October 21, 2026 – The U.S. Supreme Court on Wednesday rejected an emergency request from the Trump administration to allow federal prisons to end gender-affirming medical care for transgender inmates, a rare loss for the White House on transgender policy.

The unsigned order leaves in place a lower-court injunction blocking the Federal Bureau of Prisons (BOP) from enforcing a policy that would generally bar surgeries, hormone therapy and certain social accommodations for inmates with gender dysphoria.

High Court Leaves Injunction Intact

Solicitor General D. John Sauer asked the justices to intervene, arguing the government should be able to enforce the policy while the lawsuit proceeds. Among other arguments, the administration said providing the care poses risks, including that recipients could become targets for attacks.

The Court denied the stay without explanation, as is typical for emergency-docket orders. Justices Clarence Thomas and Samuel Alito noted they would have granted it.

• The vote: Thomas and Alito dissented; the remaining justices did not publicly note a position.
• The order: A single line denying the application, with no opinion.

Background: A Contested Policy

The BOP issued the policy in February, following an executive order signed by President Trump. It would taper hormone treatment for inmates currently receiving it. The BOP has treated gender dysphoria since at least 1992.

The ACLU estimates more than 2,000 transgender people are in federal custody. The BOP no longer publishes data on transgender inmates.

Lower Courts Reject the Policy

In June, U.S. District Judge Royce Lamberth, a Reagan appointee, blocked the policy, finding the BOP likely failed to adequately consider its own experience providing the care for decades. The D.C. Circuit later declined to put his injunction on hold.

In its filing to the Supreme Court, the ACLU argued the BOP’s rationales were “contrived to support the demand President Trump made” in the executive order.

Advocates Welcome the Ruling

Li Nowlin-Sohl, senior staff attorney with the ACLU’s LGBTQ & HIV Project, called the order a critical ruling for the plaintiffs and for all transgender people in BOP custody.

What Happens Next

The order preserves the status quo while the case continues in the lower courts. For now, the BOP cannot enforce the new policy and must continue providing care as it did before.

Key Takeaways

• Ruling: The Supreme Court denied the administration’s emergency stay request.
• Impact: Transgender federal inmates keep access to care while litigation continues.
• Dissenters: Justices Thomas and Alito.

Source: https://www.cbsnews.com/news/supreme-court-trump-gender-affirming-care-transgender-inmates/