Judge orders Trump admin to maintain gender-affirming care for transgender inmates
The judge’s ruling is the first to broadly block federal prison officials from carrying out Trump’s executive order targeting “gender ideology.”
By Josh Gerstein and Kyle Cheney
06/03/2025 02:03 PM EDT
A federal judge has ordered the Trump administration to continue providing gender-affirming care to hundreds of transgender prison inmates, ruling that an abrupt decision to curtail their medical care was not based on any “reasoned” analysis, as the law requires.
U.S. District Court Judge Royce Lamberth previously ordered the Bureau of Prisons to continue to provide medical care to several individual prisoners who are transgender, but his ruling Tuesday is the first that broadly blocks federal prison officials from carrying out an executive order from President Donald Trump targeting “gender ideology.”
Trump’s executive order requires the Bureau of Prisons to cease providing “any medical procedure, treatment, or drug for the purpose of conforming an inmate’s appearance to that of the opposite sex.”
But, amid a torrent of lawsuits, prison officials interpreted Trump’s order to allow transgender inmates to continue to receive medication unrelated to that care — such as relieving anxiety, depression and suicidal thoughts. That led to about 600 transgender inmates continuing to receive gender-affirming care while about 400 were denied.
Lamberth, however, said this parsing of Trump’s order — which did not appear to leave such wiggle room — amounted to a “fabricated distinction.” Lamberth’s order requires the Bureau of Prisons to resume providing hormone therapy and “social accommodations,” such as gender-conforming undergarments and hair removal products, that were available prior to Trump’s executive order. Lamberth ruled that there was no evidence the administration made any factual analysis before implementing Trump’s directive.
“Neither the BOP nor the Executive Order provides any serious explanation as to why the treatment modalities covered by the Executive Order … should be handled differently than any other mental health intervention,” Lamberth wrote.
Trump’s Day One executive order also directed changes in federal policies to ensure that “males are not detained in women’s prisons or housed in women’s detention centers.” The number of transgender women in federal women’s prisons make up a fraction of the population, with only about 16 nationwide, the Justice Department has said. Nearly all of the roughly 2,230 federal inmates who are transgender are housed in facilities matching their biological sex, the department has said in court papers.
A spokesperson for the Justice Department did not immediately respond to a request for comment. A spokesperson for the Bureau of Prisons declined to comment.
Lamberth, a Reagan appointee based in Washington, has repeatedly ruled in favor of transgender inmates suing over BOP’s effort to implement Trump’s policy. He ruled that transferring transgender women to men’s facilities would violate the Eighth Amendment’s protection against cruel and unusual punishment — in part by subjecting them to potential danger.
Lamberth has also ruled repeatedly against the Trump administration’s efforts to shutter Voice of America and its news affiliates in another high-profile ongoing barrage of litigation. In recent years, Lamberth has used his rulings to decry what he considers a rising tide of threats to the separation of powers, democracy and in particular misinformation by Trump and his allies over the way courts work.
In Tuesday’s ruling, the judge agreed with a claim by the Trump administration that allowing the president’s policies to take effect is an important part of “letting democratic processes play out.” But, he said, “democracy is not as simple as the defendants make it sound.”
“If democratic self-governance means anything, it means giving effect to all duly enacted laws, including those … that were enacted decades ago,” Lamberth wrote. He added: “it does not mean blind submission to the whims of the most recent election-victor.”