The Federal Bureau of Prisons has rejected calls from Democratic senators to reverse a series of policies affecting incarcerated transgender people, including restrictions on gender-affirming care and rules requiring staff to use names and pronouns tied to inmates’ sex assigned at birth.
The policies followed a Trump executive order issued earlier this year.
In an 11 May letter sent to Acting Attorney General Todd Blanche and Bureau of Prisons Director William K. Marshall III, Senators Ed Markey, Jeff Merkley, and Mazie Hirono urged the agency to withdraw policies they said endanger transgender inmates and deny them dignity and medically necessary care.
The senators also warned that some of the new guidance may violate existing federal court injunctions connected to ongoing lawsuits challenging the policies.
Bureau defends policy changes
BOP spokesperson Donald Murphy defended the changes in a statement to the Washington Blade on 14 May, claiming the current administration’s approach is based on “best medical practices”.
Murphy criticised Biden-era policies, saying: “Unlike the prior administration’s one-size-fits-all approach, the BOP’s new policy ensures individualised assessments and treatments. And while the previous administration’s policies on treating inmates with gender dysphoria was driven by radical ideology, the BOP’s current policy is based on medical studies, medical expert opinions, state correctional policies, caselaw, and penological concerns. Absent court order, there are no plans to reconsider or revisit the policy.”
However, the bureau did not specify which medical experts or studies support its position.
Every major US medical association supports gender-affirming care as safe and effective for transgender people.
Senators warn of “significant harm”
According to the senators, the February 2026 policy blocks gender-affirming care even when inmates are willing to pay privately, requires some trans inmates to gradually stop hormone therapy, and replaces gender-affirming treatment with psychotherapy.
“By stripping away appropriate medical and psychiatric care, safety protections, and measures to provide dignity, the BOP is exposing transgender individuals to significant harm,” the senators wrote.
The dispute adds to growing legal and political battles over the treatment of transgender people in US prisons, as advocates warn that denying gender-affirming care and refusing to recognise people’s names and pronouns can deepen isolation, distress, and risk of harm behind bars.
