Supreme Court Rebuffs Trump Administration on Transgender Inmate Care

The Supreme Court on Wednesday rejected an appeal by the Trump administration that sought to immediately enforce new medical care restrictions for transgender individuals incarcerated in federal prisons. The decision leaves in place a lower court's block on the policy, which was enacted following an executive order from President Donald Trump.

Justice Samuel Alito and Justice Clarence Thomas dissented from the court's decision. The Supreme Court has previously allowed other Trump administration policies affecting transgender people to proceed, including restrictions on military service and changes to passport sex markers.

Trump's executive order directed the Bureau of Prisons to revise its medical care policies, stipulating that federal funds should not be used "for the purpose of conforming an inmate’s appearance to that of the opposite sex." The proposed policy would have halted surgeries, tapered off hormone treatments, and ended social accommodations such as makeup and wigs, while continuing to offer mental health services.

Attorneys representing transgender inmates challenged the policy in court. U.S. District Judge Royce Lamberth, appointed by President Ronald Reagan, initially ordered that treatments continue. Judge Lamberth noted that untreated gender dysphoria can lead to severe psychological effects, including depression, anxiety, and suicidal thoughts.

The Trump administration appealed this ruling, contending that the treatments posed security concerns and "could no longer be justified." A divided panel of the appeals court initially upheld the lower court's order, leaving the policy on hold. According to court records, approximately 600 inmates were receiving hormone therapy in 2025. Lawyers for these inmates argued that withdrawing care would have significant negative impacts on their physical and mental health. They also pointed out that the government had not presented evidence of security problems linked to hormone therapy for transgender inmates over the three decades it has been administered.