Kingdom v. Trump – Challenging Denial of Gender Affirming Care to Incarcerated People with Gender Dysphoria

This case concerns a ban on life-saving medical treatment for incarcerated people with gender dysphoria.

Gender dysphoria arises when someone experiences clinically significant distress based on an incongruence between their gender identity (that is, their internal sense of gender) and sex designated at birth. Everyone has a gender identity; however, for some people, it does align with their sex assigned at birth. That, in and of itself, is not a health disorder. Gender dysphoria arises when people experience clinically significant distress from the incongruence. If untreated, gender dysphoria can result in severe anxiety and depression, self-harm, and suicidality.

The widely approved treatment for gender dysphoria resolves the distress by enabling individuals to live consistently with their gender identity. That can involve social transition (such as using a name, pronoun, and clothing associated with one’s gender identity), hormone treatment to masculinize or feminize the body, and surgeries to change certain sex characteristics. During the first Trump administration, and the Biden administration, the Federal Bureau of Prisons (BOP) provided gender affirming care to incarcerated people with gender dysphoria when a doctor concluded doing so was appropriate.

On January 20, 2025, President Trump issued an Executive Order titled “Defending Women from Gender Ideology Extremism and Restoring Biological Truth to the Federal Government.” The order bans BOP from using federal funds for “any medical procedure, treatment, or drug for the purpose of conforming an inmate’s appearance to that of the opposite sex.” BOP responded to the order by banning incarcerated transgender people from obtaining accommodations (such as gender-appropriate undergarments) and terminating (or threatening to terminate) their hormone treatments. BOP restored at least some individuals’ hormone treatment, but only after this lawsuit was filed and a court intervened in a related case.

Plaintiffs Alishea Kingdom, Solo Nichols, and Jas Kapule—all incarcerated transgender individuals with gender dysphoria—bring this case on behalf of themselves and others similarly situated in order to protect their basic right to crucial medical care and equal treatment under the law.

On June 3, 2025, a federal district court judge certified a class of affected individuals and preliminarily enjoined the government from enforcing the ban against them. In accordance with the requirements of the Prison Litigation Reform Act, the court has renewed the preliminary injunction multiple times.

In February 2026, BOP issued a policy (Program Statement 5260.01: Management of Inmates with Gender Dysphoria). Like the EO and BOP’s earlier policy, the Program Statement prohibits hormone therapy and social accommodations to treat gender dysphoria. It prohibits initiation of hormone therapy to treat gender dysphoria and requires those already receiving hormone therapy to be tapered off (reducing with the goal of discontinuing) hormones.

On April 29, 2026, Plaintiffs filed a supplemental complaint and motion for an updated preliminary injunction addressing BOP’s Program Statement. On June 17, 2026, the district court granted Plaintiffs’ motion for an updated preliminary injunction, blocking BOP from enforcing the Program Statement while this lawsuit continues.

The government appealed the district court’s June 17 preliminary injunction order and moved to stay the order pending its appeal in both the district court and in the U.S. Court of Appeals for the D.C. Circuit. Separately, the government has also moved for summary judgment in the district court. The district court denied the government’s motion to stay the June 17 preliminary injunction and has not yet decided the government's motion for summary judgment. The Court of Appeals has not yet ruled on the government’s motion to stay.