DOJ's fight against trans medical care in prison is a fight to erase trans people in the law

"The pendulum has swung," DOJ's Jared Littman said in a court hearing Wednesday, arguing that all transgender people — at all ages — can be denied needed medical care.

On Wednesday morning, the Justice Department went to court to advance an argument that, if accepted, would all but erase the existence of transgender people in the law.

The request before the court from several transgender people in federal prison is for an order to block the Trump administration’s policy to move trans women to men’s facilities and “taper” all trans people’s hormone treatment — with an admitted goal of ending its provision to trans people in prison altogether.

The argument has not gotten as much attention as other cases, dealing as it does with trans people in prison. According to the plaintiffs’ lawyers, there are roughly 1,000 trans people in federal prison, so this is a significant population being affected in and of itself.

Barely beneath the surface, however, was a much more broad and consequential argument from DOJ — moving beyond even DOJ’s growing attack on care for trans minors.

“The pendulum has swung,” DOJ’s Jared Littman told U.S. District Judge Royce Lamberth of what he characterized as a growing opposition to the provision of gender-affirming medical care for trans people of all ages.

Lamberth, a Reagan appointee, was skeptical of Littman’s arguments. He has repeatedly issued temporary restraining orders and then preliminary injunctions blocking the Trump administration’s anti-trans efforts in federal prisons (including holding a contempt hearing) and did so again with a preliminary injunction order on Tuesday.

Far quieter in his older age, the judge who has regularly sparred with the executive branch over his nearly 40 years on the bench still maintains a strong command of his courtroom on the sixth floor of the E. Barrett Prettyman U.S. Courthouse in D.C.

When Littman insisted that the plaintiffs’ lawyer, the ACLU of D.C.’s Michael Perloff, was incorrect to call the Federal Bureau of Prisons’s policy a “categorical ban,” Lamberth essentially told Littman that that was how he read the policy himself.

The best Littman could come back with is that the policy requires “individualized tapering bans,” but Lamberth pushed back, and eventually Littman acknowledged that the end goal of the policy is discontinuing hormone therapy for any of the roughly 600 trans federal inmates on hormones.

It was the actual legal arguments advanced by DOJ on Wednesday, however, that signal how far the administration appears ready to go to attack not just those 600 people’s medical treatment but any trans people’s medical care and broader legal recognition.

Highlighting the U.S. Supreme Court’s 2025 decision upholding Tennessee’s ban on gender-affirming medical care for trans minors, U.S. v. Skrmetti, DOJ earlier this month in its brief argued:

Plaintiffs’ Equal Protection claim fails because the 2026 Policy “does not prohibit conduct for one sex that it permits for the other.” United States v. Skrmetti, 605 U.S. 495, 514–15 (2025). Under the Policy, “no [inmate] may be administered . . . hormones [absent certain circumstances unrelated to an inmate’s sex, or provided social accommodations or sex trait modification surgery] to treat gender dysphoria.” Id. at 515.

Littman was more succinct — and blunt — on Wednesday.

“This is just an extension of what the court said in Skrmetti,” he told Lamberth.

In its briefing, DOJ went on to argue that “the 2026 Policy does not, in the words of Skrmetti, ‘prohibit conduct for one sex that it permits for the other’ but instead turns on ‘the underlying medical concern the treatment is intended to address,’ i.e., gender dysphoria.”

Echoing, while expanding, Chief Justice John Roberts’s disingenuous majority opinion from Skrmetti, DOJ now has made clear that it views — and plans to use — Skrmetti as a free-for-all to go after trans people of all ages by denying that, so far as the law is concerned, trans people exist at all.

Using Roberts’s logic, DOJ’s argument would mean that virtually any anti-trans law or policy can be reconfigured to make it neither a sex-based classification nor a trans-status-based classification:

As the Supreme Court and D.C. Circuit have recognized, not all trans-identifying individuals have gender dysphoria. Skrmetti, 605 U.S. at 502; Talbott v. United States, No. 25-5087, 2025 WL 3533344, at *2 (D.C. Cir. Dec. 9, 2025); Doe 2 v. Shanahan, 755 F. App’x 19, 24 (D.C. Cir. 2019). The classification is thus not based on trans-identifying status. See Skrmetti, 605 U.S. at 514–15 ….

As such, DOJ argued that rational basis applies and that BOP clearly had legitimate reasons for its policy.

It’s not just the Fourteenth Amendment’s Equal Protection Clause. DOJ would expand Skrmetti’s anti-trans reasoning to the Eighth Amendment’s bar on cruel and unusual punishments:

BOP’s decision to choose one side of the “fierce scientific and policy debates” about gender dysphoria treatment, Skrmetti, 605 U.S. at 525, does not offend the Eighth Amendment just as surely as the Tennessee law banning certain types of treatment for gender dysphoria at issue in Skrmetti did not offend the Equal Protection Clause of the Fourteenth Amendment.

The arguments are unlikely to work before Lamberth, but the case will soon be back before the U.S. Court of Appeals for the D.C. Circuit, where Lamberth’s initial rulings faced more scrutiny and the court sent the case back for more individualized development. After that, possibly, the case could find its way to the U.S. Supreme Court. At that point, DOJ would have a far more receptive audience judging by Roberts’s Skrmetti decision for the court (and other Republican appointees’ writings in that case).

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After Perloff had argued to Lamberth about the uncontroverted view of medical associations about the value of gender-affirming medical care, Littman repeatedly insisted that wasn’t true — primarily citing a handful of court opinions saying so and relying on Trump administration-related policy developments.

“It is controverted,” Littman insisted.

Although that sounded weak on Wednesday, that was enough for Roberts when rational basis was applied to the law at issue in Skrmetti. “Tennessee concluded that there is an ongoing debate among medical experts,“ he wrote.¹ In other words, manufactured debate is still a debate.

DOJ appears to be ready and willing to take all of the least coherent and defensible parts of Roberts’s Skrmetti opinion, expand them, and then apply them in new and varied areas of the law to pull back trans people’s rights.

Jared Littman gave a preview of how far that could go on Wednesday.

1. The full quote: “As we have explained, there is a rational basis for SB1’s classifications. Tennessee concluded that there is an ongoing debate among medical experts regarding the risks and benefits associated with administering puberty blockers and hormones to treat gender dysphoria, gender identity disorder, and gender incongruence. SB1’s ban on such treatments responds directly to that uncertainty.”