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BOP Ordered to Restart Gender Affirming Care for Trans Prisoners

by Chuck Sharman

The federal Bureau of Prisons (BOP) was ordered to halt a four-month-old policy that began to “taper” the hormone therapy treatments of trans prisoners and transfer them to housing aligning with their birth sex, in a ruling by the U.S. District Court for the District of Columbia on June 17, 2026. The district court’s new injunction also effectively mooted a ruling issued the same day by the U.S. Court of Appeals for the D.C. Circuit, staying an earlier injunction.

The back-and-forth rulings came in a suit brought by federal prisoner Alishea Kingdom in March 2025, challenging two BOP policy changes affecting trans prisoners. One discontinued hormone therapy that the prisoners had been receiving to treat their diagnosed gender dysphoria. The other reassigned them to housing that aligned with their sex at birth. Both changes were made to implement an executive order (EO) issued by incoming Pres. Donald J. Trump (R) in January 2025, banning the use of federal funds “for any medical procedure, treatment, or drug for the purpose of conforming an inmate’s appearance to that of the opposite sex.”

In June 2025, the district court certified a class of Plaintiffs and issued a preliminary injunction, preventing their medication from being discontinued and forcing the BOP to maintain “social accommodations” that had been made for their condition, including housing assignments to prisons aligning with their expressed gender identity.

Observing the 90-day limit on a preliminary injunction set by the Prison Litigation Reform Act (PLRA), 42 U.S.C. § 1997e, the district court extended it in August 2025 and renewed it again that November and in February 2026. When Plaintiffs were granted another renewal on May 26, 2026, the BOP turned to the D.C. Circuit, which issued a stay pending appeal. Employing a novel tautology, the Court said that the risk of “irreparable harm” wasn’t to Plaintiffs from disruption of their gender-affirming care but was instead posed to the BOP by “an improper intrusion by a federal court into the workings of a coordinate branch of the Government,” citing Miot v. Trump, 2026 U.S. App. LEXIS 6778 (Mar. 6, 2026) (Walker, J., dissenting) (quoting INS v. Legalization Assistance Project of Los Angeles County Federation of Labor, 510 U.S. 1301 (1993) (O’Connor, J., in chambers).

By then, the BOP had promulgated a new policy in February 2026, and the appellate Court allowed that the district court would likely grant a new injunction to stop it—thereby mooting any ruling that the Court might make. “But we nevertheless decline to delay our decision concerning this injunction, because it raises unique concerns that will no longer present themselves after the pending motion in the district court is resolved,” the Court declared—apparently aiming its ruling at other judges in the district court who might face similar suits from trans federal prisoners. In her dissent, Judge Cornelia T. Livingston Pillard said that it was the Plaintiffs who were most deserving of an injunction, since they sought to maintain the status quo, and the majority was improperly letting the government conflate its claims of “irreparable harm” with the merits of the case. See: Kingdom v. Trump, 2026 U.S. App. LEXIS 17585 (D.C. Cir.).

In fact, Plaintiffs did move for an injunction to halt the BOP’s new February 2026 policy, which “seeks to provide only psychotherapy and psychotropic medication to treat gender dysphoria,” as the district court recalled. For its part, the district court expressly disavowed “any intention of wading into the culture war being waged against transgender individuals,” determining instead that in formulating the new policy, the BOP had violated the Administrative Procedures Act (APA), 5 U.S.C. §§ 701cf.

To support this conclusion, the district court said that Plaintiffs would likely succeed in proving that the new policy was “arbitrary and capricious,” in violation of the APA. The BOP’s own experience with providing prisoners gender affirming care would prove that its pre-Trump policy was working fine, Plaintiffs argued. Moreover, none of that experience was cited in the prison agency’s decision to abandon the treatment. What was more likely instead, the district court continued, was that the new policy memo was pretextual, and the BOP was cherry-picking evidence to support the administration’s EO. Quoting the D.C. Circuit, the district court agreed with Plaintiffs that “an agency’s refusal to consider evidence bearing on the issue before it constitutes arbitrary agency action within the meaning of § 706.”

Finding it likely therefore that Plaintiffs would prevail on their claim that the BOP’s adoption of the February 2026 policy violated the APA, the district court issued a new preliminary injunction. The case remains pending, and PLN will continue to update developments. Plaintiff class members are represented by attorneys with the Transgender Law Center in Brooklyn and Oakland, California, with co-counsel from the American Civil Liberties Union in Washington, D.C. and New York City. See: Kingdom v. Trump, 2026 U.S. Dist. LEXIS 135103 (D.D.C.).

D.C. Circuit Sustains Another Challenge from a Smaller Group
of Trans Prisoners

Judge Pillard wrote the majority opinion for another BOP appeal to the D.C. Circuit, after a small group of 18 trans women prisoners successfully challenged their removal from BOP women’s prisons to male lockups. As the appellate Court noted, “Plaintiffs are a very small subset of the thousands of transgender women in [BOP] custody.” Some had already undergone gender-confirming surgery. Several reported a history of sexual assault when housed in men’s prisons. The district court granted a preliminary injunction to each of them, agreeing that “transgender women face an unconstitutional risk of harm in men’s prisons,” the D.C. Circuit continued.

When the government appealed, Plaintiffs abandoned that categorical argument and asked the Court to sustain the injunctions “on … the narrower ground that the individual plaintiffs before the court all have characteristics that make them particularly vulnerable to violence, abuse, and psychiatric harm in men’s prisons.” However, the Court said, there was nothing in the record to support this—no “findings of fact about the individual plaintiffs’ vulnerabilities, or about the reasons on which the [BOP] relied in placing plaintiffs in women’s facilities in the first place.”

The Court rejected the government’s claim that the broad prerogative granted the BOP in making housing assignment by 18 USCS § 3621 also shielded the agency from Plaintiff’s claims that their Eighth Amendment rights were violated. Also batted aside was the BOP’s claim that Plaintiffs failed to exhaust administrative remedies, as required by the PLRA. As the Court noted, the EO issued by the President left the BOP no discretion to grant the prisoners relief from the transfers. Since the agency’s grievance system could offer nothing more, the exception to the PLRA exhaustion requirement for remedies that are “unavailable” therefore applied. “[A]n administrative procedure is unavailable,” the Court said, “when (despite what regulations or guidance materials may promise) it operates as a simple dead end.”

Judge Arthur Randolph dissented to denial of the BOP’s failure-to-exhaust claim. Nevertheless, the injunctions were vacated and the cases remanded with instructions for the district court to conduct those “plaintiff-specific” inquiries that Court found lacking. Plaintiffs were represented on appeal by attorneys Jennifer L. Levi, Ernest Galvan, Kara J. Janssen, Adrienne Spiegel, Ben Hattem, Alexander Shalom, Natalie J. Kraner, Shannon Minter, Amy Whelan, Sarah Austin and Eve L. Hill, with an appearance by Christopher Stoll. See: Doe v. Blanche, 172 F.4th 901 (D.C. Cir. 2026).  

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Related legal case

Kingdom v. Trump