The court gave no explanation for its decision. Justices Samuel Alito and Clarence Thomas said they would have granted the administration’s request and lifted the injunction.

The dispute stems from a 2025 executive order by President Donald Trump that barred the Federal Bureau of Prisons from providing gender-affirming care. A federal district court in Washington, D.C., blocked the policy in June 2025 while a lawsuit challenging it moves forward.

The American Civil Liberties Union filed the class-action suit on behalf of about 1,000 federal prisoners diagnosed with gender dysphoria. The case began with claims from two transgender men and one transgender woman incarcerated in Florida, Minnesota and New Jersey. The plaintiffs argue that denying care violates the Eighth Amendment’s ban on cruel and unusual punishment.

Gender-affirming care can include hormone therapy and other treatment. The ACLU said the court’s decision preserves medically necessary care for people in Bureau of Prisons custody. “The denial of medically necessary health care, including gender-affirming health care, to people in prison is a violation of their fundamental constitutional rights,” Li Nowlin-Sohl, a senior staff attorney with the ACLU’s LGBTQ & HIV Project, said in a statement.

In its filing with the Supreme Court, the Justice Department argued that professional recommendations the Bureau of Prisons had previously followed did not reflect the latest scientific information. The department also said the prior policy raised security and prison-administration concerns that outweighed its benefits.

The Supreme Court’s action does not resolve the underlying lawsuit. It leaves the lower-court injunction in place as the legal challenge continues.