Supreme Court won't let Trump administration enforce limits on medical care for transgender federal inmates for now

As of 3:11 p.m. ET, Wednesday, Oct. 21, 2026

The Supreme Court on Wednesday denied the Trump administration's emergency request to enforce new Bureau of Prisons limits on medical care for transgender inmates, leaving a lower-court block on the policy in place.

"The application for stay presented to The Chief Justice and by him referred to the Court is denied," the court said in a one-paragraph order in Trump v. Kingdom, No. 26A416. "Justice Thomas and Justice Alito would grant the application for stay."

The order did not detail the court's legal reasoning, The Associated Press reported. The order addressed only the administration's request for a stay, and the case continues in the lower courts. Thomas and Alito would have allowed the policy to be enforced as the lawsuit played out there, according to AP.

What the policy would do

The policy was adopted after an executive order from President Donald Trump, AP reported. Trump's order called on the Bureau of Prisons to revise its medical care policies so that federal funds aren't spent "for the purpose of conforming an inmate's appearance to that of the opposite sex," according to AP.

The new policy would halt surgeries, taper off hormones and end social accommodations such as makeup and wigs, AP reported. Prisons would continue to offer mental health services.

About 600 inmates were receiving hormone therapy in 2025, the agency said in court records, according to AP.

How the case got here

Attorneys for transgender inmates challenged the policy, and U.S. District Judge Royce Lamberth ordered treatments to continue, AP reported. Lamberth, who was nominated by Republican President Ronald Reagan, pointed out that untreated gender dysphoria can cause severe side effects such as depression, anxiety and suicidal thoughts, according to AP.

The administration appealed, arguing that the treatments raised security concerns and "could no longer be justified," AP reported. A divided appeals court panel left Lamberth's order in place.

Lawyers for the inmates said withdrawing care would have significant effects on their bodies and mental health, and wrote that the government has not detailed evidence of security problems linked to hormone therapy for transgender inmates over the 30 years it has been provided, AP reported.

The court has previously allowed other administration policies affecting transgender people to take effect for now, including restrictions on military service and passport sex markers, according to AP.