The Trump administration filed an emergency appeal with the Supreme Court on Monday seeking to implement restrictions on gender-affirming medical care provided to transgender inmates in federal prisons. The action followed lower court rulings that temporarily blocked enforcement of the administration’s policy. The restrictions were adopted following an executive order directing the Bureau of Prisons to revise its medical policies to prevent federal funds from being spent on procedures intended to alter an inmate’s appearance to conform to another sex. The policy halts surgical procedures, hormone therapy, and social accommodations such as wigs, though mental health services remain available. U.S. District Judge Royce Lamberth previously ordered the government to continue providing gender-affirming care, including hormone therapy. The government maintains the policy was properly adopted and contends the judge exceeded his authority. According to agency data from 2025, the Bureau of Prisons was providing hormone therapy to more than 600 inmates at that time. The administration argues the Bureau of Prisons determined that sex-trait-modification surgeries, hormone interventions, and social accommodations could not be justified as treatment for gender dysphoria. However, the court record acknowledges that gender dysphoria can produce severe consequences, including depression, anxiety, and suicidal ideation. Legal representatives for the affected inmates, citing the ACLU, characterize the policy as a direct threat to the wellbeing of transgender individuals in federal custody and argue it violates fundamental rights. They contend that withholding gender-affirming healthcare constitutes cruel and unusual punishment. The Supreme Court has previously upheld state measures restricting certain medical treatments for transgender youth and limiting transgender athletes’ participation in women’s sports. The court has also issued interim rulings allowing the Trump administration to proceed temporarily with other policies affecting transgender military service members and passport gender designations.
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