Trump begs Supreme Court to let feds withdraw medical care for trans prisoners: ‘A dangerous thing to do’

The Trump administration asked the U.S. Supreme Court on Monday to let federal prisons withdraw gender-affirming treatment from transgender people in their custody, seeking to suspend protections for medical care that prison clinicians had previously prescribed.

The emergency application in Trump v. Kingdom asks the justices to pause an injunction blocking a Bureau of Prisons policy that prohibits new hormone treatment for gender dysphoria, directs clinicians to taper existing prescriptions, and removes gender-affirming clothing and other accommodations. The restrictions would take effect while the underlying legal challenge proceeds.

Chief Justice John Roberts ordered the prisoners’ attorneys to respond by 4 p.m. October 8, according to the Supreme Court docket.

The administration argues that prison officials should have broad discretion to decide how to treat gender dysphoria. The prisoners contend that officials cannot use that discretion to deny necessary care.

Related: Trump just rolled out a cruel anti-trans prison policy doctors are calling ‘dangerous’

A policy change with medical consequences

Issued in February, the bureau’s policy replaces access to gender-affirming treatment with an approach emphasizing psychotherapy, counseling, psychiatric services, and psychiatric medications. It prohibits gender-affirming surgery, although treatment for complications from previous surgeries would remain available.

For people already receiving hormones, the policy calls for tapering plans that consider their treatment history, response to medication, and whether they have undergone surgery. It also directs officials, when practicable, to remove or confiscate items such as binders, wigs, makeup, and breast padding.

Those changes followed President Donald Trump’s January 2025 executive order directing federal agencies to recognize only two sexes and prohibiting federal spending on treatments intended to align an incarcerated person’s appearance with their gender identity.

Medical organizations support gender-affirming treatment

Major medical organizations support gender-affirming care for transgender people. The American Medical Association recognizes medical and surgical treatments for gender dysphoria as medically necessary when determined through shared decision-making between patients and physicians, consistent with accepted standards of practice. The Endocrine Society likewise supports access to gender-affirming treatment and maintains clinical guidelines for hormone therapy, emphasizing medical assessment, informed consent, and ongoing monitoring. Those positions support individualized treatment based on a patient’s needs.

The Advocate’s March reporting examined the consequences of the bureau’s tapering directive. Dr. Carl Streed, a Boston primary care physician and transgender health researcher, warned that withdrawing hormones could affect mood and cognition and create longer-term cardiovascular, bone, and metabolic risks.

People whose surgeries have affected their ability to produce hormones naturally could be particularly vulnerable, he said.

“Withdrawing hormone therapy,” Streed told The Advocate, “is a dangerous thing to do.”

The administration’s application acknowledges that some people who have undergone surgery or experience severe withdrawal effects might initially continue receiving hormones. But it describes a policy aimed at tapering treatment and regularly reconsidering whether to stop prescriptions.

Related: Judges on both coasts weigh transgender prisoners’ rights as Trump targets prison policies

The government challenges court-ordered protections

The lawsuit began in March 2025 with three transgender people whose prison medical providers had diagnosed gender dysphoria and prescribed hormones. The ACLU, its Washington, D.C., affiliate, and the Transgender Law Center brought the challenge.

As The Advocate previously reported, U.S. District Judge Royce C. Lamberth issued an initial injunction in June 2025 protecting hormone therapy and social accommodations. He also certified a class encompassing current and future federal prisoners diagnosed with gender dysphoria.

After the bureau issued its replacement policy this February, Lamberth blocked it in June and renewed the injunction on August 26. A divided federal appeals court declined to suspend the renewed order on September 18.

Lamberth’s June opinion found that the prisoners were likely to succeed under the Administrative Procedure Act. He concluded that the bureau appeared to have worked backward from Trump’s executive order rather than adequately considering the evidence and its own experience providing care.

The judge also found that the government had not identified an instance in which gender-affirming care created prison safety problems, despite providing it for years. He left the prisoners’ Eighth Amendment claims unresolved, finding sufficient grounds for preliminary relief under administrative law.

Solicitor General D. John Sauer disputes that analysis. His application argues that the bureau independently reconsidered its policies based on medical evidence and security concerns.

The filing also argues that Lamberth’s injunction exceeds limits imposed by the Prison Litigation Reform Act, including by blocking provisions concerning surgery, even though the prisoners’ request for preliminary relief focused on hormones and social accommodations.

The medical care case is separate from litigation over the administration’s effort to move transgender women into men’s prisons. In June, Lamberth protected 14 women from transfer after reviewing evidence of the specific dangers they would face.