Supreme Court rejects Trump's order to end hormone treatments for transgender prisoners

David G. Savage, Los Angeles Times on Oct 21, 2026

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WASHINGTON — The Supreme Court on Wednesday turned down an appeal from President Donald Trump and rejected his order to end hormone treatments and other gender-affirming care for transgender inmates in federal prisons.

The justices denied Trump’s appeal without comment, over dissents by Justices Clarence Thomas and Samuel A. Alito.

The order leaves in a place a decision by a senior judge appointed by President Reagan who had blocked Trump’s new prison policy from taking effect.

The decision is a rare win for trans rights at the Supreme Court.

In June, U.S. District Judge Royce Lamberth, a Reagan appointee, said he would “not wade into the culture war being waged against transgender individuals” and ruled the Trump administration did not have evidence or good reasons for changing the long-standing policy for these inmates.

He cited the Administrative Procedure Act, which forbids abrupt and “arbitrary” changes in federal regulations.

Lamberth said the Bureau of Prisons’ new regulation would “arbitrarily deprive inmates of medications and other lifestyle accommodations that its own medical staff have deemed to be medically appropriate.” The evidence showed that “gender affirming care is the only effective treatment for gender dysphoria and severe harm flows from the cessation of such care,’’ he wrote.

Last month, the D.C. Circuit upheld his decision on a 2-1 vote, prompting the administration’s appeal to the Supreme Court.

The American Civil Liberties Union, which sued on behalf of three inmates, said the court should not “overturn a three decades-long status quo.” Since 1992, the Bureau of Prisons has “treated people with gender dysphoria with hormone therapy,” their lawyers told the court.

In response to Trump’s order, the “BOP overrode its own medical providers’ clinical judgment and mandated the cessation of treatment for almost 1,000 people in its custody,” they said.

At issue in this latest legal dispute over trans rights was whether the government had evidence to justify a sharp change in its prison regulations.

In the past, the court has often deferred to prison officials on their handling and treatment of inmates.

“If deference to prison administrators means anything, it means that courts cannot second-guess their eminently reasonable choice to treat the mental-health condition of gender dysphoria with psychotherapy rather than physical, sex-rejecting interventions,” Solicitor Gen. D. John Sauer said in his appeal.