The Supreme Court on Wednesday refused to let the Trump administration immediately cut off gender-related medical care for transgender people in federal prisons. The brief, unsigned order leaves in place a lower-court ruling that requires the Bureau of Prisons to keep providing hormone therapy and other treatment while a lawsuit over the policy continues, The Associated Press reported. Justices Samuel Alito and Clarence Thomas said they would have let the administration enforce the policy now, and the court gave no reasoning.
What the Policy Would Do
The restrictions trace to an executive order Donald Trump signed on Jan. 20, 2025, his first day back in office. It directed the Bureau of Prisons to revise its medical policies so that no federal money is spent on any procedure, treatment or drug “for the purpose of conforming an inmate’s appearance to that of the opposite sex.”
The policy the bureau wrote in response would halt gender-affirming surgeries, taper inmates off hormones and end social accommodations such as access to makeup and wigs, while keeping mental health services in place. About 600 people in federal custody received hormone therapy in 2025, according to agency court records cited by the AP.
How the Case Reached the Court
U.S. District Judge Royce Lamberth, a Reagan appointee in Washington, blocked the policy and ordered treatment to continue, noting that untreated gender dysphoria can lead to severe depression, anxiety and suicidal thoughts. He certified a class covering everyone in Bureau of Prisons custody, now or in the future, with a gender dysphoria diagnosis, according to court filings in the case, Trump v. Kingdom.
The legal path has not been smooth. One panel of the U.S. Court of Appeals for the D.C. Circuit sided with the government in June, but after Lamberth reissued his order, a divided panel refused on Sept. 18 to put it on hold, with Judge Justin Walker dissenting. The administration then asked the Supreme Court to step in.
The Arguments on Each Side
The government argued that the treatments raise security concerns and “could no longer be justified.” Lawyers for the inmates countered that cutting off care would do serious harm to their clients’ bodies and mental health, and that the government has offered no evidence of security problems tied to hormone therapy in the roughly 30 years the bureau has provided it.
Wednesday’s order does not decide whether the policy is lawful. The lawsuit goes on in the lower courts, and the administration can return to the Supreme Court later, but for now about 600 people in federal prisons will keep receiving the care the policy would have taken away.