The Supreme Court on Wednesday denied the Trump administration's emergency request to enforce new restrictions on medical care for transgender inmates in federal prisons, leaving a lower court order in place that requires the Bureau of Prisons to continue providing hormone therapy and related services.

The one-sentence order rejected the Justice Department's bid to pause a district court ruling that found the Bureau of Prisons had not adequately justified ending the treatments. The policy stems from an executive order President Trump signed on his first day back in office last year, which bars federal funds for procedures aimed at conforming an inmate's appearance to the opposite sex. The Bureau of Prisons implemented the changes earlier this year, limiting services to psychotherapy and psychiatry while halting hormones, surgeries, and social accommodations such as wigs and makeup.

The decision marks a rare setback for the Trump administration at the high court on transgender issues. Conservative Justices Clarence Thomas and Samuel Alito dissented from the order. The administration had argued that the restrictions were needed for institutional security and reflected updated scientific assessments, but the lower court determined insufficient evidence supported the abrupt policy shift.

Lawsuits challenging the policy were filed by transgender inmates, leading to a class action that seeks to preserve access for those diagnosed with gender dysphoria. Court records indicate roughly 600 to 1,000 federal inmates have been affected by the prior provision of such treatments. The ruling applies while broader litigation continues in lower courts.

The outcome preserves the status quo on taxpayer-funded interventions in federal facilities, despite the administration's efforts to align policy with biological sex distinctions emphasized in the executive order. The Supreme Court has previously permitted other Trump administration measures on transgender matters, including military service restrictions, to proceed.