The Supreme Court on Wednesday refused to let the Trump administration gradually end transgender-related medical services for prison inmates who want to be treated as members of the opposite sex.
The justices split 7-2 against the government, turning away its emergency request to enforce the restrictions while the lawsuit continues. The majority gave no explanation. Only Clarence Thomas and Samuel Alito would have granted the request: Thomas, appointed by George H.W. Bush, and Alito, by George W. Bush.
At issue is a Bureau of Prisons policy adopted this year that would halt hormone therapy, surgery, and a range of day-to-day accommodations such as female undergarments, makeup, and wigs for inmates who identify as transgender. It followed an executive order Trump signed on his first day back in office in January 2025, which pledged to restore what he called “biological truth” and barred federal money for care meant to help inmates live as the opposite sex.
Government lawyers maintained that the restrictions were the prison bureau’s own decision, not a product of the order, and that running a secure prison was justification enough on its own. Transgender inmates would lose nothing they truly needed, the administration argued, calling hormones and social accommodations “not medically necessary” for gender dysphoria
U.S. District Judge Royce Lamberth, a Ronald Reagan appointee, rejected that account. He concluded the policy had been built backward from the executive order to give it a legal footing and froze it while the case runs its course, faulting officials for never explaining why gender dysphoria should be handled differently from any other medical condition.
In its Supreme Court filing, the Justice Department pressed the argument that courts owe “double deference” to prison administrators and said the medical guidelines behind the care are scientifically unreliable. Solicitor General D. John Sauer led the appeal, the administration’s 41st emergency application to the high court.
The ACLU, which represents the inmates, called the outcome a win for roughly 1,000 transgender people in federal custody. White House spokeswoman Allison Schuster called it “a loss for common sense”:
Since the President’s very first day in office, he has fought to halt the U.S. taxpayer funding of transgender mutilation of prison inmates, and the waste of taxpayer resources on so-called “social accommodations.”
The dispute is one of several transgender fights the administration has carried to the high court. Earlier this year, the Justice Department asked the justices to let it remove transgender service members from the military, and in 2025, a federal judge blocked Trump’s order moving transgender inmates out of women’s prisons.
The Bureau of Prisons said in 2025 it was providing hormone therapy to more than 600 inmates. A February policy change was projected to save roughly $1.6 million from surgeries alone.
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