Management of Inmates with Gender Dysphoria (Program Statement 5260.01)

By Elizabeth Franklin-Best, Esq., and Christopher Zoukis, JD, MBA

Field	Value
Program Statement	5260.01
Subject	Management of Inmates with Gender Dysphoria
Effective / current edition	February 19, 2026 — signed by Director William K. Marshall III (PS 5260.01 at p. 2)
Change notices	None. BOP’s published policy list carries 5260.01 with no change notice.
Supersedes	The Program Statement itself names nothing. It carries no “supersedes” line, no rescission line and no Summary of Changes (PS 5260.01 at p. 2). Its transmittal memo calls it “a new policy” (p. 1). Separately, PS 5200.08, Transgender Offender Manual (1/13/2022), no longer appears in BOP’s published policy set — see What changed.
Governing statute	The Program Statement cites none. The Bureau’s general duties are 18 U.S.C. § 4042(a); the Prison Rape Elimination Act is 34 U.S.C. §§ 30301–30309, and § 30307 is the authority for the Attorney General’s national standards. The PS quotes Executive Order 14168, 90 Fed. Reg. 8,615 (Jan. 30, 2025), at pp. 6–7.
28 C.F.R. anchor	The Program Statement cites no C.F.R. section and implements none. The regulations that bind on this subject sit elsewhere: the PREA standards at 28 C.F.R. part 115 — in particular § 115.15, § 115.41 and § 115.42 — and the non-discrimination rule at 28 C.F.R. § 551.90. See What binds, and what does not.
Related BP forms	BP-A0171, Record of Information Release · BP-A0621, Authorization for Release of Medical Information (PS 5260.01 at p. 5)
Official PDF	bop.gov/policy/progstat/5260_001.pdf

Checked against the BOP policy set · 2026-09-06.

Court order affecting this policy — read before relying on anything below. On August 26, 2026, Judge Royce C. Lamberth entered an order in Kingdom v. Trump, No. 1:25-cv-00691 (D.D.C.), stating that “Program Statement 5260.01 is stayed and that Defendants are ENJOINED from enforcing Program Statement 5260.01 from September 15, 2026 to December 14, 2026” (Dkt. 242). The government filed an interlocutory appeal on August 28, 2026 (Dkt. 245), docketed in the D.C. Circuit as No. 26-5310 on September 1, 2026. As of 8 September 2026 the court of appeals has docketed that appeal and consolidated it with the government’s earlier appeal, No. 26-5236, by clerk’s order of 1 September 2026. The government moved on 30 June 2026 to stay the district court’s order pending appeal; that motion was fully briefed on 27 July 2026 and remains undecided. No appellate stay is in place, so the district court’s order stands. See also our page on the Transgender Offender Manual, which is the policy the injunction returns the Bureau to. This page describes what the Program Statement says. Whether and when it is being enforced is a live question in active litigation, and anyone acting on this page should confirm the current posture first.

Program Statement 5260.01 is the Bureau of Prisons policy that tells staff how to diagnose, evaluate and treat people in federal custody who meet the diagnostic criteria for gender dysphoria. It is a clinical policy: it covers screening, diagnosis, mental-health care levels, psychotherapy, psychotropic medication, surgery, hormones and personal items the Bureau calls “social accommodations” — and it says nothing at all about housing, facility designation, or searches.

That gap matters more than anything else on this page, so it comes first. Housing, designation and search protections for transgender and intersex people in federal prison do not live in this Program Statement. They live in the PREA regulations at 28 C.F.R. part 115, which are law rather than internal policy, and which the Bureau’s own PREA program statement reproduces only in part. If the problem you are trying to solve is where someone is housed or who is searching them, the sections below on the regulation and on protective custody are the ones to read. Our companion page on protective custody explains how the separation route works in practice, and links back here for the clinical rule.

The rule itself: gender dysphoria

Everything in this section is transcribed from the Bureau’s own text at bop.gov/policy/progstat/5260_001.pdf, with the page anchor for each passage. Where the Program Statement uses quotation marks around a term, they are the Bureau’s, not ours.

