The US Supreme Court on Wednesday refused to let President Donald Trump’s administration immediately enforce restrictions on medical care for transgender inmates, leaving in place a lower-court order that allows treatments to continue while a legal challenge proceeds.The brief order did not explain the court’s reasoning. Conservative Justices Samuel Alito and Clarence Thomas dissented, saying they would have allowed the policy to take effect as the case moved through the lower courts.The policy followed an executive order by Trump, a Republican who has taken several steps to roll back transgender rights during his second term. It directs the Bureau of Prisons to revise its medical care rules so that federal funds are not spent “for the purpose of conforming an inmate’s appearance to that of the opposite sex.”Under the policy, prisons would halt gender-affirming surgeries, gradually withdraw hormone therapy and end social accommodations such as makeup and wigs. Mental health services would continue to be available.Transgender inmates challenged the restrictions in court. US District Judge Royce Lamberth ordered that their treatments continue. Lamberth, who was nominated by Republican President Ronald Reagan, noted that untreated gender dysphoria can cause severe side effects, including depression, anxiety and suicidal thoughts.The Trump administration appealed, arguing that the treatments raised security concerns and “could no longer be justified”. A divided appeals court panel declined to lift the block, prompting the administration to approach the Supreme Court.About 600 inmates were receiving hormone therapy in 2025, according to court records cited by the Bureau of Prisons. Lawyers for the inmates argued that withdrawing treatment would have significant effects on their bodies and mental health. They also said the government had not presented evidence of security problems linked to hormone therapy for transgender inmates during the 30 years it had been provided.The Supreme Court has previously allowed other Trump administration policies affecting transgender people to take effect while legal challenges continued. These include restrictions on military service and passport sex markers.The conservative-majority court has also upheld state laws banning certain medical treatments for transgender minors and restricting transgender athletes from participating in women’s sports.
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