The US Supreme Court has refused to let the Trump administration end hormone therapy for transgender prisoners in federal custody, leaving a lower-court order in place while the underlying lawsuit continues.

The justices denied the government's emergency application for an immediate stay in an unsigned order on Wednesday 21 October 2026, in Trump v. Kingdom. The ruling is not a decision on the merits, so the policy stays blocked for now.

Court Declines to Pause Injunction Without Explanation

The order gave no explanation for the decision and came 23 days after the government filed its application. Courthouse News described the vote as an apparent 7-2, and Justices Clarence Thomas and Samuel Alito were reported to have dissented. Coverage characterised the outcome as a rare win for transgender rights at a conservative-majority court.

Its lawyers argued that the policy was properly adopted and that the judge had overstepped. The policy prohibits gender-affirming surgeries, hormone therapy and social transition accommodations, including items such as gender-affirming clothing and wigs, while allowing psychotherapy and psychiatric services to continue. It also requires existing hormone treatment to be tapered off.

The Supreme Court has previously let other Trump administration measures affecting transgender people take effect during litigation, including restrictions on military service and passport gender markers.

Key facts: The Bureau of Prisons issued the policy in February 2026. The administration applied to the Supreme Court on 28 September 2026. District Judge Royce Lamberth had blocked the policy in June, and a divided appeals panel left that order standing. The bureau said in 2025 that it provided hormone therapy to more than 600 inmates.

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How Judge Lamberth and the Appeals Court Got Here

Kingdom v. Trump was filed in March 2025 by the American Civil Liberties Union (ACLU) and the Transgender Law Center, challenging a January 2025 executive order and related bureau policies. Judge Lamberth, a Reagan appointee, issued an initial injunction in June 2025 and certified a class covering current and future federal prisoners diagnosed with gender dysphoria.

After the bureau adopted its 2026 policy, he blocked that too. He found the administration lacked evidence or good reasons for changing a long-standing approach. His ruling rested on the Administrative Procedure Act, and he left the prisoners' Eighth Amendment claims unresolved. He also wrote that the court had 'no intention of wading into the culture war' over transgender people.

The prisoners' lawyers told the Supreme Court that the bureau had treated gender dysphoria with hormone therapy since at least 1992. In its place, the government's request said, the bureau offers therapy, counselling and psychiatric drugs.

What Happens Next for Hormone Therapy for Transgender Prisoners

ACLU lawyers had called the policy 'a direct threat to the well-being of transgender people in federal custody'. After Wednesday's order, the organisation publicly praised the decision as critical for its clients and for all transgender people in bureau custody.

The three named prisoners had argued that the change would end treatment for nearly 1,000 people in custody, against the bureau's 2025 figure of more than 600 receiving hormones.

The Supreme Court's refusal does not settle the pending class action, which continues with Judge Lamberth's injunction in place. The Bureau of Prisons remains blocked from enforcing the challenged policy against the prisoners covered by the injunction, while the administration maintains that its policy was properly adopted.

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