Supreme Court Rules on Trump Admin Policy Blocking Sex-Rejecting Procedures for Prisoners
The Supreme Court Wednesday denied the Trump administration’s request to block a lower court order preventing the Bureau of Prisons from denying previously prescribed transgender procedures to prison inmates.
The court denied the stay in an unsigned order, noting that Justices Clarence Thomas and Samuel Alito would have granted the stay.
The Bureau of Prisons under President Joe Biden had addressed gender dysphoria by providing inmates with both mental-health treatment, such as psychotherapy, and sex-rejecting interventions, such as hormone injections, sex trait-modification surgeries, and social accommodations.
Earlier this year, however, the bureau determined that sex-rejecting procedures “could no longer be justified as treatment for gender dysphoria.” The administration noted many flaws with the previous rules, including what the administration described as overreliance on the World Professional Association for Transgender Health.
Prisoners, represented by the American Civil Liberties Union and the Transgender Law Center, sued on claims that denying the previously-prescribed interventions violated their constitutional rights.
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The plaintiffs claimed the policy violated their Eighth Amendment rights protecting them from cruel and unusual punishment. They also raised claims under the Administrative Procedure Act and the Fifth Amendment.
Solicitor General D. John Sauer asked the Supreme Court to lift a lower-court injunction after the Court of Appeals for the Washington, D.C., Circuit let the injunction stand on Sept. 18.
A district court judge had ruled that the Bureau of Prisons had not adequately considered “its own experience providing gender-affirming care under its prior policy,” that the policy is “objectively unreasonable,” and that the policy is “pretextual and reverse engineered to implement” President Donald Trump’s executive orders.
Yet Sauer’s brief states that the Bureau of Prisons adopted the policy independent of the executive order after an exhaustive review, including a 3,200-page administrative record, explained in a 43-page memorandum. The review explained why the Trump administration rejected the authority of WPATH, the very authority that President Barack Obama’s administration had relied on to approve sex-rejecting procedures for inmates.
“WPATH openly engages in ideologically based political advocacy, systematically misrepresents evidence, and often bases its recommendations, no matter how impactful for the patient, on low-quality supporting evidence,” the memo noted.
The Department of Health and Human Services previously published a peer-reviewed report finding “extremely weak evidence” for any benefits from sex-rejecting procedures for minors.
Internal WPATH files revealed that WPATH members expressed concerns about minors’ inability to consent to interventions with potentially lifelong impacts.
In 2022, WPATH left age recommendations for specific treatments out of its Standards of Care for transgender medicine, following political pressure from then-Assistant Secretary of Health Rachel Levine.
The Trump administration claims the injunction is harming the government’s ability to implement policy.
“Without meaningfully engaging with either BOP’s reasoning or the administrative record, the district court prohibited BOP from applying its 2026 policy to any inmate who is or will be diagnosed with gender dysphoria,” Sauer wrote.
The bureau argued that its revised policy reflects treatment for gender dysphoria that is “more aligned with the latest scientific information,” concluding that sex-rejecting procedures are “not medically necessary.”
The new policy still offers mental health treatment but will reject inmates’ requests to begin sex-rejecting medical procedures. If an inmate had previously been receiving hormones, however, the Bureau of Prisons will develop a tapering plan for each inmate after considering appropriate factors.
Sauer also noted the bureau’s finding that providing such interventions would “raise fairness concerns” and “breed resentment among other inmates,” because they represent costly interventions. The bureau also found that accommodating social transition requests could permit inmates to “hide contraband” or “obfuscate or conceal” their identity.
Sauer argued that the bureau relied on its “experience and expertise” in concluding that greater access to sex-rejecting procedures increased security and prison-administration concerns.
“Prison administration is … a task that has been committed to the responsibility of [the legislative and executive] branches, and separation of powers concerns counsel a policy of judicial restraint,” the solicitor general argued.”
The Bureau of Prisons would “develop a tapering plan” for inmates currently receiving hormones for gender dysphoria, Sauer noted.
This is a breaking news story and may be updated.
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