Purpose, scope and the definitions the rest of the policy runs on

PS 5260.01 at p. 2, Purpose and Scope, transcribed verbatim:

To establish professional guidelines for the mental health evaluation and treatment of inmates meeting the diagnostic criteria for Gender Dysphoria (GD) to assist their progress toward recovery, while reducing or eliminating the frequency and severity of symptoms and associated negative outcomes.

The same page lists three program objectives — “To ensure inmates diagnosed with GD receive timely, appropriate mental health services and individualized treatment programming, as clinically indicated,” with treatment that “shall target psychological distress/dysphoria as well as any co-occurring mental health disorders and be tailored to the unique needs of the inmate”; “To allocate sufficient staff and resources to deliver appropriate services to such inmates”; and “To enhance staff’s understanding of the mental health issues associated with individuals diagnosed with GD and the appropriate treatment that accounts for the evolving scientific understanding.” It also states, in full: “b. Institution Supplement. None required.” There is no local supplement to request.

The defined terms carry a great deal of the policy’s weight. These are transcribed from PS 5260.01 at pp. 3–4:

Defined term	The Program Statement’s own definition	Pin-cite
Gender Dysphoria (GD)	“a mental health diagnosis currently defined by the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5 TR), or its replacement. It is a psychological disorder caused by clinically significant distress or impairment due to the perceived discrepancy between a person’s expressed/experienced gender identity and his or her biological sex.”	p. 3
Gender Identity	“a fully internal and subjective sense of self, disconnected from biological reality and sex and existing on an infinite continuum, that does not provide a meaningful basis for identification and cannot be recognized as a replacement for sex.”	p. 3
Sex Trait Modification Surgeries	“surgical procedures that seek to modify the person’s physical characteristics to appear to align with the person’s ‘gender identity’ rather than the person’s sex. Examples of these surgeries include vaginoplasty, phalloplasty, orchiectomy, vulvoplasty, hysterectomy, oophorectomy, mastectomy, metoidioplasty, chest reconstruction, breast augmentation, hair removal, facial feminization surgery, and voice modification. These surgeries are also called ‘cross-sex,’ ‘sex reassignment,’ or ‘sex rejection’ surgeries.”	pp. 3–4
Social Accommodations	“items, including cosmetics and clothing, used to alter the person’s appearance to align with the person’s ‘gender identity.’ Examples of ‘social accommodations’ include buttock padding, breast padding, binders, undergarments, makeup, and wigs.”	p. 4
Social Transition	“the process by which a person begins to try to live and present in a way that aligns with their ‘gender identity’ rather than the person’s sex. This typically involves various non-medical actions, such as the use of ‘social accommodations’ to alter the person’s appearance to align with the person’s ‘gender identity.'”	p. 4
Multidisciplinary Review Team (MRT)	“a multidisciplinary group of staff representing different disciplines, which has the responsibility for ensuring access to necessary assessment, treatment, continuity of care, and services to inmates in accordance with their identified mental health needs, and which collaboratively develops, implements, reviews, and revises the treatment plan.”	p. 3

The MRT is the body that appears at the single most consequential decision point in the policy, so its composition is worth having exactly. PS 5260.01 at p. 3: the MRT “is coordinated by the Psychology Services Branch (PSB), which is responsible for scheduling meetings, maintaining records, and documenting official notes,” and “will consist of the following members (or their designee): (1) Psychology Services Branch (PSB) Administrator; (2) PSB, Chief of Mental Health; (3) Health Services Division (HSD) Chief Psychiatrist; (4) HSD Chief of Health Programs; (5) HSD Chief Pharmacist; (6) HSD Chief Social Worker; and (7) Women and Special Populations Branch (WASP) Administrator.” The same paragraph adds that “institutions may request a review by the MRT of individual inmates based on treatment concerns or clinical consultation needs.”

Who decides what

The Program Statement assigns each decision to a named actor. This table pairs each decision with the office the policy gives it to, in the policy’s own words.

