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Why Prisons Must Allow Hormone Therapy for Trans People Despite Trump’s Order

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June 3, 2025
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A photo of a White man behind a microphone gesturing while wearing a black judge’s robe.
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3:25 p.m. EDT

06.03.2025

The district judge ordered the prison system to continue providing hormone therapy to transgender people as needed, while a lawsuit proceeds.

A photo of a White man behind a microphone gesturing while wearing a black judge’s robe.

Senior Judge Royce Lamberth of the U.S. District Court for the District of Columbia, pictured in 2008, ruled that federal officials cannot withhold gender-affirming care from people incarcerated in federal prisons while a lawsuit proceeds.
Charles Dharapak/Associated Press

Federal officials cannot withhold gender-affirming care — for now — from people incarcerated in the Bureau of Prisons, a federal judge ruled on Tuesday.

Under an executive order that President Trump signed in January, transgender federal prisoners lost the right to receive hormone therapy and other accommodations, such as access to undergarments and gender-specific commissary items. The new order, by senior Judge Royce Lamberth of the U.S. District Court for the District of Columbia, applies temporarily while attorneys for the ACLU and the Transgender Law Center pursue a lawsuit against the Trump administration challenging the presidential order.

In his opinion Tuesday, Lamberth wrote that the rules the federal Bureau of Prisons laid out in response to Trump’s executive order seemed “arbitrary and capricious” and that they likely violated the law requiring federal agencies to carefully weigh and explain new policies. “And nothing in the thin record before the Court suggests that either the BOP or the President consciously took stock of — much less studied — the potentially debilitating effects that the new policies could have on transgender inmates,” Lamberth wrote.

The judge ordered the prison system to continue providing hormone therapy to transgender people as needed, and to restore access to social accommodations such as hair removal, chest binders and undergarments. “The BOP may not arbitrarily deprive inmates of medication or other lifestyle accommodations that its own medical staff have deemed to be medically appropriate,” he wrote.

The ACLU and the Transgender Law Center filed the suit on behalf of one trans woman and two trans men, but the judge made it a class action representing any person incarcerated in federal prison who now needs, or who may in the future need, access to gender-affirming care. More than 600 people have been prescribed gender-affirming hormone therapy by prison doctors, according to documents in the case.

Corene Kendrick, an attorney with the ACLU, said that after Lamberth’s orders, “The court showed that trans people, like everyone else, have constitutional rights, even when they are incarcerated.”

Donald Murphy, a spokesperson for the Bureau of Prisons, declined to comment on the pending litigation. In court filings, lawyers for the bureau argued that the federal prison system “has not categorically banned the provision of hormone medication to inmates with gender dysphoria,” and that there are no grounds for the lawsuit because the named plaintiffs are still receiving their medicines. But the judge rejected that argument, saying that the plaintiffs were told that they may lose their access to hormones in the future, and that he was not reassured that others would not as well. “It suffices to say that all three plaintiffs’ access to hormone therapy is, as best the Court can tell, tenuous.”

Lamberth was nominated to the bench by President Ronald Reagan in 1987 and is also overseeing several other cases challenging the bureau’s recent attempts, in response to Trump’s executive order, to move transgender women from women’s prisons to men’s facilities.

Trump signed his order shortly after his inauguration in January, but for more than a month afterward, bureau officials in Washington, D.C., issued no formal guidance about how to implement it. More than 2,000 people incarcerated in federal facilities have self-identified to prison psychology services as transgender. As a result of the delay in guidance, there was chaos and confusion across the system, as wardens and other officials confiscated clothing, then returned them, then confiscated them again.

In late February, bureau officials identified several long-standing accommodations for trans people that would no longer be provided. A Feb. 21 memo said, “Staff must refer to individuals by their legal name or pronouns corresponding to their biological sex.” Trans people could no longer have access to gender-affirming clothing and underwear. All support groups and programs for trans people “must also halt.” Across the country, people reported having bras and other undergarments confiscated in cell searches. Other accommodations, like pat-down searches of trans women by female correctional officers, were no longer available.

When it came to gender-affirming medications, the bureau’s Health Services Division sent prison administrators a memo on Feb. 28 that reiterated the language of the executive order barring medical procedures and medications. But the memo did not explain what to do about the hundreds of people already on hormones, or how to proceed when prison psychologists think hormone treatment or surgery is needed.

On Tuesday, the judge ordered the bureau to stop implementing both of those memos, and ordered Attorney General Pam Bondi and other federal officials to stop enforcing the executive order when it comes to gender-affirming care and social accommodations in federal prisons.

The judge’s ruling applies temporarily while the lawsuit makes its way through the courts in the coming months.



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