Supreme Court blocks Trump policy restricting transgender inmate treatment

The Supreme Court rejected an emergency request from the Trump administration on October 21, 2026, keeping in place a lower court injunction that prevents the Bureau of Prisons from ending hormone therapy, surgeries, and social accommodations for roughly 1,000 transgender federal inmates. Lower courts found the administration offered no evidence or security records justifying the policy shift away from 30-year-old medical standards, calling the rationales pretextual.

Supreme Court denies emergency appeal

• ▪The Supreme Court issued an unsigned order on October 21, 2026, rejecting a Justice Department emergency appeal to revive a Bureau of Prisons policy restricting medical care for transgender inmates
• ▪Supreme Court Justices Clarence Thomas and Samuel Alito dissented from the October 21, 2026 order, noting they would have granted the Trump administration's request to enforce the Bureau of Prisons policy restricting treatment for transgender inmates

Bureau of Prisons medical restrictions

• ▪The February 2026 Bureau of Prisons Program Statement terminates gender transition surgeries, hormone therapy, and social accommodations such as wigs, binders, breast padding, and makeup for federal inmates with gender dysphoria
• ▪The Bureau of Prisons policy requires federal inmates currently receiving hormone therapy to be placed on tapering plans that gradually discontinue the treatment
• ▪Under the restricted Bureau of Prisons policy announced in February 2026, mental health services and psychotropic medications are the only authorized care options for federal inmates diagnosed with gender dysphoria

Trump executive orders on gender identity

• ▪President Donald Trump's January 2025 executive order instructed federal agencies not to recognize gender identity outside of immutable biological classifications of male or female
• ▪President Donald Trump issued an executive order directing that no federal funds be used for medical procedures or treatments for transgender federal inmates in Bureau of Prisons custody

Lawsuit plaintiffs

• ▪Transgender federal inmates Alishea Kingdom, Jas Kapule, and Solo Nichols filed a lawsuit backed by the American Civil Liberties Union challenging the Bureau of Prisons treatment restrictions
• ▪Lead plaintiffs Alishea Kingdom, Jas Kapule, and Solo Nichols have all been receiving hormone treatment in federal prison for several years

Arguments over prison security rationale

• ▪Lawyers representing transgender inmates stated to the Supreme Court that the Bureau of Prisons failed to point to any specific security incidents resulting from its prior medical treatment policy
• ▪Solicitor General D. John Sauer argued in Supreme Court filings that the Bureau of Prisons' February 2026 restrictions on transgender inmate care are necessary to maintain institutional security and federal prison administration

Prior prison medical care

• ▪The Bureau of Prisons has provided hormone treatment to federal inmates diagnosed with gender dysphoria since 1992
• ▪The Bureau of Prisons gradually expanded transgender inmates' access to medical treatments and social accommodations in the years following 1992