Dee Farmer sees great risk if the federal government succeeds in its efforts to end critical health care for incarcerated people with gender-affirming care needs. “People will die,” Farmer told the Vera Institute of Justice (Vera), she herself a formerly incarcerated transgender woman who has been fighting for the rights of people in prison for decades, advocating for access to gender-affirming care behind bars.

In an extension of relentless attacks on the rights and dignity of transgender people by the Trump administration, the Federal Bureau of Prisons (BOP) issued a new policy in February 2026 that directed federal prisons to stop providing critical gender-affirming care, including hormone therapy. This is in keeping with an executive order President Donald Trump issued in January 2025, targeting transgender people in the federal prison system, limiting access to gender-affirming care behind bars.

Last June, Senior Judge Royce Lamberth of the U.S. District Court for the District of Columbia issued a preliminary injunction to block the BOP from withholding gender-affirming care while a class action lawsuit—Kingdom v. Trump brought by the ACLU and Transgender Law Center to challenge the executive order—proceeded. And just last week, the judge ordered the BOP for the second time to continue providing hormone medications to transgender people in federal prisons, in response to the BOP’s new policy. Prison officials should heed the judge’s order. The class action lawsuit is still ongoing.

During legal maneuvering over this executive order, incarcerated people have reported that prisons around the country have not complied with last year’s preliminary injunction and are delaying or denying the care that transgender people need, despite the court order. “Denial of treatment . . . has resulted in suicide before,” Farmer told Vera about the fight for gender-affirming care behind bars. “People are at risk.”

Farmer is best known for her victory in the landmark 1994 Supreme Court case Farmer v. Brennan, which established that a prison official’s “deliberate indifference” to risk of serious harm to an incarcerated person violates the Eighth Amendment of the United States Constitution’s prohibition against cruel and unusual punishment. Farmer also sued for the right to adequate medical treatment in prison, including hormone therapy.

Read the full article about gender-affirming care behind bars by Erica Bryant at Vera Institute of Justice.