On October 21 the Supreme Court denied the Trump administration's request to pause a lower-court injunction against a Bureau of Prisons policy that would end hormone therapy and other treatments for transgender inmates. The order gave no reasons; Justices Clarence Thomas and Samuel Alito said they would have granted the stay.

The injunction by U.S. District Judge Royce Lamberth stays in place while the litigation continues; the D.C. Circuit had also declined to pause it. The class action, Kingdom v. Trump, argues the policy violates the Eighth Amendment's ban on cruel and unusual punishment. According to the ACLU, the class covers about 1,000 inmates with a gender dysphoria diagnosis, roughly 800 of them prescribed hormones. In its filings the administration argued that providing the care puts recipients at risk of attack and raises "fairness concerns" with other inmates. NPR notes the decision is at odds with other recent rulings that sided with the administration's transgender policies.