Decision or function	Who the Program Statement assigns it to	Pin-cite
Bureau-wide oversight, consultation, assessment, and “advice and guidance related to the identification, evaluation, and recommendations for treatment needs of inmates with GD”	Psychology Services Branch (PSB), Reentry Services Division, Central Office	p. 4
Oversight of “the treatment of inmates for all medical and psychiatric diagnoses”; clinical guidance “provided at the direction of the Medical Director”	Health Services Division (HSD)	p. 4
Oversight of “the provision of non-medical services” for women and other special populations “including those individuals diagnosed with GD”	Women and Special Populations Branch (WASP)	p. 4
“[O]versight and consultation to institutions regarding services and care provided to inmates, including those diagnosed with GD”	Regional Offices	p. 5
Establishing “a local multi-disciplinary approach for the management of inmates diagnosed with GD”	Wardens	p. 5
“[P]rimary point of contact in the institution for issues related to this population,” consulting “as needed, with the Executive Team, Captain, Clinical Director, Unit Manager, or other individuals, as appropriate”	The Chief Psychologist	p. 5
Making the GD diagnosis	“a mental health clinician or primary care medical provider”	p. 5
Determining that the person “no longer meets the criteria for the diagnosis based on clinical outcomes,” so the diagnosis is entered as “Resolved”	“a mental or medical health professional”	p. 8
“[E]nsuring that the inmate understands and signs the informed consent form, before any medication orders”	“The medical provider”	p. 8
Developing the hormone tapering plan	The Primary Care Provider	pp. 8–9
Reviewing and approving or disapproving the tapering plan	“the MRT shall review and approve or disapprove the tapering plan submitted by the Primary Care Provider for all such inmates”	p. 8
Evaluating the person before tapering begins and developing “a monitoring and follow-up evaluation plan”	“Medical and mental health professionals”	p. 9

Two things stand out. The Warden is nowhere in the treatment chain — the Warden’s assigned role is to set up a local multidisciplinary approach, and the Chief Psychologist is the institution’s point of contact. And the one national committee, the MRT, has exactly one operative power in the text: approving or disapproving a hormone tapering plan.

Screening, diagnosis and the care-level floor

PS 5260.01 at p. 5, transcribed:

Diagnostic screening and evaluation of GD can occur at any time throughout an inmate’s incarceration. All diagnostic evaluations are documented in the electronic health record as a Diagnostic and Care Level Formulation note. If primary care medical providers are diagnosing GD, the diagnosis will be documented in the electronic health record as a Clinical Encounter note.

The records-release procedure, same page:

If an inmate reports or presents a documented history of GD before incarceration, Psychology staff will request the inmate to complete a BP-A0171 Record of Information Release form to authorize the Bureau to obtain the inmate’s prior mental health records from community providers who diagnosed or treated the inmate. Similarly, Health Services staff will request completion of a BP-A0621, Authorization for Release of Medical Information form, to obtain prior medical records relevant to the inmate’s care. Signed documents will be added to the electronic health record.

If the person declines to sign, “this refusal will also be documented in the electronic health record as a General Administrative Note” (p. 5).

Then the one hard number in the entire document, PS 5260.01 at p. 5:

As appropriate, a diagnosis of GD will be made by a mental health clinician or primary care medical provider. The diagnosis will be added to the electronic health record. At a minimum, the inmate will be classified and maintained as a Mental Health Care Level 2.

Mental health care levels are set by PS 5310.16, Treatment and Care of Inmates with Mental Illness, which PS 5260.01 cross-references by name at p. 7. A care-level assignment is not a diagnosis and not a housing decision; it is the Bureau’s own measure of how much mental-health service a person is expected to need, and it feeds into designation and into what programming an institution has to be able to deliver.

The evaluation instruments

PS 5260.01 at p. 6 directs that “[a]ll inmates diagnosed with GD will be individually evaluated,” that “a complete diagnostic and psychiatric/medical assessment of those with GD will be performed by Psychology Services clinicians and Health Services, respectively,” and that clinicians “will conduct a detailed clinical interview, and consider the use of the following instruments (as applicable) to evaluate the inmate.” The list, transcribed exactly:

• Clinical interview
• Beck Depression Inventory-II (BDI-II)
• Beck Anxiety Inventory (BAI)
• Wechsler Adult Intelligence Scale, 5th Edition
• Kaufman Brief Intelligence Test- 2nd Edition (KBIT-2)
• Montreal Cognitive Assessment (MoCA)
• Personality Assessment Inventory (PAI)
• Columbia Suicide Severity-Rating Scale Lifetime Recent (C-SSRS)
• Beck Scale for Suicidal Ideation (BSS)
• Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5)
• Utrecht Gender Dysphoria Scale- Gender Spectrum (UGDS-GS)
• If diagnosed with an autism spectrum disorder (ASD), the inmate may be additionally assessed with the Adaptive Behavior Assessment System 3rd edition (ABAS-3)

The same page states that “[a]nxiety, depressive, personality, and posttraumatic stress disorders are mental health disorders that may coexist in those with GD,” and that results are documented “as Psychological Testing with results summarized in the Diagnostic Care Level Formulation note.”

