Lawyers for a group of transgender inmates urged the Supreme Court to uphold a federal judge’s order. This order blocks the Federal Bureau of Prisons (BOP) from enforcing a new policy on transgender healthcare. The policy, if implemented, would prevent such inmates from obtaining hormone therapy and social accommodations like makeup and wigs.
The policy, adopted earlier this year, follows an executive order signed by President Donald Trump in February 2025. This executive order directed the attorney general to ensure that no federal funds are used for medical procedures, treatments, or drugs aimed at conforming an inmate’s appearance to that of the opposite sex. The BOP’s new policy, introduced in February 2026, claims to be based on the latest scientific information, though it has sparked intense legal and ethical debates.
A Decades-Long Status Quo at Stake
Representing the inmates, Li Nowlin-Sohl argued that the Trump administration aims to overturn a three-decade-long status quo. The BOP’s new policy contradicts its earlier stance, which was based on recommendations from the World Professional Association for Transgender Health (WPATH). Nowlin-Sohl emphasized that the BOP’s previous policies had been aligned with WPATH standards, which are widely recognized in the medical community for their wide-ranging approach to transgender healthcare.
The BOP now deems these standards “unreliable” and “unpersuasive,” a stance that has raised concerns among medical professionals and advocates for transgender rights.
Legal Battle and Inmates’ Arguments
Three transgender inmates filed a class-action lawsuit in Washington, D.C., to block the policy. Senior U.S. District Judge Royce Lamberth issued his most recent order on August 26, barring the BOP from implementing its 2026 policy. On September 18, a divided panel of the U.S. Court of Appeals for the District of Columbia Circuit rejected the government’s request to pause Lamberth’s order, further complicating the administration’s efforts to enforce the new policy.
The Trump administration then went to the Supreme Court on September 28, asking the justices to step in and block Lamberth’s order. U.S. Solicitor General D. John Sauer argued that the district court had overstepped its bounds by substituting its own policy judgment for that of the BOP and relying on evidence outside the administrative record. Sauer also contended that the court failed to give prison administrators the deference they are due in managing prison operations.
The inmates argue that the BOP’s new policy falls short under federal laws governing administrative agencies because the BOP had not provided a reasoned explanation for its decision. They claim the BOP’s extensive record lacks evidence supporting its conclusions about the medical necessity and security implications of the care. Specifically, the record does not address the BOP’s long-standing experience in providing hormone therapy and social accommodations, nor does it include input from BOP healthcare providers on the effectiveness or harm of such treatments.
The BOP’s Medical Director acknowledges that the proposed psychotherapy and psychotropic medications treat co-existing conditions, not gender dysphoria itself. The inmates also assert that the BOP’s rationales seem contrived to comply with President Trump’s executive order, rather than being based on genuine medical or security concerns.
Potential Harm and Permanent Consequences
The inmates told the justices that they will be permanently harmed if the district court‘s order is paused. 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 highlight that the abrupt discontinuation of hormone therapy can have irreversible physical and psychological effects, showing the urgency of maintaining the current protections.
