Supreme Court blocks Trump policy restricting transgender inmate care

The Supreme Court on Wednesday refused to let the Trump administration enforce a policy that would end hormone therapy, gender-transition surgery and certain other accommodations for transgender people in federal prisons.

In an unsigned, one-line order, the justices rejected the Justice Department’s emergency request to suspend a lower court injunction while the case proceeds. Justices Clarence Thomas and Samuel Alito said they would have granted the request. The court gave no explanation for its decision.

The dispute centers on a Bureau of Prisons policy issued in February in response to a presidential executive order. It would stop the agency from providing surgery or hormone therapy to treat gender dysphoria and allow it to taper off hormone treatment already being given. It would also end access to accommodations including breast padding, binders, wigs and makeup.

Lawyers challenging the policy said the bureau has provided hormone treatment to inmates with gender dysphoria since 1992 and that the change would end treatment for nearly 1,000 people in federal custody. NBC News reported that there are about 1,000 transgender inmates in federal custody.

A transgender woman and two transgender men in federal prisons sued on behalf of inmates diagnosed with gender dysphoria. NBC News identified the lead plaintiffs as Alishea Kingdom, Jas Kapule and Solo Nichols, who have received hormone treatment for several years. The American Civil Liberties Union is backing their challenge. The plaintiffs argue that the bureau did not adequately explain its reversal and that the policy violates the Eighth Amendment’s ban on cruel and unusual punishment.

The administration says the change is needed to “maintain institutional security.” In a memo accompanying the policy, the bureau said its approach better reflected “the latest scientific information,” inmates’ individual medical needs and the security and administrative demands of prisons. Solicitor General D. John Sauer argued that a lower court had improperly substituted its judgment for the agency’s and prevented the administration from applying its chosen policy.

The inmates’ lawyers countered that the bureau had produced no evidence from its own health care providers showing that the treatments it previously offered were ineffective or harmful. They also said the agency had not identified “a single security incident” tied to providing the care. They argued that the bureau had replaced treatment recommended for decades with psychotherapy and medications that did not address gender dysphoria itself.

U.S. District Judge Royce Lamberth blocked the policy in June and continued the prohibition in August, ordering the bureau to keep providing medical treatment and social accommodations to the affected class of inmates. He found that the bureau had failed to adequately account for its experience under the previous policy.

“The court does not wade into the culture war being waged against transgender individuals,” Lamberth wrote. “The court simply concludes that the government violated [federal law] when it issued a new policy restricting the provision of gender-affirming care to inmates diagnosed with gender dysphoria.”

A divided federal appeals court in Washington declined in September to lift his injunction. In its 2-1 decision, the panel said the bureau had not adequately considered its prior experience providing the care and had not shown a strong likelihood of prevailing in the case.