Treatment, and the Executive Order the policy quotes

The treatment section opens by quoting an Executive Order. Here is that passage exactly as the Program Statement prints it, PS 5260.01 at pp. 6–7 — the words are the Bureau’s characterization of the Order, and the internal quotations are the Bureau’s:

Executive Order 14,168, Defending Women from Gender Ideology Extremism and Restoring Biological Truth to the Federal Government, 90 Fed. Reg. 8,615 (Jan. 30, 2025), prohibits the Bureau from expending federal funds for “any medical procedure, treatment, or drug for the purpose of conforming an inmate’s appearance to that of the opposite sex” “to the extent consistent with applicable law.” Id. at 8,617-18. The Bureau will comply with this Executive Order unless compliance with the Executive Order is prohibited by a court injunction or court order. Though Executive Order 14,168 supports this policy, the Bureau also adopts this policy independently of Executive Order 14,168.

That last sentence is doing real work: the Bureau says it adopts the policy independently of the Order, which is a statement about the policy’s own footing rather than about the Order’s.

On the individualized treatment plan, PS 5260.01 at p. 7:

In general, identified medical and psychiatric comorbidities should be addressed before treatment for GD proceeds. As appropriate, medical and psychiatric comorbidities should be addressed through psychotherapy, psychotropic medication, or other appropriate medically accepted interventions. When comorbidities are addressed before GD, further treatment for GD may be necessary and may proceed once these medical and psychiatric comorbidities are resolved or ruled out as the potential cause of GD.

And:

Psychotherapy should be prioritized. Treatment should include, at a minimum, therapy in accordance with their mental health care level as outlined in Program Statement PS 5310.16, Treatment and Care of Inmates with Mental Illness. Additionally, other treatments, such as psychoeducational group interventions, may be added as clinically indicated. Treatment interventions will focus on managing the psychological distress/dysphoria, assisting with adjustment to incarceration, community re-entry, and strengthening resilience.

On acute distress, same page: “All clinicians will ensure individuals with GD are not experiencing acute distress during any clinical contact. If the individual is experiencing suicidal ideation, a suicide risk assessment and appropriate protocols related to decreasing distress will be prioritized (in accordance with Program Statement PS 5324.08, Suicide Prevention Program).” At p. 8: “Psychotropic medication should be considered to determine if its use may alleviate the symptoms of GD.”

On informed consent, p. 8: “Consent must be voluntary, and the inmate must be able to understand and appreciate the risks and potential side effects of the prescription. If the required documented evidence is insufficient, or if the inmate fails to sign the consent form, the clinician shall not prescribe medication or provide the procedure.”

Surgery, hormones, and social accommodations

These three provisions are the operative core of the 2026 edition. All are transcribed verbatim.

Surgery — PS 5260.01 at p. 8:

In instances when an inmate is diagnosed with GD, the Bureau will not provide sex trait modification surgeries to address GD and the inmate will not receive sex trait modification surgeries to address GD.

For inmates who have had sex trait modification surgery, medical care will be provided as necessary to address any complications or resulting conditions, such as urethral stricture and pelvic infections.

Hormones, for someone not currently receiving them — PS 5260.01 at p. 8:

In instances when an inmate is diagnosed with GD but is not currently receiving hormones to address GD, the Bureau will not provide hormones to address GD and the inmate will not receive hormones to address GD. Such inmates will continue to have an individualized treatment plan to meet the inmate’s needs. The individualized treatment plan may include psychotherapy, group counseling, psychiatric services, and psychotropic medications.

