the prison was willing to provide the trans person with hormones. The Seventh Circuit has not reversed since then, and ruled on US constitutional grounds, meaning no state law or policy can disturb the ruling.
- Wyoming: Likely to provide you with HRT
- As of 2024, the Wyoming Department of Corrections had gone on record with a local news outlet, saying that they "provide[] hormone therapy medications to inmates who were already on hormones before going to prison". However, I wasn't able to find anything definitive from 2025.
If you made it to the bottom of this list and wondered why your state wasn't listed,
that's a good thing! I only reviewed the 28 states that lgbtmap.org
ranked as the worst according to its gender identity equality index. If your state wasn't listed, that means that your state very likely has better laws around accessing HRT while in prison than the ones listed here. If your state wasn't listed and you're still worried though, I'd be happy to review the remaining 22 states for you...after a full night's sleep >.<
Importantly, if your state was listed as "Uncertain" or "...unless you sue", then you should hand
THIS PDF and
THIS OPINION and
THIS OPINION to your lawyer - these documents form a roadmap for suing your state prison if they deny you access to HRT. If your lawyer doesn't know what to do with those documents, then your lawyer is an idiot and you should find a new one. Or better yet, reach out to the ACLU, which exists to serve you and was responsible for winning most (all?) of those cases in the first place. (EDIT: If your lawyer has access to clear precedent, statutory law, or prison regulation that makes appeal less likely to succeed, your lawyer may not be an idiot. But it'd have to be *very* clear.)
Finally, this isn't legal advice, but when it comes to self-castration....PLEASE be careful. Doing it yourself carries
the very real risks of disfigurement, infection, urinary fistulae, and nerve damage. You wouldn't be the first trans person to self-castrate (or the second, or the third), and I certainly wouldn't judge you if you did. Just know that it's possible that doing so could make your dysphoria worse, not better.
Alright, that's enough out of me, but I'm going to be thinking about you a lot from now on. Wishing you the best of luck, wherever your journey takes you <3
