Under Trump, U.S. Prisons Offered Gender-Affirming Care

A campaign ad released by former President Donald J. Trump in battleground states slams Vice President Harris for supporting taxpayer-funded transgender surgeries for prisoners and migrants, concluding: “Kamala is for they/them. President Trump is for you.”

But the Trump administration’s record on providing services for transgender people in the sprawling federal prison system, which houses thousands of undocumented immigrants awaiting trial or deportation, is more nuanced than the 30-second spot suggests.

Trump appointees at the Bureau of Prisons, a division of the Justice Department, provided an array of gender-affirming treatments, including hormone therapy, for a small group of inmates who requested it during Mr. Trump’s four years in office.

In a February 2018 budget memo to Congress, bureau officials wrote that under federal law, they were obligated to pay for a prisoner’s “surgery” if it was deemed medically necessary. Still, legal wrangling delayed the first such operation until 2022, long after Mr. Trump left office.

“Transgender offenders may require individual counseling and emotional support,” officials wrote. “Medical care may include pharmaceutical interventions (e.g., cross-gender hormone therapy), hair removal and surgery (if individualized assessment indicates surgical intervention is applicable).”

The statement, in part, reflected guidelines that officials in the Obama administration released shortly before they left office in January 2017, which were geared at ensuring “transgender inmates can access programs and services that meet their needs.”