The U.S. Bureau of Prisons (BOP) issued a new program statement on February 19, 2026, titled “Management of Inmates with Gender Dysphoria,” setting out mental-health “evaluation and treatment” guidelines that describe gender dysphoria as a DSM-5-TR mental health diagnosis and define gender identity as “disconnected from biological reality and sex.” Advocates say the policy would end or restrict gender-affirming hormones and require the removal of gender-affirming personal items, but a federal court order in Kingdom v. Trump has required the BOP to continue providing hormone therapy and certain accommodations while the case proceeds.
The Federal Bureau of Prisons on February 19, 2026, issued a new program statement—No. 5260.01—titled “Management of Inmates with Gender Dysphoria.” The document states it is intended to create professional guidelines for the mental health evaluation and treatment of incarcerated people who meet diagnostic criteria for gender dysphoria, with treatment meant to reduce symptoms and support “progress toward recovery.”
In its definitions, the program statement describes gender dysphoria as a diagnosis defined by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5-TR) and characterizes it as distress or impairment stemming from a perceived discrepancy between “expressed/experienced gender identity” and “biological sex.” The glossary also defines “gender identity” as “fully internal and subjective,” “disconnected from biological reality and sex,” and says it cannot be recognized as a replacement for sex.
Advocates for transgender prisoners say the practical effect of the policy would be to restrict gender-affirming care in federal custody. In a statement condemning the new program statement, Shannon Minter of the National Center for Lesbian Rights described it as a “blueprint” for government-run conversion therapy, arguing it would bar hormone therapy for people not already receiving it, require the tapering and discontinuation of hormones for those who are, and direct prisons to “remove or confiscate” items that allow incarcerated people to socially transition.
Court order and earlier directives
The policy arrives against the backdrop of ongoing litigation over the federal government’s approach to transgender prisoners. On June 3, 2025, a federal judge in Washington issued a preliminary injunction in Kingdom v. Trump requiring the BOP to continue providing hormone therapy and “social accommodations” consistent with the policy in effect immediately before a January 20, 2025 executive order. The Associated Press reported the ruling required continued hormone therapy and accommodations for transgender inmates affected by the executive order.
Court filings in the Kingdom case also describe earlier internal BOP memoranda issued in February 2025. A declaration submitted in the case says a February 21, 2025 memo acknowledged the agency had been temporarily blocked from removing medical and mental health care, but directed that certain accommodations—such as gender-affirming pronouns, undergarments and some purchased personal items—were to stop.
The February 2026 program statement itself includes an accompanying legal guidance memo that references the ongoing obligation to comply with the Kingdom injunction while the case continues.
What remains uncertain
Some claims circulating about the new policy—such as whether it mandates forced psychotherapy in all cases or categorically bars all related medications—are not stated in the program statement’s core text as universal requirements and are described in sharper terms mainly by advocacy commentary. Separately, figures cited in some reports about the number of transgender women in federal custody and how many are housed in women’s facilities have varied by source and time period; a court filing cited by the Associated Press said that as of February 20, 2025, there were 22 transgender women housed in federal women’s facilities, and that transgender inmates made up about 1% of roughly 2,200 transgender people the agency said it held.
Advocates also warn that transgender women placed in men’s prisons face heightened risks of sexual victimization, a concern that has figured prominently in legal challenges and public debate over prison placement and protections.
Meanwhile, prison-safety policy has also been affected by federal funding decisions related to the Prison Rape Elimination Act (PREA) infrastructure. The Brennan Center for Justice reported that Justice Department funding cuts in late 2025 terminated funding for the National PREA Resource Center, leading the center to temporarily shut down, though the Brennan Center also reported the department later restored funding to support auditing.
The BOP has not publicly framed the February 2026 policy as a ban on medical care; instead, the program statement presents the policy as mental-health evaluation and treatment guidance for inmates diagnosed with gender dysphoria. But with the Kingdom injunction still in effect, the extent to which the new policy can be implemented remains tied to ongoing court proceedings.