Hormones, for someone currently receiving them — PS 5260.01 at pp. 8–9:

In instances when an inmate is previously and currently diagnosed with GD and is currently receiving hormones to address GD, the MRT shall review and approve or disapprove the tapering plan submitted by the Primary Care Provider for all such inmates. Each tapering plan shall consider the appropriate factors, such as the duration the inmate has been receiving hormones to address GD, the initial rationale for receiving the hormone intervention, the response by the inmate to the intervention, and whether the inmate has undergone sex trait modification surgery.

For inmates that have recently begun receiving hormones to address GD, the Primary Care Provider shall develop a tapering plan that includes a rapid discontinuation of the hormone intervention.

For inmates that have been receiving hormones to address GD for an extended period of time, the Primary Care Provider shall develop a tapering plan that includes an appropriately paced discontinuation of the hormone intervention.

For inmates who (1) are post sex trait modification surgery or (2) have been receiving hormones to address GD for an extended period of time and develop severe physiological and psychological withdrawal effects from tapering, it may not be appropriate in all cases for the initial tapering plan to include cessation of hormones. But tapering plans should be reevaluated regularly with respect to cessation of hormones, including during the inmate’s chronic care clinic appointments.

The same section, p. 9, adds the monitoring and request provisions:

Medical and mental health professionals shall evaluate the inmate before beginning tapering. Based on that evaluation and patient-specific needs, medical and mental health professionals shall develop a monitoring and follow-up evaluation plan. All inmates who are tapering and were receiving mental health treatment before tapering shall continue to receive counseling and pharmacological treatment as appropriate as part of the inmate’s individualized treatment plan. Tapering plans may be adjusted as necessary based on monitoring and follow-up evaluations, but the adjusted tapering plans must still be consistent with the purpose of this policy and based on all relevant factors, including security and prison-administration concerns.

Patients may submit a request for additional medical or mental health care or evaluation if they have acute concerns during the tapering process. All requests shall be considered in a reasonable amount of time in accordance with standard procedure, and decisions concerning such requests shall be based on all relevant factors, including security and prison-administration concerns.

Social accommodations — PS 5260.01 at p. 9:

The Bureau will not provide social accommodations, including to inmates diagnosed with GD, and the inmate will not receive social accommodations. If the inmate currently has social accommodations, the Bureau shall no longer provide the social accommodations and, when practicable, remove or confiscate the social accommodations. When appropriate, and in accordance with standard procedure, inmates may still have access to purchase items on the standardized list of Commissary items available to inmates in their facility.

Review intervals, records, remedies and the closing sections

There is no numeric review interval anywhere in this Program Statement. The words the policy uses are “regularly,” “including during the inmate’s chronic care clinic appointments” (p. 9), and “in a reasonable amount of time” (p. 9). Screening “can occur at any time throughout an inmate’s incarceration” (p. 5). The only number in the document is the Mental Health Care Level 2 floor at p. 5. That is worth knowing before anyone goes looking for a deadline in it, and it is a real difference from the regulation, which does carry a fixed interval — see the next section.

On records, PS 5260.01 at p. 10: information “will be maintained in the current electronic recordkeeping system or health record system in accordance with PS 6090.04, Health Information Management and PS 5310.17, Psychology Services Manual,” and is “considered confidential and may only be released in accordance with appropriate laws, rules, and regulations.”

On remedies, p. 10, in full: “Inmates who wish to seek formal review of any issue relating to this policy may use the procedures in PS 1330.18, Administrative Remedy Program.” That is the entire administrative-remedy section, and it points at the ordinary ladder described under Administrative Remedy Program.

The closing section, p. 10, is titled “SEVERABILITY, APPLICATION OF THIS POLICY AND NO PRIVATE RIGHT OF ACTION,” and reads in part:

The intent of this policy is for federal funds to not be expended for any medical procedure, treatment, or drug for the purpose of conforming an inmate’s appearance to that of the opposite sex to the maximum extent permitted by law, including the Eighth Amendment to the U.S. Constitution.

Nothing in this policy shall prevent a prison official from providing care required by federal law, including the Eighth Amendment to the U.S. Constitution. The Bureau shall ensure that all inmates diagnosed with GD receive care in accordance with federal law, including the Eighth Amendment to the U.S. Constitution.

Nothing in this policy is intended, nor shall it be construed, to create a private cause of action.

What binds, and what does not

This is the distinction that decides what a reader can actually do, and on this subject it is unusually consequential.

