The US Supreme Court has rejected an attempt by Donald Trump’s administration to restrict healthcare for transgender inmates. On Wednesday, October 21, the court denied the Trump administration‘s emergency request to impose new restrictions on gender-affirming care, meaning that trans prisoners can continue receiving treatment while the case continues.

The proposed policy would have stopped access to hormone therapy and gender-affirming surgeries. It would also have removed access to items such as chest binders, breast padding, wigs and makeup. Mental health services would still have been available under the new rules.

The restrictions followed an order signed by Trump after he returned to the White House in January 2025, as part of his administration’s wider efforts to roll back trans rights. However, three inmates, two trans men and one trans woman, challenged the policy in court, arguing that withdrawing their treatment could seriously harm their physical and mental health.

Their lawyers pointed out that the Federal Bureau of Prisons has provided hormone therapy to inmates with gender dysphoria since at least 1992. According to court records, approximately 600 prisoners were receiving hormone therapy in 2025. Lawyers representing the transgender inmates argued that the restrictions could affect nearly 1,000 people.

The Trump administration defended the changes, raising concerns about prison security and questioning the need for the treatments. However, lawyers challenging the policy argued that the government had provided no evidence of security problems linked to hormone therapy during the more than 30 years it had been offered.

US District Judge Royce Lamberth previously blocked the restrictions, raising concerns about the harm that removing treatment could cause.

The Supreme Court’s latest decision leaves that ruling in place. Justices Samuel Alito and Clarence Thomas disagreed and would have allowed the restrictions to go ahead.

The decision is a rare win for transgender rights in the US Supreme Court, which has previously allowed several Trump administration policies targeting the community to take effect. These have included restrictions on transgender military service and changes to gender markers on US passports.

While the latest ruling prevents the prison healthcare restrictions from being introduced for now, it is not a final decision on the policy’s legality. The legal challenge is still ongoing.