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It’s going to be another bad year for trans rights at the Supreme Court, and this time, it may cost lives. The justices will soon consider the case of Alishea Sophia Kingdom, a transgender woman who’s incarcerated in the federal prison system. In a statement filed in court, she explains that she knew from the age of 7 that she was a girl, and when she was incarcerated, the doctors at the Federal Bureau of Prisons diagnosed her with gender dysphoria and prescribed her hormone therapy. But on Jan. 26, 2025, less than a week after Donald Trump took office, BOP staff told her she couldn’t get hormones any more. They started misgendering her, and they even removed the books with LGBTQ themes from the prison library.

The denial of care, Kingdom says, made her gender dysphoria become incapacitating. She experienced anxiety, panic attacks, and mood swings. She can’t sleep. She began having suicidal thoughts. The ACLU filed a lawsuit on her behalf, and a federal judge entered a preliminary injunction finding that the policy was probably unlawful and directing the government to continue providing medical care while the litigation goes forward.

Cathy Thompson, a psychologist and prison administrator who formerly worked for the BOP as its acting national administrator for psychology services, explained to the court that cutting off care for trans inmates is not only unhealthy but dangerous, “potentially causing attempts to self-castrate, self-harm, suicide, and aggression.”

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As the ACLU’s brief observes, the Trump policy is a sudden about-face for an agency that has been providing healthcare for trans inmates for decades. Before 2026, the rule has been that if you were getting hormones at the time you’re incarcerated, you’d continue to get them during your incarceration. And in 2010, the Bureau of Prisons made a new rule that prisoners could start........

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