A Program Statement is the Bureau’s internal instruction to its own staff. It is not a regulation, and PS 5260.01 says as much about itself: “Nothing in this policy is intended, nor shall it be construed, to create a private cause of action” (p. 10). Regulations are different. The PREA standards in 28 C.F.R. part 115 were adopted by the Attorney General under the Prison Rape Elimination Act, 34 U.S.C. § 30307, and they are law binding on the agency, not staff guidance. They are also where the housing, placement and search protections actually sit — the subjects PS 5260.01 does not address.

Every provision below was pulled from eCFR and is current as of the Code’s August 2026 revision date.

Regulation	What the regulation says
28 C.F.R. § 115.41(a)	“All inmates shall be assessed during an intake screening and upon transfer to another facility for their risk of being sexually abused by other inmates or sexually abusive toward other inmates.”
§ 115.41(b)	“Intake screening shall ordinarily take place within 72 hours of arrival at the facility.”
§ 115.41(d)(7)	The intake screening “shall consider, at a minimum,” among ten listed criteria, “[w]hether the inmate is or is perceived to be gay, lesbian, bisexual, transgender, intersex, or gender nonconforming.”
§ 115.41(f)	“Within a set time period, not to exceed 30 days from the inmate’s arrival at the facility, the facility will reassess the inmate’s risk of victimization or abusiveness based upon any additional, relevant information received by the facility since the intake screening.”
§ 115.41(h)	“Inmates may not be disciplined for refusing to answer, or for not disclosing complete information in response to, questions asked pursuant to paragraphs (d)(1), (d)(7), (d)(8), or (d)(9) of this section.”
§ 115.42(c)	“In deciding whether to assign a transgender or intersex inmate to a facility for male or female inmates, and in making other housing and programming assignments, the agency shall consider on a case-by-case basis whether a placement would ensure the inmate’s health and safety, and whether the placement would present management or security problems.”
§ 115.42(d)	“Placement and programming assignments for each transgender or intersex inmate shall be reassessed at least twice each year to review any threats to safety experienced by the inmate.”
§ 115.42(e)	“A transgender or intersex inmate’s own views with respect to his or her own safety shall be given serious consideration.”
§ 115.42(f)	“Transgender and intersex inmates shall be given the opportunity to shower separately from other inmates.”
§ 115.42(g)	“The agency shall not place lesbian, gay, bisexual, transgender, or intersex inmates in dedicated facilities, units, or wings solely on the basis of such identification or status, unless such placement is in a dedicated facility, unit, or wing established in connection with a consent decree, legal settlement, or legal judgment for the purpose of protecting such inmates.”
§ 115.15(a)	“The facility shall not conduct cross-gender strip searches or cross-gender visual body cavity searches (meaning a search of the anal or genital opening) except in exigent circumstances or when performed by medical practitioners.”
§ 115.15(e)	“The facility shall not search or physically examine a transgender or intersex inmate for the sole purpose of determining the inmate’s genital status.”
§ 115.15(f)	“The agency shall train security staff in how to conduct cross-gender pat-down searches, and searches of transgender and intersex inmates, in a professional and respectful manner, and in the least intrusive manner possible, consistent with security needs.”
28 C.F.R. § 551.90	“Bureau staff shall not discriminate against inmates on the basis of race, religion, national origin, sex, disability, or political belief. This includes the making of administrative decisions and providing access to work, housing and programs.”

Now the part that is not obvious from reading either document alone. The Bureau’s current PREA program statement — PS 5333.01, Sexually Abusive Behavior Prevention and Intervention Program Manual, dated March 19, 2026 — reprints the part 115 standards section by section, and it stops short of several of the provisions above. Its reproduction of § 115.42 runs subsections (a) and (b) and then prints three asterisks and moves to § 115.43, omitting (c) through (g) (PS 5333.01 at pp. 33–34). Its reproduction of § 115.15 runs (a) through (d) and then moves to § 115.16, omitting (e) and (f) (PS 5333.01 at pp. 16–18).

The regulation is still the regulation. A Program Statement that does not reprint a rule does not repeal it; only rulemaking does that, and no rulemaking has removed these subsections — they carry a December 29, 2016 effective date and appear in the current Code. What the omission means practically is that a staff member working from the program statement alone will not see them, which is exactly why the citation to cite in a written request is the C.F.R. section number, not the program statement. Our page on that policy is PREA and Sexual Abuse Prevention.

