WASHINGTON — The Supreme Court on Wednesday refused to allow the Trump administration to immediately enforce new medical restrictions for transgender people in prison.

The decision leaves in place a lower-court block on the policy. It was adopted after an executive order from President Donald Trump, who has taken several steps to roll back transgender rights during his second term.

Justice Samuel Alito and Clarence Thomas would have allowed the policy to be enforced.

The Supreme Court has previously allowed other policies for transgender people to move ahead for now, including restrictions on military service and passport sex markers.

Trump’s order called on the Bureau of Prisons to revise its medical care policies so that federal funds aren’t spent “for the purpose of conforming an inmate’s appearance to that of the opposite sex.”

The new policy would halt surgeries, taper off hormones and end social accommodations like makeup and wigs. Prisons would continue to offer mental health services.

Attorneys for transgender inmates challenged the policy in court and U.S. District Judge Royce Lamberth ordered treatments to continue. Lamberth, who was nominated to the bench by President Ronald Reagan, pointed out that untreated gender dysphoria can cause severe side effects like depression, anxiety and suicidal thoughts.

The Trump administration appealed, arguing that treatments raised security concerns and “could no longer be justified.” A divided appeals court panel left the order in place.

About 600 inmates were receiving hormone therapy in 2025, the agency said in court records. Withdrawing care would have significant effects on their bodies and mental health, their lawyers said. The government has not detailed evidence of security problems linked to hormone therapy for transgender inmates over the 30 years it has been provided, they wrote.

The conservative-majority Supreme Court has previously upheld state laws banning certain medical treatments for transgender youth, and restricting sports participation by transgender athletes in women’s sports.