The Trump Administration Admits to Medically Experimenting on Trans People in Prisons

The Trump administration admits to testing conversion therapy on trans prisoners and implies its policy of forcibly detransitioning trans men in prisons has the aim of preserving their fertility.

Image: Ye Jinghan // Unsplash

Last month, the Trump administration released its new policy concerning the treatment of trans people in federal prisons. As Transitics reported at the time, this policy is nothing short of egregious: under it, the ~2,200 trans people in federal custody will be medically and socially detransitioned against their will, all in the name of helping them “recover” from gender dysphoria.

When coupled with the controlled environment that is prison, this forced conversion therapy policy amounts to little more than medical experimentation—and it’s in explicit violation of most of the Nuremberg Code, which was created in the aftermath of WWII. Simply put, if the courts allow it to take effect, this policy will undoubtedly lead to tremendous suffering.

At the time the Bureau of Prisons’ policy was published, the biggest questions surrounded what, if anything, the Trump administration had relied on when making it. However, on March 12th, these questions were answered after the BOP was forced to release an administrative record for the policy, which contains everything the Trump administration considered during the policy-making process.

In this case, the administrative record lists around 80 different sources—including studies, journal articles, news stories, and policies—and these can be sorted into 3 broad categories. The first of these categories contains the sources supporting gender-affirming care access in prisons and more generally, and this alone makes up around half of the sources listed.

While the inclusion of things like the DSM 5, WPATH Standards of Care, and APA & Endocrine Society guidelines isn’t particularly surprising, it does establish that existing standards were acknowledged but willfully ignored by the BOP. Furthermore, the Trump administration also reveals that it evaluated prison policies from California, Minnesota, and Oklahoma—all of which explicitly affirm trans prisoners’ healthcare access—along with Kentucky’s policy, which does not provide gender-affirming care due to a 2023 law but still allows for social transition.

On top of this, the BOP overturns its own policies from over a decade ago and cites—but evidently ignores—two journal articles arguing that prisons are both ethically and legally bound to provide care to the trans people in their custody. Finally, the rest of the sources in this category are studies and statements from medical professionals that reinforce the scientific consensus surrounding gender-affirming care, including one concerning a trans woman’s psychosis that resulted from medical detransition and another that found most detransitioners do not regret the care they received.

The 20 sources that were clearly used to refute the established medical consensus fall into the second category, and through these sources, it becomes increasingly evident that the BOP did not create the prison policy in good faith. First of all, many of these are not relevant to the topic to begin with. In fact, the two most notable sources in this category, the Cass Review and the review conducted by RFK Jr.’s HHS, deal exclusively with the treatment of trans minors. Because minors are not housed in federal prisons, the BOP has no reason to consider these reviews—or the three other sources solely about trans kids, for that matter—when making this policy.

Secondly, a few more of these sources were not created in good faith, either. And here, three stick out: the Florida policy that the BOP copied word-for-word in many places, which was, by Florida’s own admission, created in response to political pressures against gender-affirming care; a 2024 detransition prevalence study conducted by Finnish psychiatrist Riittakerttu Kaltiala, who has deep ties to anti-trans SPLC-designated hate group Society for Evidence-Based Gender Medicine (SEGM); and a declaration from Kristopher Kaliebe, a known opponent of gender-affirming care who was one of the nine authors of the HHS review, which was specifically sought by the BOP when it was creating this policy.

Finally, another 6 sources are being used rather disingenuously. These 6 are studies relating to the long-term health effects that could result from gender-affirming care—all of which were conducted in order to further understand trans people’s specific health needs. Most importantly, it’s worth pointing out that the studies analyzing trans people’s risk of developing cancer, insulin resistance, and cardiovascular disease emphasize that they were not able to establish a causation between these things and hormone therapy.

However, by including them, along with two studies dealing with gender-affirming surgery complications and another concerning weight gain, the BOP is arguing that, despite the proven benefits, gender-affirming care as a whole is dangerous and risky. Thus, under this framing, Trump officials are essentially asserting that withholding gender-affirming care is necessary to prevent these outcomes—outcomes this care has not been shown to cause in the first place.

