The Supreme Court on Wednesday refused to let the Trump administration immediately enforce new medical restrictions for transgender people in federal prison. The brief order leaves in place a lower-court block on the policy, which followed an executive order from President Donald Trump directing the Bureau of Prisons to revise its medical care rules.
The order did not explain the court’s reasoning. Justices Samuel Alito and Clarence Thomas said they would have allowed the policy to take effect while the lawsuit proceeds in lower courts.
The policy would halt surgeries, taper off hormone therapy and end social accommodations such as makeup and wigs. Prisons would still offer mental health services. U.S. District Judge Royce Lamberth, a Reagan appointee, ordered treatments to continue, noting that untreated gender dysphoria can lead to depression, anxiety and suicidal thoughts. A divided appeals court panel left that order in place.
The government told the court that about 600 inmates received hormone therapy in 2025. Lawyers for the inmates said withdrawing care would have serious effects on their bodies and mental health, and argued the government has not offered evidence of security problems tied to the therapy over the 30 years it has been provided.
The Supreme Court has previously allowed other Trump policies on transgender issues to move forward, including limits on military service and passport sex markers.
