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BONNE TERRE — Missouri on Tuesday executed by lethal injection a transgender inmate who stabbed, strangled and raped an ex-girlfriend 19 years ago.

The 49-year-old inmate had been living for about 18 months as a woman named Amber McLaughlin, but filed appeals and signed a final written statement Tuesday with a previous name, Scott McLaughlin.

McLaughlin is the first openly transgender woman executed in the U.S. and the third person executed since May in Missouri.

The state delivered a fatal dose of pentobarbital at 6:39 p.m., and McLaughlin was pronounced dead a short time later, according to a spokeswoman for the Missouri Department of Corrections.

In a final written statement, McLaughlin said, “I am a loving and caring person� and apologized for “what I did.�

Two witnesses on behalf of 45-year-old Beverly Guenther, of Moscow Mills, who was stabbed with a steak knife in November 2003 after leaving her job in Earth City, attended Tuesday’s execution at the Eastern Reception, Diagnostic and Correctional Center in Bonne Terre.

Guenther’s sister-in-law, Annie Wedepohl, witnessed the execution along with her husband, Al, who was Guenther's younger brother. Wedepohl said, "To me, it was unremarkable. It was a very humane way. I think, to me, it was too humane." Annie Wedepohl, who is a nurse, described the process as "quick and peaceful," similar to seeing a family member sedated for surgery.

"I teared up a little bit because I was thinking about Bev," Annie Wedepohl said. "I'm not crying over Scott."

A spiritual adviser, the Rev. Lauren Bennett, stood by McLaughlin during the execution, state officials said.

McLaughlin was convicted in 2006 of first-degree murder, rape and armed criminal action in the death of Guenther, who was dumped near the Mississippi River in ºüÀêÊÓƵ. Jurors, however, could not decide on punishment.

Ultimately, ºüÀêÊÓƵ County Judge Steven H. Goldman sentenced McLaughlin to death — a decision that can be made by a judge only in Missouri and Indiana in the event of a deadlocked jury.

A federal judge in 2016 threw out McLaughlin’s death sentence, ruling, in part, that a flawed jury form meant a judge could not have known whether the jury thought the factors warranting death outweighed mitigating circumstances.

But five years later, the 8th U.S. Court of Appeals reversed that decision and effectively reinstated McLaughlin’s death sentence.

Then, in December, McLaughlin’s attorneys filed a petition for clemency with Gov. Mike Parson, highlighting McLaughlin’s abusive childhood, brain damage, fetal alcohol syndrome and suicide attempts as an adult.

None of that information was presented to the jury, the attorneys argued, “and it still deadlocked, not agreeing that death was warranted,� the petition said.

On Tuesday, Parson denied that request and affirmed the state would move forward with the execution.

“McLaughlin terrorized Ms. Guenther in the final years of her life,� Parson said in a statement after the execution, “but we hope her family and loved ones may finally have some peace.�

At 10:48 a.m. Tuesday, McLaughlin was delivered a final meal of a cheeseburger, fries, strawberry milkshake and peanut M&Ms.

Shortly before 6:40 p.m., witnesses were moved into the execution viewing area, and the Missouri attorney general notified officials there were no remaining legal impediments to executing McLaughlin.

McLaughlin was pronounced dead at 6:51 p.m. The body is set to be cremated, a spokeswoman with the Department of Corrections said.

Wedepohl, Guenther's sister-in-law, said she and her husband will put flowers on Guenther's grave Friday to celebrate Guenther "because this is over."

"I'm a nurse, and my friends want to know how can I be for the death penalty and watch this," Wedepohl said. "I am a caregiver. I believe in saving people. But he violently, mindfully took someone's life. This has been a long time coming."

McLaughlin is the third person to be executed in Missouri in a nine-month period, a marked increase from recent years.

Carman Deck, who killed a Jefferson County couple in 1996, was executed in May, and and Kevin Johnson, who killed a Kirkwood police officer in 2005, was executed in November.

Members of Johnson’s family, including his daughter and grandson, joined a group of roughly 50 anti-death penalty protesters outside the prison in Bonne Terre on Tuesday night, carrying signs with statements including “stop state murder.� A handful of people advocating for transgender rights also joined the group.

Missouri is set to carry out another execution next month. Leonard Taylor, who fatally shot a 28-year-old woman and her three children in Jennings in 2004, is set to die by lethal injection Feb. 7.

Robert Cohen and Kim Bell contributed to this report.