On searches, the Bureau’s operative internal instruction changed in 2025. PS 5521.06, Searches of Housing Units, Inmates, and Inmate Work Areas, Change Notice 1 dated March 6, 2025, states on its face that “[t]hroughout this CN the term ‘gender’ has been replaced with ‘sex’ and the term ‘cross-gender’ has been replaced with ‘opposite sex,'” struck the former subsection titled “Transgender Inmates” — which had allowed a Warden-authorized pat-search exception — in its entirety, and replaced it with this, highlighted as an addition (PS 5521.06 CN-1 at pp. 1–2):

(2) Inmates. For purposes of pat searching, inmates will be pat searched according to the sex of the institution or housing assignment, where they are assigned.

Applied Insight — Christopher Zoukis, JD, MBA, Managing Director: When two documents cover the same ground and one is a regulation, cite the regulation by section number and quote it. A request that says “please conduct the reassessment required by 28 C.F.R. § 115.42(d), which provides that placement and programming assignments for each transgender or intersex inmate shall be reassessed at least twice each year” is a different document from one that says “I would like to be reassessed.” The first names a rule, a subsection, and an interval; it can be answered or it can be refused, and either answer is a record. The second invites a shrug. This is also why the checkable numbers matter: 72 hours for intake screening, 30 days for the first reassessment, twice a year thereafter. Write the date you arrived and the date you asked, every time.

What the gender dysphoria policy means for you

If you are the person inside: what is addressed to you directly

Three things in this policy are addressed to you directly, and none of them requires a lawyer to start.

First, records. If you were diagnosed or treated before you came in, the policy directs Psychology staff to ask you to sign a BP-A0171 and Health Services to ask you to sign a BP-A0621 so the Bureau can pull those community records (p. 5). Nobody may be able to tell you whether staff have done that. You can ask, in writing, whether the forms were offered and whether the records were requested — and if you decline to sign, understand that the refusal itself goes into the electronic health record as a General Administrative Note (p. 5).

Second, the care-level floor. The policy states that on diagnosis, “[a]t a minimum, the inmate will be classified and maintained as a Mental Health Care Level 2” (p. 5). If you have been diagnosed and your care level does not reflect that, that is a specific, checkable discrepancy — not a matter of opinion — and it belongs in a written request to the Chief Psychologist, who the policy names as “the primary point of contact in the institution for issues related to this population” (p. 5).

Third, requests during tapering. The policy says in terms that “[p]atients may submit a request for additional medical or mental health care or evaluation if they have acute concerns during the tapering process,” and that all such requests “shall be considered in a reasonable amount of time” (p. 9). Put those requests in writing on a BP-A0148 Inmate Request to Staff — the form everyone calls a “cop-out” — describe the symptom and the date it started, and keep your copy.

Two more points. If you are in acute distress or having thoughts of suicide, tell a staff member now rather than writing anything; the policy directs clinicians to prioritize a suicide risk assessment (p. 7), and the suicide prevention program exists for exactly that. And if the problem is safety rather than treatment, it is a different problem with a different route — see protective custody and the PREA screening provisions above.

If you are the family member: chronology, and the right door

Your two useful jobs are chronology and pressure on the right door.

Chronology first. Medical and mental-health information is confidential and, as PS 5260.01 puts it at p. 10, “may only be released in accordance with appropriate laws, rules, and regulations.” That means the institution will not discuss a diagnosis with you, and it does not mean you are powerless. Keep a dated log of what your loved one tells you: when they were seen, by whom, what they were told, whether a form was offered, whether a taper started and on what date. Families are frequently the only party keeping a written chronology, and a chronology is what turns a vague complaint into a specific one.

The right door depends on the problem. Clinical questions go to the Chief Psychologist and the Clinical Director. Safety and housing questions go through the unit team and, where the concern is risk of assault, through the PREA route described above and on our protective custody page. Nothing gets faster because a family member calls the institution’s main line; things get faster when the incarcerated person has an unanswered written request with a date on it and the family has a copy of it.

