Lawyers for a group of transgender inmates in the custody of the Federal Bureau of Prisons urged the Supreme Court on Thursday to leave in place an order by a federal judge in Washington, D.C., that bars the BOP from enforcing a new policy on healthcare for transgender inmates that would prevent such inmates from obtaining (among other things) hormone therapy and “social accommodations” (such as makeup, wigs, and padding). Li Nowlin-Sohl, representing the inmates, told the justices that the Trump administration is asking the justices “to overturn a three decades-long status quo.”
The Trump administration adopted the policy earlier this year. It followed a policy adopted in February 2025 to implement an executive order signed by President Donald Trump shortly after his second inauguration. That order directed the attorney general to “ensure that no Federal funds are expended for any medical procedure, treatment, or drug for the purpose of conforming an inmate’s appearance to that of the opposite sex.”
When it adopted the February 2026 policy, which the BOP said that it did “independently of” Trump’s Feb. 2025 executive order, the BOP also included an extensive administrative record and a 43-page memorandum in which it attributed the change from its prior policy to, among other things, “the latest scientific information.” Specifically, it said, its earlier policies had relied on recommendations by the World Professional Association for Transgender Health, but that group’s standards had been deemed “unreliable” and “unpersuasive” by prison administrators. Moreover, the BOP expressed concerns that providing access to procedures such as gender-transition surgeries could subject transgender prisoners to “attacks,” “raise fairness concerns,” and “breed resentment among other inmates.”
Three transgender inmates went to federal court in Washington, D.C., seeking to file a class action lawsuit to block the enforcement of the policy. On Aug. 26, Senior U.S. District Judge Royce Lamberth issued his most recent order barring the BOP from implementing its 2026 policy, and on Sept. 18 a divided panel of the U.S. Court of Appeals for the District of Columbia Circuit rejected the government’s request to pause Lamberth’s order.
The Trump administration then went to the Supreme Court on Sept. 28, asking the justices to step in and block Lamberth’s order. U.S. Solicitor General D. John Sauer told the Supreme Court that the district court had “substitut[ed] its own policy judgment for that of the” BOP, “rel[ied] on evidence outside the administrative record, and fault[ed] the agency for following presidential directions.” Moreover, he added, the district court “also denied prison administrators the substantial deference they are due.”
In their filing on Thursday, the inmates argued that the new policy fell short under the federal laws governing administrative agencies because the BOP had not provided a “reasoned explanation” for its decision. For example, Nowlin-Sohl wrote, the extensive record that the BOP had provided was “silent about BOP’s extensive experience providing” hormone therapy and social accommodations “and whether it supports” BOP’s conclusions that “this care is not medically necessary and poses security and administrative issues.” The record, the brief continued, is also “devoid of any evidence indicating whether BOP healthcare providers found this care effective, ineffective, or harmful to patients.”
Moreover, the inmates said, the BOP had “cut off treatment that its healthcare providers had recommended for decades and replaced it with psychotherapy” and “psychotropic medications” – which “BOP’s Medical Director recognizes … treat co-existing conditions such as depression and anxiety, not gender dysphoria itself.” And the BOP’s failure to include “key evidence” in the record “make[s] it clear that the rationales were contrived to support the demand President Trump made in the EO.”
Finally, the inmates told the justices that they will be permanently harmed if the district court’s order is paused. “Withdrawing care will cause significant changes to their bodies and put [them] and class members at serious risk of worsening gender dysphoria as well as other mental health symptoms including depression, anxiety, self-harm, and suicidality.”
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