The unsigned emergency order leaves in place an injunction issued this summer by U.S. District Judge Royce Lamberth, which prevents the Bureau of Prisons from implementing a policy that would end hormone therapy and other treatments for transgender inmates. The Supreme Court gave no explanation for its decision. Justices Clarence Thomas and Samuel Alito said they would have granted the administration’s request to put the injunction on hold.

The administration, through Solicitor General D. John Sauer, asked the justices to intervene after the U.S. Court of Appeals for the District of Columbia Circuit also declined to pause Lamberth’s order. The underlying lawsuit, Kingdom v. Trump, remains unresolved; the Supreme Court’s action does not decide the case’s merits.

The American Civil Liberties Union, which represents inmates in the case, estimates that more than 2,000 people in Bureau of Prisons custody identify as transgender. The case involves about 1,000 inmates with a gender dysphoria diagnosis, according to Li Nowlin-Sohl, a senior staff attorney with the ACLU. The organization estimates about 800 of those people have been prescribed hormone therapy, and many receive other social transition accommodations.

The Bureau of Prisons stopped publishing data on transgender inmates after President Donald Trump took office in 2025. Its public statistics now categorize incarcerated people only as male or female.

In its request to the Supreme Court, the administration argued that providing the care could expose recipients to attacks and raise fairness concerns among other inmates. The ACLU disputed the government’s position, noting that the Bureau of Prisons has treated people diagnosed with gender dysphoria since at least 1992. The organization also argued that the agency’s records did not show that its doctors had found the treatment harmful or that it compromised prison security.

Gender-affirming care can include hormone therapy and surgery, though individual treatment needs vary. Medical organizations describe such care as a treatment for gender dysphoria; withholding treatment can contribute to serious mental-health problems, including anxiety, depression and self-harm.

The decision comes amid broader disputes over transgender rights and the administration’s policies. The Supreme Court has recently allowed state restrictions on transgender girls’ participation in publicly funded school sports and upheld state laws restricting gender-affirming care for minors. Wednesday’s order, however, leaves the federal prison-care injunction intact as the litigation continues.