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President Trump has ordered federal prisons to house transgender inmates in male facilities and suspend medical treatment related to gender transition.

The move was part of a broad executive order issued by Mr. Trump on his first day in office aimed at limiting government recognition of an individual’s gender to their sex at birth.

The Prisoners Directive also applies to detainees with immigration backgrounds and is one of the most concrete parts of the ordinance. Mr. Trump imposed some restrictions on housing and health care for transgender prisoners during his previous term, but the new measure went further.

The Women’s Liberation Front, which defines women based on their sex at birth and advocates single-sex prisons, called the directive a “major victory.” The group is challenging a California law that allows inmates to request housing that matches their gender identity. It argues that the law violates the constitutional rights of inmates who are not transgender, including the Eighth Amendment right to protection from cruel and unusual punishment.

Mr. Trump’s order echoes these arguments, asserting that “efforts to eradicate the biological reality of sex fundamentally attack women by stripping them of their dignity, safety and well-being.”

Advocates for transgender people and inmates criticized the order, saying it would put them in danger.

“There will be rapes and physical assaults because of this policy,” said Shannon Minter, legal director of the National Center for Lesbian Rights, which represents transgender prisoners. “It’s also terrible for prison officials, who now have the power to exercise discretion over what makes the most sense for the safety and security of the facility.”

Legal experts said it would also be vulnerable to legal challenges. Federal courts have held that prison systems are required to protect vulnerable inmates. Some also argued that they were required to offer medical care such as hormonal therapies to inmates diagnosed with gender dysphoria, the distress associated with a mismatch between body and gender identity.

In 2022, a federal district judge in Illinois ordered the office to perform gender transition surgery on a transgender inmate after finding that refusing the procedure was most likely a violation of the Eighth Amendment, which also guarantees right to necessary medical care.

“Constitutional protections do not end if a person is in prison, or in immigration detention centers,” said Richard Saenz, an attorney with Lambda Legal, an LGBTQ legal advocacy organization.

Mr. Trump’s executive order, titled “Defending Women from Ideological Gender Extremism and Restoring Biological Truth to the Federal Government,” appears to require rehousing only transgender women, not transgender men.

The ban was part of an executive order issued by Mr. Trump on his first day in office.Credit…Haiyun Jiang for the New York Times

The number of people affected is relatively small. There are about 1,500 federal prisoners who are transgender women, according to the Bureau of Prisons. But they represent a considerable share of federal prisoners, particularly among women: 15% of incarcerated women are transgender. There are 750 transgender men out of approximately 144,000 male prisoners.

Transgender people make up less than 1% of adults in the United States, according to the Williams Institute, a research center at the University of California, Los Angeles, law school that studies the LGBTQ population. It’s unclear why that number is higher in federal prisons, but experts point to studies that show transgender people are more likely to attract the attention of law enforcement. They are also more likely to face family rejection and economic hardship.

Federal data shows that transgender inmates are 10 times more likely to report being victims of sexual violence than other inmates.

The Supreme Court recognized the vulnerability of transgender prisoners decades ago in Farmer v. Brennan 1994. The plaintiff in that case was a transgender woman, Dee Farmer, who said she was raped while living with men. The court ruled that the government had a duty to protect prisoners from violence.

Ms. Farmer now leads Fight4Justice, a nonprofit advocacy group for LGBTQ prisoners, including a transgender woman who is currently on suicide watch after being the target of abuse at the Washington, D.C., prison, she said. she declared. The jail is not a Bureau of Prisons facility.

The Bureau of Prisons has informed transgender prisoners of impending changes, she said, adding, “Yesterday I received three calls from inmates panicking about what was going to happen to them. »

Under the Prison Rape Elimination Act, transgender status is one of several risk factors considered when determining housing assignments. The new decree calls for these regulations to be amended “if necessary.”

At the end of the Obama administration, the Bureau of Prisons issued new guidelines saying transgender prisoners should be housed according to their gender identity in most cases. During President Trump’s first term, it was revised to require housing based on “biological sex” except in rare cases. But the first Trump administration did not consider this issue a central policy priority.

The administration of President Joseph R. Biden Jr. reinstated Obama’s guidelines. During the 2024 presidential campaign, a key part of the Republicans’ strategy was to portray Democrats as out of step with the mainstream on transgender issues. A widely circulated ad attacked Vice President Kamala Harris for supporting “taxpayer-funded prisoner sex changes” as a candidate in the 2020 Democratic primary.

Some of Mr. Trump’s supporters had hoped he would issue an executive order on his first day in office regarding transgender athletes in sports, which would affect many more people. But they welcomed the prison directive as a sign of his willingness to act on transgender issues.

“We are encouraged to see these privacy protections in women’s prisons and rape shelters, ensuring that no woman ever faces abuse, harassment or loss of privacy and of his dignity from a man sharing these intimate spaces,” said Matt Sharp, senior attorney and director of public policy at Alliance Defending Freedom, a conservative legal advocacy group.

The order requires that all medical care related to gender transition cease, stating that no federal funds should be spent “for any medical procedure, treatment, or medication intended to conform an inmate’s appearance to that of of the opposite sex.”

The American Medical Association says treatments that “affirm gender or treat gender dysphoria” may be medically necessary. These treatments may include psychological counseling, surgical procedures, and hormone therapy. Estrogen, in particular, has several effects sought after by many trans women taking the hormone, including breast growth, finer body hair, and redistribution of body fat.

Stopping treatment may reverse these effects. Jasmine Tasaki, a transgender woman who has been in prison and is now executive director of Black and Pink, a national organization that advocates for the rights of incarcerated LGBTQ people, said taking it away from inmates would cause depression.

“If someone takes hormones and they have breasts, they will disappear. Can you imagine yourself as a woman watching your breasts go? » she said.

Surveys and other studies show that transgender people across the country face particularly harsh treatment in the criminal justice system. When incarcerated, they are often housed according to the sex they were assigned at birth and report receiving substandard medical care. They are also much more likely than other inmates to be placed in solitary confinement, which prisons often claim is for their protection.

Ms Tasaki said she was sometimes placed in solitary confinement and not allowed to bathe.

Under a new policy adopted in Florida last fall, prison officials forced transgender women to cut their hair, ditch their bras and meet much stricter requirements to obtain treatment related to gender transition, according to a lawsuit filed by the American Civil Liberties Union.

Rana Adam

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