Topline
Federal prisons in the U.S. must provide hormone therapy and social accommodations for hundreds of transgender inmates, a judge ruled Tuesday, blocking an earlier executive order by President Donald Trump—an opponent of gender-affirming care—that prevented federal funds for their treatment.
Trump issued an executive order blocking federal funds for “the purpose of conforming an inmate’s … More
Key Facts
Judge Royce Lamberth ruled neither the Bureau of Prisons nor Trump’s executive order provided “any serious explanation” as to why hormone therapy and social accommodations, including cosmetics and clothing that match the inmate’s gender identity, should not be provided for more than 600 transgender inmates.
Inmates who challenged Trump’s order successfully argued their treatment is necessary to “lessen the personal anguish” caused by their gender dysphoria, Lamberth said, noting the Bureau of Prisons did not dispute gender dysphoria could pose severe side effects, including anxiety, depression and suicidal thoughts.
Shortly after his inauguration, Trump ordered the Bureau of Prisons to revise its medical care policies to be consistent with other federal policies recognizing only two sexes, male and female, by ensuring federal funds aren’t used for any medical procedure, treatment or drug “for the purpose of conforming an inmate’s appearance to that of the opposite sex.”
Trump’s order also asked the Bureau of Prisons to make sure “males are not detained in women’s prisons,” with dozens of transgender women later moved to men’s facilities, though Lamberth and other judges have challenged or blocked the transfer of some inmates.
The Bureau of Prisons did not immediately respond to a request for comment.
Big Number
2,198. That’s how many transgender inmates are within the federal prison system as of Feb. 20, 2025, according to Bureau of Prisons data obtained by NPR.
Key Background
Trump targeted gender-affirming care and the transgender community early in his second presidency. His executive order, which he argued would defend women from “gender ideology extremism,” declared the federal government would recognize male and female as the only two sexes. Trump issued another executive order in late January that limited access to gender transition surgeries for people younger than 19, after he said the U.S. would “rigorously enforce” laws that “prohibit or limit these destructive and life-altering procedures.” Trump’s push against gender-affirming care follows a yearslong effort by dozens of states to bar or limit access.
What To Watch For
The U.S. military has asked transgender service members to voluntarily leave active-duty service by June 6, according to guidance issued by Defense Secretary Pete Hegseth. About 1,000 service members have disclosed being diagnosed with gender dysphoria and have agreed to leave, Pentagon spokesperson Sean Parnell said in a statement, though just over 4,000 transgender people serve in the military. Hegeth’s guidance follows an earlier ruling by the Supreme Court, which said Trump could implement a ban on transgender people serving in the military.
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