The Supreme Court on Wednesday left in place an order by a federal judge in Washington, D.C., that prohibits the Federal Bureau of Prisons from enforcing a new policy on healthcare for transgender inmates that would prevent such inmates from obtaining (among other things) hormone therapy and “social accommodations” (such as makeup, wigs, and padding). In a brief, unsigned order, the court turned down the BOP’s request to pause that decision.
Justices Samuel Alito and Clarence Thomas indicated, without any explanation, that they would have granted the Trump administration’s request.
The BOP adopted the policy in February, roughly one year after it issued two memoranda to implement an executive order signed by President Donald Trump on the first day of his second term. That order directed the attorney general to “ensure that no Federal funds are expended for any medical procedure, treatment, or drug for the purpose of conforming an inmate’s appearance to that of the opposite sex.”
The BOP emphasized that it adopted the February 2026 policy “independently of” the February 2025 executive order. In connection with the 2026 policy, the BOP also included an extensive administrative record and a 43-page memorandum in which it attributed the change from its prior policy to, among other things, “the latest scientific information.” Its earlier policies, the BOP said, had relied on recommendations by the World Professional Association for Transgender Health, but that group’s standards had been deemed “unreliable” and “unpersuasive” by prison administrators. Moreover, the BOP expressed concerns that providing access to procedures such as gender-transition surgeries could subject transgender prisoners to “attacks,” “raise fairness concerns,” and “breed resentment among other inmates.”
Three transgender inmates filed a class-action lawsuit in federal court in Washington, seeking to block the enforcement of the policy. On Aug. 26, Senior U.S. District Judge Royce Lamberth issued his most recent order prohibiting the BOP from implementing its 2026 policy; just over three weeks later, a divided panel of the U.S. Court of Appeals for the District of Columbia Circuit turned down the government’s request to freeze Lamberth’s order.
The BOP went to the Supreme Court on Sept. 28, asking the justices to pause Lamberth’s order. U.S. Solicitor General D. John Sauer told the Supreme Court that the district court had “substitut[ed] its own policy judgment for that of the” BOP, “rel[ied] on evidence outside the administrative record, and fault[ed] the agency for following presidential directions.” Moreover, he added, the district court “also denied prison administrators the substantial deference they are due.”
The inmates countered that the Trump administration is asking the justices “to overturn a three decades-long status quo.” They contended that the new policy fell short under the federal laws governing administrative agencies because the BOP had not provided a “reasoned explanation” for its decision. Moreover, the inmates added, they will be permanently harmed if the district court’s order is paused – one of the factors that courts consider in deciding whether to grant emergency relief. “Withdrawing care will cause significant changes to their bodies and put [them] and Class members at serious risk of worsening gender dysphoria as well as other mental health symptoms including depression, anxiety, self-harm, and suicidality,” they wrote.
In a one-sentence order on Wednesday, the court rejected the Trump administration’s request. It did not provide the reasoning behind its decision, nor did it explain why it took so long – 12 days after the government filed its reply brief – for the justices to act.