Supreme Court Blocks Trump Prison Transgender Care Restrictions

The U.S. Supreme Court on Wednesday, October 21, 2026, refused to let President Donald Trump's administration enforce restrictions on gender-affirming care for transgender people in federal prisons. The decision leaves a lower court order protecting access to treatment in place while the legal challenge continues, affecting a policy that could have ended hormone therapy and other care for nearly 1,000 transgender people in federal custody.

The justices issued a brief, unexplained order denying the administration's emergency application to suspend the lower court ruling. Justices Clarence Thomas and Samuel Alito indicated they would have granted the government's request but provided no explanation for their position.

The dispute centers on a policy developed by the Bureau of Prisons following Trump's January 2025 executive order directing federal agencies to recognize sex according to what the administration described as an immutable biological classification of male or female.

Under the revised policy, federal prisons would continue providing mental health services, including psychotherapy and psychiatric care, but would discontinue hormone treatments, gender-transition surgeries and social accommodations such as wigs, makeup and padding. The restrictions reversed longstanding practices that had permitted gender-affirming care for incarcerated people.

Three transgender prisoners, Alishea Kingdom, Jas Kapule and Solo Nichols, challenged the policy with support from the American Civil Liberties Union. All three had received hormone treatment for years and argued that the administration had changed established policy without adequately explaining its decision or demonstrating that previous treatments were ineffective or harmful.

U.S. District Judge Royce Lamberth, a Reagan appointee, blocked the policy earlier this year. He concluded that the Bureau of Prisons had failed to adequately evaluate its experience providing gender-affirming care before reversing course.

Lamberth wrote that the government's policy document contained no evidence from its own medical or mental health professionals supporting the conclusions behind the restrictions. He also found that officials had not demonstrated that the previous approach was ineffective or harmful.

In June, Lamberth granted a preliminary injunction, and a subsequent order in August maintained the protections while the case proceeded. He also rejected the administration's claims that continuing treatment would create safety concerns in federal prisons.

The U.S. Court of Appeals for the District of Columbia Circuit subsequently declined to suspend the injunction. In September, the appeals court ruled against the administration's request, with the panel divided 2-1.

The administration argued that the lower courts had improperly interfered with the Bureau of Prisons' authority to determine medical policy. Solicitor General D. John Sauer told the Supreme Court that the agency had concluded that gender-transition interventions lacked sufficient medical justification and raised security and prison-administration concerns that outweighed their benefits.

The government's application described the policy as one that provides appropriate, individualized treatment for gender dysphoria while excluding interventions it considers medically unnecessary. Officials also maintained that their assessment took account of concerns arising from the previous treatment framework.

The American Civil Liberties Union disputed that reasoning in its court filings. Its lawyers argued that the agency had not adequately explained why it abandoned decades of practice and noted that hormone therapy had been provided to federal prisoners since 1992.

The ACLU also challenged the administration's security argument, stating that the Bureau of Prisons had not identified a security incident linked to its provision of gender-affirming treatment over the preceding 30 years. The prisoners' legal challenge alleges that the abrupt policy change violates the Eighth Amendment's prohibition on cruel and unusual punishment.

The Supreme Court's decision represents a temporary legal victory for transgender rights advocates at a court with a 6-3 conservative majority. The ruling does not resolve the underlying case, but it leaves the lower court's protections in place as litigation continues.

The decision follows a series of Supreme Court rulings unfavorable to transgender rights. In June 2026, the court upheld state restrictions on transgender athletes participating in girls' and women's sports. In 2025, it also upheld state laws restricting gender-transition treatments for transgender minors and allowed other administration policies affecting transgender people to proceed.