On Jan. 21, Molly was serving lunch in the prison cafeteria when a fellow trans inmate shared the news with her: A day earlier, Donald Trump had signed an executive order declaring that the Bureau of Prisons (BOP) was prohibited from spending money on any gender-affirming care for inmates. Molly realized that she and the 2,000 or so transgender people currently being held in federal prison faced a dire future: being prohibited from receiving gender-affirming care such as hormones for their gender dysphoria.
A month later, Molly learned that a new BOP memo banned gender-affirming commissary items for trans inmates, such as makeup and women’s underwear, calling these offering "items that align with transgender ideology." The memo also required guards to misgender trans inmates. Soon after, makeup, underwear, bras, and other gender-affirming items were removed from Molly's prison commissary.
"I felt the rug pulled out from under me and suspected it was only the beginning," said Molly, who is 50 years old and has been incarcerated for 27 of those years. "Without hope of surgery, I feel I might as well be dead."
In the months since the executive order was signed, I've communicated via letter with Molly and five other incarcerated trans women at her prison. (They live in a low-security prison but didn't want it named for fear of retribution.) For these prisoners, life behind bars during the Trump administration has been marked by fear and uncertainty as their rights are stripped away. "I've already had intrusive thoughts about castrating myself or harming myself," said Bambi, a 28-year-old trans prisoner. "If I were to lose access, I would probably have to be placed on suicide watch."
The executive order wasn't just cruel, it was potentially unconstitutional. Prisons are required by the Eighth Amendment to provide adequate medical care for "serious medical conditions," A.D. Lewis, a lawyer who works with the advocacy group Trans Behind Bars, wrote in a recent memo that he shared with Defector.
(The executive order also stated that trans women living in women's prisons must be moved to male prisons. This didn't affect Molly or most federally incarcerated trans people, because nearly all inmates live in the prison of their birth gender.)
Molly stressed that the executive order was misguided, mistaking medical care for a culture-war issue."The order purports to protect women from gender ideology, but those needing treatment for gender dysphoria are not fighting for ideology but for health. It is a medical issue, not political," she said.
On June 3, after three trans inmates sued, 81-year-old Reagan-appointed federal judge Royce Lamberth granted a preliminary injunction, which would stop Trump's order from going into effect for the duration of the litigation of their case.
Despite Lamberth's decision, at Molly’s prison, gender-affirming commissary items remained unavailable.
"The executive order greenlights state-mandated discrimination against trans people in county jails or prisons," Lewis said. "It's a green light for increased harassment, misgendering, and assault for a population that already suffers disproportionately behind bars." Lewis sees the executive order as part of a broader anti-trans agenda that the Trump administration seeks to inflict on all trans people. "The Trump presidency wants to do everything in its power to make being trans difficult, expensive, impossible, ostracizing … Because ultimately, I believe that this is a huge effort to ensure that trans people get criminalized and are coercively detransitioned," he said.
Before Trump's order, life behind bars wasn't great for Molly or the other trans women. They experienced everything from misgendering, struggles to get proper treatment, harassment from guards and inmates, time in solitary, and sexual assault.
But life in a federal prison was better than life in county jail, where transgender inmates, who number about 5,000, are not afforded much protection. In county jail, Bambi was sexually assaulted for being trans, as was Emily, who has been incarcerated since 2017. Sexual assault is unfortunately extremely common for all inmates, but even more so for trans people. Trans inmates are nine times more likely to be assaulted, according to a 2015 survey by the Bureau of Justice.
"Imagine being trapped in a box full of strangers and sexual predators, and they either want to fight you or have sex with you or both," said Ashley Jane, 29, who has been behind bars seven years.
"Because of the executive order, the protections offered by the BOP are slowly being taken away," Bambi said. "At this rate, it is only a matter of time before BOP facilities are just as dangerous for transgender inmates."
Before January 2025, Bambi and the others were receiving some treatment for their gender dysphoria, but it was inadequate. Bambi, who has been behind bars for two and a half years, said they were not given access to an endocrinologist and that trans prisoners are "extremely limited" in how they are allowed to express themselves. "We experience 10 times the amount of gender dysphoria than we would on the outside," she said.
Though the women I spoke to had all been able to access hormones before the executive order, many said they weren't given adequate doses. Molly told her doctor she thought the dose was too low, and they refused to adjust it. So, she shifted her hormones through a cruder method: by having another prisoner castrate her.
Aileta, a 33-year-old trans woman who has been incarcerated for 11 years, said she initially was only prescribed a testosterone blocker. "After years of fighting, I finally got estradiol," she said.
Though gender-affirming items were available at the commissary, trans prisoners had to use a special-purpose order process to buy them at exorbitant cost. "A 1.5-ounce Lady Speed Stick and a six-pack of Hanes panties cost $51.55," Emily said. "Those same items from Walmart.com at that time cost only $15."
