The Supreme Court left a lower-court block in place on the Trump administration’s policy ending transgender surgeries for federal prison inmates, handing the Justice Department a 7-2 emergency-docket defeat while the fight continues.
On Wednesday the high court rejected the Department of Justice’s emergency petition seeking to lift an injunction against a February 2026 Bureau of Prisons rule. The brief order offered no explanation. Justices Clarence Thomas and Samuel Alito noted they would have granted the request and allowed the policy to take effect while the case proceeds.
The Washington Examiner reported that the order keeps the Bureau of Prisons from applying its new gender-dysphoria rules to any inmate who is or will be diagnosed with the condition. Litigation continues in the lower courts, and the matter could eventually return on the regular merits docket.
The February policy ends surgeries that modify sex traits as treatment for gender dysphoria. It keeps mental-health treatment options available. An earlier version with similar aims had already been held up in federal court.
A federal district court halted the February rule in June. In September a divided federal appeals court refused to lift that injunction. Solicitor General D. John Sauer then filed the emergency petition on Sept. 28, arguing the Bureau of Prisons lawfully used its rulemaking authority.
Sauer told the justices the district court had failed to engage the agency’s reasoning or the administrative record. He wrote:
"Without meaningfully engaging with either BOP’s reasoning or the administrative record, the district court prohibited BOP from applying its 2026 policy to any inmate who is or will be diagnosed with gender dysphoria,"
He also said the lower court had “radically” departed “from the significant deference that BOP is due” in its policymaking.
Fox News reported additional details from the filing. The updated Bureau of Prisons policy prohibits surgeries that modify sex traits, stops new hormone treatments for inmates not already receiving them, and bars social accommodations inconsistent with biological sex, items such as padding, binders, makeup, wigs, or opposite-sex undergarments. U.S. District Judge Royce Lamberth had ordered continued care and accommodations. The D.C. Circuit declined to revive the policy pending appeal.
In the Justice Department papers Sauer argued the agency’s choice falls inside normal administrative bounds:
"BOP’s decision to prioritize mental-health treatment, while discontinuing medically disputed and unproven sex-rejecting interventions, falls well within the bounds of reasoned decision-making."
The filing also invoked long-standing Supreme Court language on prison management:
"Prison administrators... should be accorded wide-ranging deference in the adoption and execution of policies and practices that in their judgment are needed to preserve internal order and discipline and to maintain institutional security."
The Trump administration has generally fared well on the Supreme Court’s emergency docket, yet it has absorbed several high-profile losses. Last month the Court declined to lift a lower-court block on a new Postal Service mail-ballot rule ahead of the midterms. In other matters the justices allowed a rule expanding favorable advertising rates for campaigns and permitted third-country deportations to proceed ahead of full merits arguments set for December.
This latest denial leaves the February Bureau of Prisons policy frozen. Inmates who claim gender dysphoria continue to receive the treatments and accommodations the district court ordered. Taxpayers keep funding whatever surgeries and related procedures the injunction requires. The administration’s argument that prison officials deserve deference on medical and security judgments remains unresolved until the lower-court case finishes or the justices take it up on the ordinary calendar.
Federal prisons are not elective medical clinics. When courts freeze a policy that ends disputed surgeries and new hormone regimens for inmates, the practical result is that the prior regime stays locked in place, complete with the costs and institutional demands that come with it. The justices who would have lifted the injunction saw the problem clearly; the majority left it for another day.
