On his first day in office for a second term, former President Donald Trump signed several executive orders, including one aimed at transgender individuals in the federal prison system.
The order, titled “Defending Women from Gender Ideology Extremism and Restoring Biological Truth to the Federal Government,” specifically targets transgender inmates. It criticizes “ideologues” who support self-identification of gender and aims to block transgender women from being housed in women’s prisons or detention centers.
The directive also bans the use of federal funds for gender-affirming treatments or surgeries for incarcerated individuals, reinforcing its stance against gender-affirming medical care.
Transgender Inmates in Federal Prisons
Although transgender individuals make up only about 1% of the federal prison population, the policy change is expected to have significant implications. According to Bureau of Prisons (BOP) data, approximately 2,000 transgender people are currently held in federal facilities. In 2022, the Bureau spent a modest $153,000—just 0.01% of its healthcare budget—on hormone therapy for transgender inmates.
The now-former BOP Director Colette Peters, who oversaw policies regarding transgender prisoners, resigned on Trump’s first day back in office. Her successor, yet to be named, will be tasked with implementing the new order.
Safety and Housing Concerns
Life in prison is already fraught with dangers, but transgender inmates face heightened risks, including extortion, assault, and sexual abuse. Transgender women held in men’s prisons are particularly vulnerable. Of the 1,300 transgender women in federal custody in 2023, only 10 were housed in female facilities.
The BOP’s Transgender Offender Manual—which determines housing decisions on a case-by-case basis—has been revised over the years. While the manual initially came into effect during Trump’s first term, it was slightly updated under President Biden. The policy required considerations such as clear conduct and hormone therapy before making housing decisions.
Former BOP official Alix McLearen defended these policies, emphasizing their focus on safety and legal compliance. “These decisions were never made lightly,” McLearen noted, adding that decisions prioritized the well-being of staff and inmates.
Legal and Policy Challenges
The executive order’s language resembles a controversial Florida law that disrupted access to gender-affirming care for transgender inmates and sparked ongoing legal battles. Trump’s order has reignited debates on transgender rights, with critics warning that housing transgender women in men’s facilities could lead to dangerous outcomes.
Jeffrey Bristol, a lawyer involved in a recent case, expressed concerns about the potential risks. “The answer isn’t throwing them into general population, as it could result in horrific situations,” Bristol said. He also acknowledged the challenges of rewriting rules to ban gender-affirming care while maintaining constitutional protections.
Experts warn that denying gender-affirming care could face constitutional challenges. David Fathi, director of the National Prison Project at the ACLU, highlighted legal precedents that prohibit “deliberate indifference” to the medical needs of inmates. Courts have consistently ruled that failing to treat gender dysphoria constitutes such indifference.
“The law requires individualized medical determinations,” Fathi explained. “Governments cannot preemptively ban gender-affirming care any more than they could deny treatment for conditions like diabetes or cancer.”
Trump’s crackdown on what he calls “gender ideology” aligns with his campaign promises, including controversial ads targeting Democrats for supporting gender-affirming care in prisons. Critics argue that the new policies risk worsening already dangerous conditions for transgender inmates, while advocates continue to fight for safety and medical rights for all incarcerated individuals.