US Supreme Court blocks Trump administration's ban on gender-affirming care for Transgender prisoners

The US Supreme Court on Wednesday blocked President Donald Trump’s administration from suspending hormone therapy and other gender-affirming treatments for transgender people held in federal prisons. The decision marks a rare victory for transgender rights at the conservative-leaning court. The justices issued a one-sentence order without providing an explanation for their decision.

“This is a critical ruling for our clients and all transgender people in Bureau of Prisons custody,” said Li Nowlin-Sohl, a senior staff attorney with the ACLU’s LGBTQ & HIV Project. “The denial of medically necessary health care, including gender-affirming health care, to people in prison is a violation of their fundamental constitutional rights. We will continue to defend the rights of our clients and all incarcerated people.”

The ruling comes amid a series of Supreme Court decisions allowing the Trump administration to pursue restrictions affecting transgender Americans. Since Trump returned to the White House last year, the court has permitted a ban on transgender people serving in the military and upheld a policy requiring US passports to reflect an individual's sex assigned at birth. Earlier this year, the court also upheld state laws prohibiting transgender athletes from competing on girls’ sports teams.

Trump’s executive order targeted gender-affirming treatments

The legal dispute stems from a policy Trump promoted during his 2024 presidential campaign. His campaign aired television advertisements criticising Democratic nominee Kamala Harris over her approach to transgender issues. On his first day back in office, Trump signed an executive order seeking to prohibit any medical procedure, treatment, or drug intended for the purpose of conforming an inmate’s appearance to that of the opposite sex.

Following the order, the Federal Bureau of Prisons introduced a policy allowing psychotherapy and psychiatric services for incarcerated people diagnosed with gender dysphoria. However, the policy excluded hormone therapy, surgical procedures and what officials described as social accommodations. Such accommodations can include access to gender-affirming clothing and makeup. The administration's restrictions were subsequently challenged in court, with both a federal district court and the US Court of Appeals for the DC Circuit blocking the policy from taking effect in the short term.

Also Read: US midterms 2026: Trump's approval rating hits record low as Democrats gain ground

Federal appeals court questioned the administration’s policy

In an order issued last month, the DC Circuit concluded that the administration's policy was likely arbitrary and capricious because prison officials had failed to adequately evaluate their own experience providing gender-affirming care under the previous policy. The appeals court's decision raised questions about whether the Bureau of Prisons had sufficiently justified its departure from its longstanding approach to treatment for transgender inmates.

The Trump administration challenged that ruling in an emergency appeal to the Supreme Court, arguing that officials had considered their previous experience with gender-affirming care. The administration maintained that earlier treatment practices and accommodations raised security and prison-administration concerns that outweighed whatever limited benefits they had.

Transgender prisoners challenged treatment restrictions

The case was brought by three incarcerated people who said they had received hormone therapy for years before the new restrictions were introduced. They argued that the administration's policy represented a sudden departure from decades of practice and would terminate treatment for nearly 1,000 people held in federal custody.

The American Civil Liberties Union also challenged the government's justification for the restrictions, questioning the claim that gender-affirming care posed security risks in prisons. The American Civil Liberties Union told the Supreme Court that the assertion of security concerns was odd given that BOP has not pointed to a single security incident relating to its provision of this treatment over the past 30 years. The challengers argued that abruptly ending medically necessary treatment could violate the constitutional rights of transgender people in federal custody.

Thomas and Alito dissent from Supreme Court order

Conservative Supreme Court Justices Clarence Thomas and Samuel Alito dissented from Wednesday's order. Neither justice provided an explanation for opposing the decision. The absence of a detailed explanation was particularly notable because the case had been fully briefed and had been ready for the justices to decide for nearly two weeks.

Although the Supreme Court's order did not include a written rationale, it temporarily prevents the Trump administration's restrictions from taking effect while the legal dispute continues.

The decision stands out against the broader pattern of recent court rulings that have allowed the administration to implement several policies restricting transgender rights. For transgender inmates and their advocates, the order represents an important legal development in the ongoing fight over access to gender-affirming medical care in federal prisons. The broader dispute also raises questions about the government's authority to restrict medical treatment for incarcerated people and the constitutional protections afforded to individuals in federal custody.