A federal judge has blocked the Bureau of Prisons from discontinuing hormone therapy for transgender inmates, issuing a preliminary injunction against the agency’s new policy that sought to phase out such treatments. The ruling, handed down on Wednesday by Judge Royce C. Lamberth of the U.S. District Court for the District of Columbia, challenges the Trump administration’s efforts to restrict medical care for transgender prisoners.

Judge Lamberth found that the Bureau of Prisons had failed to provide an adequate justification for reversing its existing policy, which had allowed the continued provision of hormone medications to prisoners diagnosed with gender dysphoria. The judge ruled that the agency’s new stance, which favors psychotherapy and psychotropic drugs over hormone therapy and denies certain gender-affirming items such as bras and cosmetics aligned with an inmate’s gender identity, was likely arbitrary and capricious under the Administrative Procedure Act.

The case is notable for focusing on medical treatment for transgender adults in federal custody, a subject that has been less contentious compared to disputes over transgender healthcare for minors. While the Department of Health and Human Services has questioned hormone therapy for adolescents, citing concerns over risks like infertility, the Bureau of Prisons argued that the benefits of hormone therapy for adults remain unclear. The agency’s February policy update reflected this viewpoint, recommending the discontinuation of hormone therapy and social accommodations for transgender inmates.

Legal representatives for transgender prisoners countered that hormone treatment is the only medically recognized effective approach to managing gender dysphoria, which involves significant distress due to a mismatch between an individual’s birth sex and gender identity. They highlighted the treatment’s longstanding acceptance by major U.S. medical and mental health organizations and raised concerns about the mental health risks associated with withdrawing hormone therapy, including increased depression, anxiety, suicidal ideation, and self-harm.

The Bureau of Prisons estimates that approximately 1,028 federal inmates have been diagnosed with gender dysphoria, with 628 currently receiving hormone treatment to align physical characteristics such as facial hair, voice range, and body composition to their gender identity.

This ruling marks the second time Judge Lamberth has intervened to protect access to hormone therapy for transgender prisoners. In a previous June ruling, he blocked a similar attempt to change treatment protocols, finding that the agency likely violated federal regulations by failing to justify policy changes properly.

The current injunction comes after the government sought to lift the earlier order, arguing that its policy shift was based on extensive review and the conclusion that evidence supporting hormone therapy’s effectiveness was weak. However, the judge determined that the agency’s reasoning was based largely on the opinion of a doctor with limited expertise in gender dysphoria who advocated for psychotherapy, despite admitting that the approach lacks an evidence base.

Judge Lamberth also stated the policy appeared to have been “reverse-engineered” to align with executive orders issued during the Trump administration, a process he found in violation of legal standards requiring agencies to base decisions on sound evidence.

A Justice Department spokeswoman emphasized that the Bureau of Prisons’ policy is intended to ensure treatment consistent with best medical practices, though the court’s ruling will maintain current hormone therapy access pending further legal proceedings.