The U.S. Supreme Court on Wednesday denied an emergency request from the Trump administration to lift a lower-court injunction that prevents the government from ending gender-affirming care for federal inmates. The unsigned, one-line order means that the Bureau of Prisons (BOP) must continue providing hormone therapy and other medical interventions to incarcerated individuals while litigation over the policy proceeds. Justices Clarence Thomas and Samuel Alito noted they would have granted the administration's request for a stay.
The legal dispute follows a February 2026 BOP policy, issued after a presidential executive order, that sought to terminate hormone treatments and surgical interventions for inmates diagnosed with gender dysphoria. The policy included a tapering plan to discontinue existing treatments and barred social accommodations such as wigs, binders, and makeup. U.S. District Judge Royce Lamberth first blocked the rules in June 2026, and the U.S. Court of Appeals for the D.C. Circuit later declined to lift that injunction, leading U.S. Solicitor General D. John Sauer to appeal to the Supreme Court.
In court filings, the Trump administration argued that the policy change was necessary for institutional security, claiming specialized care could breed resentment or make recipients targets for attack. Lawyers for the inmates, including representatives from the American Civil Liberties Union (ACLU), countered that the BOP has provided such care since 1992 without documented security incidents. They characterized the government's security concerns as "contrived" and noted that the new policy replaced medically recommended treatments with psychotherapy and psychotropic medications.
For the affected inmates, the court's action means they will continue to receive hormone therapy and social accommodations in the immediate term rather than being placed on the administration's proposed tapering plan to end treatment. Medical organizations such as the World Professional Association for Transgender Health (WPATH) and the American Medical Association state that such care is medically necessary to prevent severe mental health issues, including anxiety, depression, and self-harm. The Trump administration, however, has questioned these standards of care in its legal filings.
The ruling maintains a status quo that contrasts with other recent Supreme Court decisions, including a 2025 ruling that upheld state bans on gender-affirming care for minors and a June 2026 decision allowing states to ban transgender girls from female sports at publicly funded schools. This case now returns to the lower courts for a final determination on whether the BOP policy violates federal law or the U.S. Constitution. No specific date for the next hearing or a final ruling was reported.