Supreme Court rejects ending trans care in federal prisons in rare win for LGBTQ advocates

2026-10-21T15:29:44.023Z / CNN

Supreme Court rejects ending trans care in federal prisons in rare win for LGBTQ advocates

By John Fritze

Updated 8 min ago

Updated Oct 21, 2026, 11:36 AM ET
PUBLISHED Oct 21, 2026, 11:29 AM ET

The Supreme Court building is seen on August 13.

Andrew Harnik/Getty Images

The Supreme Court on Wednesday blocked President Donald Trump from suspending hormone therapy and other treatments for transgender Americans in federal prisons, a rare win for transgender rights at the conservative high court.

The court handed down a one-sentence order that did not explain the decision.

Since Trump returned to power last year, the Supreme Court has allowed the administration to ban trans people from serving in the military and permitted a policy that requires that the sex designation on US passports align with a traveler’s sex assigned at birth. The court also this year upheld state laws that prohibit transgender athletes playing on girls’ sports teams.

The latest emergency appeal hit on an issue Trump raised during his 2024 campaign with a series of television advertisements that criticized Democratic nominee Kamala Harris for her approach to trans Americans. On his first day back in the White House, Trump signed an executive order barring “any medical procedure, treatment, or drug” for the purpose of “conforming an inmate’s appearance to that of the opposite sex.”

The Bureau of Prisons later implemented a policy that permits psychotherapy and psychiatry services for inmates with gender dysphoria, but not hormone therapies, surgeries or “social accommodations.” That can include items such as clothing and makeup.

A US district court and a federal appeals court in Washington, DC, blocked the Trump policy from taking effect in the short term. In a brief order last month, the DC Circuit concluded that the administration’s 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.”

In its emergency appeal to the Supreme Court, the Trump administration argued that it did consider that experience and that the previous treatment and accommodations “raised security and prison-administration concerns that outweighed whatever limited benefits they had.”

Three prisoners who said they had been receiving hormone therapy for years challenged the policy, arguing it was an abrupt change to decades of policy and would end treatment for nearly 1,000 people in custody. The assertion of security concerns within prisons, the American Civil Liberties Union told the Supreme Court, was odd “given that BOP has not pointed to a single security incident relating to its provision of this treatment over the past 30 years.”

Two conservative justices — Clarence Thomas and Samuel Alito — dissented from Wednesday’s order, but did not say why. The lack of explanation was particularly notable given that the case has been fully briefed and ripe for an order for almost two weeks.