The Trump administration has asked the U.S. Supreme Court to allow the Federal Bureau of Prisons to enforce restrictions on gender-affirming care for transgender prisoners while a legal challenge to the policy continues.
The Justice Department filed an emergency request Monday asking the justices to lift a lower-court order preventing the Bureau of Prisons from implementing the restrictions. The policy, issued in February, would halt gender-affirming surgeries and hormone treatments and eliminate certain social accommodations for transgender prisoners, including items used to align a person’s appearance with their gender identity. Mental health and psychiatric services would remain available.
The policy followed an executive order President Donald Trump signed after returning to office in January 2025 directing federal agencies to recognize sex as male or female and ordering the Bureau of Prisons to stop using federal funds for medical treatment intended to change an inmate’s appearance to that of the opposite sex.
Before the change, federal prison policy permitted prisoners diagnosed with gender dysphoria to receive gender-affirming treatment when medically indicated. The Bureau of Prisons reported that more than 600 incarcerated people were receiving hormone therapy in 2025.
Three transgender prisoners incarcerated in New Jersey, Florida, and Minnesota challenged the new restrictions in a class-action lawsuit.
U.S. District Judge Royce Lamberth blocked the policy, concluding that the challengers were likely to succeed on their claim that the Bureau of Prisons acted arbitrarily and capriciously under federal administrative law. Lamberth wrote that the agency appeared to have disregarded its previous experience and evidence when developing the new policy.
The U.S. Court of Appeals for the District of Columbia Circuit declined on September 18 to lift Lamberth’s injunction, leaving the restrictions blocked while litigation continues.
The administration argues that prison officials reasonably determined the restricted treatments were not medically necessary and that security and prison-management concerns provided additional justification for changing the policy.
Attorneys representing the transgender prisoners dispute that position. The ACLU has argued that denying medically necessary gender-affirming healthcare threatens the health of transgender people in federal custody and violates their constitutional rights.
The Supreme Court is not currently being asked to issue a final ruling on whether the Bureau of Prisons policy is lawful. Instead, the emergency request asks the justices to decide whether the administration may begin enforcing the restrictions while the underlying lawsuit proceeds.
The dispute reaches the court after several recent decisions involving transgender rights. The justices have upheld state restrictions on gender-affirming medical care for minors and transgender participation in girls’ and women’s school sports, while also allowing Trump administration restrictions involving transgender military service and passport gender markers to take effect during ongoing litigation.
For transgender people in federal custody, the immediate question is whether the lower-court protections remain in place or whether the Bureau of Prisons can begin implementing its new policy before the courts determine its legality.
