The Supreme Court turned down the Trump administration’s emergency request to stop hormone treatment and other gender-transition care for transgender federal inmates, so a judge’s order protecting that care stays in force while the lawsuit goes on.
Story Snapshot
- The justices refused to lift a lower-court order that blocks a federal prison policy ending hormone treatment, surgery and what the policy calls social accommodations, such as clothing, makeup, wigs and hair-removal devices, for transgender inmates.
- Justices Clarence Thomas and Samuel Alito dissented. The Court gave no reasons for its order.
- The administration says the treatments are “not medically necessary” and raise security concerns.
- The order is not a final ruling. The case goes back to the lower courts, and the policy stays on hold until they decide it.
What the Justices Did
In a short order issued on Wednesday, October 21, the Supreme Court said no to the Justice Department’s request for a stay, which is a court order that would have let the prison policy take effect while the case is argued. The administration had asked the Court on Sept. 28 after a federal appeals court in Washington, D.C., turned it down on Sept. 18. Thomas and Alito said they would have granted the request. The other justices did not explain their vote.
The policy stays blocked, but the fight is not over. The case will keep moving through the lower courts, and the administration can come back to the Supreme Court later.
What the Prison Policy Would Do
The Federal Bureau of Prisons, the agency that runs federal prisons, wrote the policy to carry out President Trump’s January 2025 executive order, which told the agency not to spend federal money “for the purpose of conforming an inmate’s appearance to that of the opposite sex.” Under the policy, prisons would stop transition surgeries and taper inmates off hormone drugs. They would also end what the policy calls social accommodations, such as clothing, makeup, wigs and hair-removal devices. Mental health care would continue.
The care at issue is mainly for gender dysphoria, the distress some people feel when their body does not match the gender they identify with. Federal prisons have given hormone treatment for it since at least 1992. About 600 inmates received hormone therapy in 2025, according to agency court records.
Why the Administration Wants the Change
The Justice Department argues that the Bureau of Prisons used its own experience to decide the treatments are not medically necessary. It says security concerns inside prisons also justify the change. A Bureau of Prisons spokesperson has said the policy is meant to make sure inmates are properly diagnosed and treated one by one, based on medical studies and expert opinions, rather than with a one-size-fits-all approach. A brief filed in support of the policy pointed to side effects of hormone drugs, including anger and aggression.
Why the Judge Blocked It
U.S. District Judge Royce Lamberth, who was named to the bench by President Ronald Reagan, blocked the policy in June. He found it was likely “arbitrary and capricious,” a legal phrase for a government decision made without good reasons. He said the agency ignored its own evidence and “reverse engineered” the policy to carry out the executive order. He also noted the government had no evidence that the treatments had caused security problems in the past.
The lawsuit was filed by three transgender inmates held in federal prisons in New Jersey, Florida and Minnesota, on behalf of a larger group of inmates. Their lawyers argue that cutting off care would cause “immediate and catastrophic” harm, including worse depression, anxiety and thoughts of suicide.
What It Means Going Forward
For taxpayers and prison officials, the order keeps the old rules in place until the courts reach a final answer. The question of whether a prison system can set one rule for all inmates, or must decide each case on its own medical facts, will be settled further down the road. When it is, it could shape how federal money is spent on inmate medical care across the country.
Sources:
apnews.com, supremecourt.gov, washingtonblade.com, bop.gov