The last category constitutes the Trump administration’s unequivocal admission of guilt, and it consists of the final 16 studies. The first 10 of these concern trans people’s suicide risk, and most of these explicitly emphasize the positive effects of social and/or medical transition. As a result, by admitting that it reviewed this research, the Bureau of Prisons is also admitting that its policy knowingly goes against these findings. Because of this, it can be said that the BOP is fully aware of the risks but is still choosing to endanger the trans people in its custody.

Of course, the ‘justification’ here seems to be that these suicide risks can be avoided entirely if the person simply stops being trans, and therefore, forced detransition is a legitimate course of action. Except that’s not and will never be how it works: the fact of the matter is, trans people can’t be forced to stop being who they are. Attempts to do so are known as conversion therapy—a discredited practice recognized by the UN to be a form of torture. As Transitics previously reported, that torture is exactly what this policy imposes.

The remaining 6 studies provide an even clearer window into what the BOP hopes to achieve and how it views trans people more generally. Firstly, there are the two menopause studies, one that recommends the use of menopausal hormone therapy and another that found a “tapering” approach should be taken when stopping menopausal hormone therapy. And the latter of these two seems to have had a profound impact on the policy: here, trans people will be put on a “tapering plan” when being forced off of hormone therapy.

It goes without saying that, outside of voluntary detransition, this “tapering” is not supported by gender-affirming care research, as it would be highly unethical to conduct it. In other words, the Trump administration relied on research for an entirely different condition when creating this policy—entirely ignoring trans people’s unique health needs. This testing of unproven guidelines evidences the medical experimentation this policy will carry out.

The inclusion of the third study in this category attempts to compare trans women who undergo gender-affirming surgery to those with an entirely unrelated medical condition known as ‘adult acquired buried penis.’ Equating these two is an entirely medically inaccurate and hateful rhetorical decision, and it’s telling of the manner in which the Trump administration is trying to frame trans people’s bodies.

Meanwhile, the fourth study analyzes fertility in 18 trans men who paused their hormone therapy in order to have children, and it constitutes the only fertility study the BOP admits to have reviewed. As if that wasn’t alarming enough, this specific study doesn’t evaluate if trans men can carry children after going off testosterone; it actually evaluates when. Given the fact that the BOP has no legitimate reason to concern itself with fertility, this implies that the Trump administration—at least in part—created the prison policy out of a desire to find out how soon the forcibly detransitioned trans men in its custody will be able to carry children.

Finally, perhaps the greatest confession is provided by the last two sources. The first of these is a medical article providing commentary on a study—a study that was not reviewed during the creation of this policy—of trans patients at Kaiser Permanente clinics, and in its words, its sole purpose is to “describe methods of cohort ascertainment and data collection and to characterise the study population.” Put differently, it communicates two things: how to single out trans people through health information and what data a study on trans people should collect.

On top of this, the second source is a CDC document that sets data collection standards for research into suicide and self-harm specifically. When taken together, these two sources appear to serve as an instruction manual for the Trump administration to collect and evaluate the results of this policy. Additionally, knowing that the BOP also reviewed 10 studies pertaining to trans people’s suicide risk, it’s strongly suggested that the BOP expects an increase in trans suicides, and rather than preventing these outcomes, it wants to sit by and collect the data.

Make no mistake: this checks all the boxes of medical experimentation. By its own admission, the Trump administration is throwing out existing medical standards and instead wishes to force arbitrary guidelines onto a captive population—all the while being fully aware of the risks and actively documenting the results. As Transitics reported last month, this is being done with the intention of ‘helping’ trans people “recover” from gender dysphoria, which is a euphemism for conversion therapy. And this will be imposed onto the ~2,200 trans people in federal prisons until it ‘works,’ until they are released, or until it breaks them.

So far, the judge overseeing the ACLU’s lawsuit against this policy, Reagan appointee Royce Lamberth, has been surprisingly sympathetic towards the plaintiffs and, as a result, has blocked it from being enforced for the ~800 that have been diagnosed with gender dysphoria. However, if the Bureau of Prisons’ policy is eventually allowed to stand by the Supreme Court, it will undoubtedly lead to tremendous suffering among the trans people in federal custody.

Simply put, the Trump administration cannot be allowed to get away with this. Trans people’s lives depend on it.