SCOTUS allows lower court to block Trump admin’s policy prohibiting ‘transgender’ procedures for inmates

The Supreme Court of the United States on Oct. 21 upheld a lower court’s order prohibiting the Federal Bureau of Prisons (BOP) from enforcing a policy that prevents inmates who identify as “transgender” from accessing sex-rejecting surgeries and hormones.

The Supreme Court gave a one-sentence order stating that it rejects the Trump administration’s application to stay the lower court’s order, according to SCOTUSBlog. The court’s document also indicated that Justices Samuel Alito and Clarence Thomas would have granted the Trump administration’s application.

According to SCOTUSBlog, the BOP adopted a new policy in February 2026 disallowing sex-rejecting surgeries for inmates; the bureau said it was adopted “independently” of President Donald Trump’s 2025 executive order directing the attorney general to ensure federal funding is not spent on sex-rejecting procedures or hormones for inmates. 

The BOP said in a 43-page memorandum about the policy change that the “latest scientific information” had a role in the shift, pointing to having previously relied on the World Professional Association for Transgender Health (WPATH). SCOTUSBlog reported that prison administrations determined that WPATH’s standards had since been determined “unreliable” and “unpersuasive,” according to the memorandum. 

WPATH came under fire in May 2024 when a set of leaked internal files revealed widespread medical malpractice and flaws in its guidelines. BOP said “its prior policies reflected WPATH’s standards of care, which had since been cast into serious doubt,” Solicitor General D. John Sauer wrote in the appeal to SCOTUS.

Three inmates who identified as “transgender” filed a class action lawsuit in federal court to block the BOP’s policy, which Senior U.S. District Judge Royce Lamberth granted in August, according to the outlet. The U.S. Court of Appeals for the District of Columbia Circuit rejected the Trump administration’s request to block Lamberth’s order, prompting the BOP to go to the Supreme Court. 

The BOP argued that the new policy, more consistent with the latest scientific information, does not see sex-rejecting procedures as medically necessary. The new policy still offers mental health treatment, but it will not allow inmates to begin undergoing sex-rejecting procedures. 

“Under prior policies, BOP had addressed gender dysphoria by providing both mental-health treatment (such as psychotherapy and psychiatry services) and sex-rejecting interventions (such as sex-trait-modification surgeries, hormone interventions, and social accommodations),” Sauer wrote in the appeal to SCOTUS. “In developing the 2026 policy at issue here, however, BOP determined that sex-trait-modification surgeries, hormone interventions in general, and social accommodations could no longer be justified as treatment for gender dysphoria.”

A second factor in the policy change, according to Sauer, is that the BOP determined that “security and prison-administration concerns independently justified a change in policy.” 

Sauer explained earlier in the appeal, “In particular, BOP had determined, based in part on its own ‘experience and expertise,’ that providing greater access to those interventions would risk turning the recipients of those interventions into ‘target[s] for attacks,’; ‘raise fairness concerns’ and ‘breed resentment among other inmates,’; and undermine BOP’s ‘reasonable practice of refusing to reward threats of self-harm’.”

SCOTUSBlog reported that the three inmates had argued in part that “they will be permanently harmed if the district court’s order is paused,” pointing to being at serious risk of worsening gender dysphoria, and other mental health symptoms such as depression, self-harm, suicidality, and self-harm.

Sauer continued, “In BOP’s view, providing social accommodations also would enable inmates to ‘hide contraband’ or ‘obfuscate or conceal [their] identity.’ BOP explained that such security and prison administration concerns ‘outweigh[ed]’ any benefits, medical or otherwise, from providing greater access to sex-trait-modification surgeries, hormone interventions, and social accommodations in the prison setting.”