Supreme Court leaves in place order blocking federal prison policy on gender dysphoria care

The U.S. Supreme Court on Wednesday, Oct. 21, 2026, denied the federal government’s application to stay a lower-court order that blocks the Federal Bureau of Prisons from enforcing its 2026 policy on treatment for inmates diagnosed with gender dysphoria. The brief order in Trump v. Kingdom, No. 26A416, gives no reasons. It notes that Justice Clarence Thomas and Justice Samuel Alito would have granted the stay.¹ The court posted the order on its website; as of midday Oct. 21, its online docket for the case did not yet list it, and its last entry was the government’s Oct. 9 reply.²

What stays in effect

The ruling leaves in place an Aug. 26 order by U.S. District Judge Royce C. Lamberth of the District of Columbia, which took effect Sept. 15. It stays the bureau’s Feb. 19, 2026, Program Statement 5260.01 under the Administrative Procedure Act, bars officials from enforcing it, and requires them to keep providing gender-affirming care to the plaintiffs and class members under the policy and practice in place before Executive Order 14168 was issued on Jan. 20, 2025.³

Under the 2026 policy, the bureau would continue mental-health treatment such as psychotherapy but would stop providing sex-trait-modification surgeries, hormone interventions in general or social accommodations, according to the government’s application. Inmates already receiving hormones would get an individual tapering plan.⁴ The executive order directed the attorney general to ensure the bureau revised its medical-care policies to be consistent with the order.⁴

How the case got here

Three federal inmates diagnosed with gender dysphoria, Alishea Sophia Kingdom, Solo Nichols and Jas Kapule, sued in March 2025. In June 2025 the district court certified a nationwide class of people in bureau custody who have or will have the diagnosis and blocked the bureau’s 2025 memoranda carrying out the executive order.⁴⁵ After the bureau issued the 2026 policy, the court issued a new injunction on June 17 and renewed it Aug. 26.⁴

On Sept. 18, a divided panel of the U.S. Court of Appeals for the D.C. Circuit, Judges Wilkins, Walker and Garcia, denied a stay. The order said the government had not shown a strong likelihood of success on whether the bureau failed to adequately consider its own experience under its prior policy. Judge Walker would have granted the stay.³ The appeal is set to be fully briefed by Dec. 23, 2026, the inmates’ filing says.⁵

The two sides

In the Sept. 28 application, Solicitor General D. John Sauer wrote that the bureau had determined surgeries, hormone interventions in general and social accommodations “could no longer be justified as treatment for gender dysphoria,” citing newer scientific information and security concerns. Of the district court’s reasoning, the application said “none of the reasons the court gave for that conclusion has merit,” and it argued the order also violates the Prison Litigation Reform Act.⁴

The inmates’ lawyers, from the American Civil Liberties Union and the Transgender Law Center, wrote in their Oct. 8 opposition that the bureau had “mandated the cessation of treatment for almost 1,000 people in its custody” to carry out the executive order. They argued the bureau “has not pointed to a single security incident relating to its provision of this treatment over the past 30 years” and that ending care would put class members at serious risk of worsening gender dysphoria, depression, anxiety, self-harm and suicidality.⁵

What the records do not show

• The Supreme Court’s order does not explain the denial, and no justice wrote separately.¹
• The figure of almost 1,000 people comes from the inmates’ filing; the government’s application does not state how many inmates the policy would affect.⁵⁴
• No court has ruled on the final merits of the challenge to the 2026 policy; the D.C. Circuit appeal of the preliminary injunction is pending.³⁵