WASHINGTON, D.C. — The Trump administration filed an emergency appeal with the U.S. Supreme Court on Monday asking to enforce restrictions on gender-affirming care for transgender inmates in federal prisons. The request seeks to overturn a lower court order that blocked the Federal Bureau of Prisons from implementing a policy adopted in February 2026.

Judge Lamberth ruled that the administration's new policy was likely arbitrary and capricious because the Bureau of Prisons had not adequately considered its own experience providing gender-affirming care under its prior policy. He wrote that the Bureau of Prisons does not dispute that gender dysphoria can cause severe side effects, including depression, anxiety, and suicidal thoughts. "With this opinion, the court has no intention of wading into the culture war being waged against transgender individuals," Lamberth wrote.

ACLU attorneys representing the inmates stated the policy is "a direct threat to the well-being of transgender people in federal custody and an open violation of their fundamental rights." They further stated that withholding necessary gender-affirming healthcare constitutes cruel and unusual punishment. The Administrative Procedure Act requires federal agencies to provide reasoned explanations for their regulatory actions, and the court found that the Bureau of Prisons did not meet this standard in justifying its 2026 policy change.

The U.S. Court of Appeals for the District of Columbia Circuit declined to restore the policy while proceedings moved forward in a brief order issued earlier in September 2026. In 2025, the U.S. Court of Appeals for the District of Columbia Circuit upheld a lower court's decision that the Bureau of Prisons could not unilaterally terminate gender-affirming care for transgender inmates without proper justification. The Supreme Court’s 2025 decision in United States v. Skrmetti directly influenced the BOP’s 2026 policy, as the agency cited the case to justify rejecting World Professional Association for Transgender Health standards as unreliable, according to a 2026 Court of Appeals filing.

Timeline

The policy was adopted following an executive order signed by President Donald Trump on January 20, 2025, which directed federal agencies to ensure no federal funds are spent on medical procedures or treatments for the purpose of conforming an inmate’s appearance to that of the opposite sex. The Federal Bureau of Prisons policy adopted in February 2026 prohibits gender-transition surgeries, hormone therapy, and social accommodations such as wigs, makeup, chest binders, breast padding, and clothing requests for inmates diagnosed with gender dysphoria. The Federal Bureau of Prisons policy allows psychiatric and mental health services, including psychotherapy, to continue for inmates diagnosed with gender dysphoria.

The Federal Bureau of Prisons cited concerns that providing access to gender-affirming care could subject transgender prisoners to attacks, raise fairness concerns, and breed resentment among other inmates. The Federal Bureau of Prisons stated in its administrative record that the policy change was based on the latest scientific information and a determination that previous standards from the World Professional Association for Transgender Health were unreliable and unpersuasive.

What's New

Solicitor General D. John Sauer stated that the Bureau of Prisons determined its policy on medical treatments for transgender inmates was necessary to maintain institutional security. The BOP’s 2026 policy included a 43-page memorandum and a 3,200-page administrative record to justify its shift away from gender-affirming care, as outlined in a September 2026 Supreme Court filing.

The Bureau of Prisons previously provided gender-affirming care to over 600 federal inmates as of 2025, according to internal BOP reports. In 2025, the Bureau of Prisons issued a guidance memo outlining the policy and practice regarding hormones and social accommodations for transgender inmates that was in effect immediately prior to January 20, 2025, under which it continued to provide gender-affirming care. Research titled Donald Trump Administration was published in 2019 in When the President Calls. Research titled "U.S.-Israel Relations During The Trump Administration" was published in 2021 in Foreign Perceptions of the United States under Donald Trump.

Why It Matters

The Supreme Court has a 6-3 conservative majority that includes three justices who have previously supported restrictions on transgender rights, including Justice Amy Coney Barrett and Justice Brett Kavanaugh. The Court has previously upheld state laws banning certain medical treatments for transgender youth and restricting sports participation by transgender athletes in women’s sports. It has also issued decisions allowing the Trump administration to ban transgender people from serving in the military and to require that sex designation on U.S. passports align with biological sex.

The Supreme Court previously ruled in 2022 that state laws banning gender-affirming care for transgender minors were not necessarily unconstitutional, signaling a potential alignment with the Trump administration’s stance on restricting such care. The Supreme Court’s 2025 ruling in Bostock v. Clayton County established broader protections for LGBTQ+ individuals under Title VII, creating a contrast with the BOP’s 2026 policy that critics argue undermines those principles. Judge Royce Lamberth, who issued the order blocking the new policy, was nominated to the bench by President Ronald Reagan.