Before January 2025, misgendering and guards performing excessive pat-downs of trans inmates were a regular occurrence. "[They] criticized my 'choice' to be transgender," Molly said. Brittany, 39, has also been put in solitary numerous times just because she's trans, which is done ostensibly for safety.
"[Trans people] are being forced in solitary confinement regularly under the guise of protection, when in reality, it's prolonged isolation and torture," said Anastasia Franco, the national prison correspondence coordinator at Critical Resistance, a prison abolition non-profit.
There is a double-standard in prison when it comes to personalizing garments, Bambi said. "Plenty of other inmates alter their clothing to fit better or tighter, but I cannot without my clothing being confiscated," she said. "Inmates wear chain necklaces … but I and other trans inmates aren't allowed to wear beaded necklaces made in our own BOP hobby shop because it makes us 'stand out' too much as if looking like a woman in an all-male prison doesn’t already."
Since the executive order in January, life has become even more difficult. Some inmates have had their hormone levels reduced. Molly lost access to finasteride, and doctors refused to increase her estradiol. Brittany, who has been incarcerated for eight years and on HRT for 17, was taken off the anti-androgen finasteride and her estradiol was lowered. "The[y] keep saying my estrogen levels are 'too high for a male,'" she said. Emily was taken off finasteride, too. Lewis has fielded anxious phone calls from trans inmates throughout California who are wondering how they can safely taper off hormones if the government forces them to.
Pat-search exemptions have been taken away, too. These exemptions allowed trans inmates to request pat-downs by a female guard. The exemptions were a key part of the Prison Rape Elimination Act (PREA), which is intended to protect trans people and other minorities from sexual assault. According to Franco, over half of trans women in men's prisons report being victims of sexual violence, much of it by guards. "The state is using prisons to punish people for being trans, to frame trans people as threats, at the same time ignoring the actual violence of guards, police, and prisons themselves," Franco said.
Nell Gaither of the Trans Pride Initiative, a non-profit that works with incarcerated trans people, said that strip searches are sometimes used as a cover to sexually abuse inmates. Brittany no longer has a pat-search exemption and Bambi, who had filed for one, will not be getting one.
"I do fear that, being emboldened by the hateful speech in the executive order, there is a possibility for male officers to use the pat-searches to make fun of or sexualize us," Bambi said. But there are some rays of hope. The inmates I corresponded with told me that the 20 or so inmates in their prison who identify as trans or gender non-conforming have come together while the government attacks them. "We have a very strong LGBTQ community among inmates at this facility," Ashley Jane said. "We are all sticking together and doing what we can to keep each other informed and in good spirits … Even those of my friends who are cisgender/hetero think the E.O. is a crock of shit. They see us every day, they know how negatively we're impacted."
Some staff are also providing support. Bambi, whose hormones were not altered, said the medical and psychology staff told her that "they have no desire to take away anyone's hormone replacement therapy … [because] it would cause adverse medical complications … and [is] wrong ethically." Emily said that for the most part, "staff have been professional and courteous during this period. Some have even checked in with me to make sure I am OK."
The psychology department is also supporting trans inmates, who regularly meet with them to discuss questions and concerns. "A large majority of the department's staff members were genuinely concerned when news of the E.O. came around. They understand that gender dysphoria is real and has real impacts on our lives and mental health," Ashley Jane said. "They told us that they are doing what they can to follow the guidance, but in a way that keeps the respect of our identities intact." Instead of misgendering inmates, they are using inmates' last names.
Although staff are willing to fight for them, "they are only capable of so much," Bambi said.
So inmates are turning to those on the outside. Ashley Jane has instructed her family to contact advocacy groups in her home state of Iowa, including the ACLU and LGBTQ organization One Iowa. "Though not much if anything has arisen from reaching out, I like to hope that my voice is being heard," she said. "I was and still am determined to do what I can to fight for my medical rights."
It's hard for the inmates to be optimistic. "Life in here is already stacked against us. If Trump continues this inquisition against us, people will get hurt and some will die," Aileta said. According to Trump's executive order, sex is "immutable" and gender identity is a fiction. "If we don't exist to the government, do any injustices done onto a trans person exist?" Ashley Jane said. Bambi fears the worst: "I am afraid that, with the full might and discretion of the federal government, my identity as a human being will disappear."
Whether the plaintiffs will prevail and HRT will remain available for inmates who already have it is unclear. Inmates newly diagnosed with gender dysphoria, however, will probably not have access. And it's up in the air as to whether gender-affirming commissary items will ever return. "As we are powerless in this situation, all we can do is wait to see what they will take from us next," Bambi said.
Ashley Jane is concerned not just about herself, but those whose sentences are much longer. "I only have two or so years left to serve. I am worried for those I will inevitably leave behind, those who still have a long, long time to deal with the fallout and aftershocks of this hate-filled, tyrannical, autocratic, hypocritical presidential administration," she said. "I know it's only four years, but for those that will suffer, the pain will last a lifetime."