Two further practical notes. Because the policy directs that social accommodations already possessed be removed or confiscated “when practicable” (p. 9), property disputes may follow; those run on the inmate personal property track, and a property loss claim is a Federal Tort Claims Act matter on an SF-95 rather than a grievance — see Federal Tort Claims Act. And do not assume this page is current on the litigation; the posture in Kingdom v. Trump has changed repeatedly, and the note at the top of this page reflects only what the docket showed on September 6, 2026.

If you are counsel: gender dysphoria

Four things are worth knowing before you write anything.

The Program Statement disclaims a private right of action and is internal guidance; the enforceable text on housing, screening and searches is the regulation. Build the record around 28 C.F.R. §§ 115.15, 115.41 and 115.42 and around § 551.90, and note in any filing that PS 5333.01 (3/19/2026) does not reproduce § 115.42(c)–(g) or § 115.15(e)–(f) — which is a fact about the agency’s internal guidance, and one worth establishing.

The documentary record here is unusually rich and unusually specific. The policy names the note types: the Diagnostic and Care Level Formulation note, the Clinical Encounter note, the General Administrative Note, the Psychological Testing entry, and the tapering plan itself with its MRT approval or disapproval (pp. 5–9). Those are discrete, nameable documents. Request them by name through the unit team and, where staff will not produce them, through a Freedom of Information Act or Privacy Act request.

Exhaustion is a live issue on any conditions claim. Under the Prison Litigation Reform Act, 42 U.S.C. § 1997e(a), no action may be brought about prison conditions until available administrative remedies are exhausted — meaning every level of the internal ladder, on time, before filing. PS 5260.01 routes readers to PS 1330.18 for that (p. 10); the ladder is BP-A0148, then BP-9 to the Warden, BP-10 to the Regional Director, BP-11 to the Office of National Inmate Appeals, under 28 C.F.R. part 542, subpart B.

Finally, the legal questions here are unsettled and moving. Whether and to what extent the Eighth Amendment or any other provision constrains this policy is being litigated right now; the Program Statement itself says at p. 10 that “[n]othing in this policy shall prevent a prison official from providing care required by federal law, including the Eighth Amendment to the U.S. Constitution,” which is the Bureau’s own acknowledgment that the constitutional floor sits above the policy. We are not going to tell you how a court will resolve that, and no page on the internet should. If a specific person is affected, the route is a consult — see Federal Prison Consulting Services or contact us.

What changed in the gender dysphoria policy

This is the section no competitor carries, because the changes are spread across five documents and two of them hide the change in strikethrough that does not survive text extraction.

PS 5260.01 names nothing that it supersedes. Its cover page (p. 2) has no supersession line and no Summary of Changes — a departure from the Bureau’s own convention, which normally prints “Program Statement Rescinded” followed by the retired number and date. The transmittal memo signed the same day by Assistant Director/General Counsel Elisa Mason calls it “a new policy entitled Management of Inmates with Gender Dysphoria” (p. 1).

PS 5200.08, Transgender Offender Manual (1/13/2022), is no longer in BOP’s published policy set. It does not appear in BOP’s published program-statement index; the only statements in the 5200 series are 5200.06, Management of Inmates with Disabilities, and 5200.09, Female Offender Manual. Two Change Notices issued in the February 2025 wave struck the reference to it out of the statements that had cited it:

• PS 5321.09, Unit Management and Inmate Program Review, CN-1 (2/27/2025), struck the sentence directing the Unit Manager, at each program review, to review “work, programming, and housing unit assignments for transgender and intersex inmates with consideration given for the inmate’s view of their safety,” struck the cross-reference to the Transgender Offender Manual, and struck “5200.08 Transgender Offender Manual (1/13/2022)” from the References. The CN states it “removes language to ensure consistency with Executive Orders issued by the Executive Office of the President of the United States.”
• PS 7331.05, Pretrial Inmates, CN-1 (2/27/2025), struck the same cross-reference and the same References entry from the pretrial program-review section.

That is significant beyond bookkeeping, because the struck sentence in PS 5321.09 was the internal instruction that carried the substance of 28 C.F.R. § 115.42(c) and (e) into the Bureau’s routine program-review cycle. The regulation was not amended. The instruction that operationalized it inside unit management was removed.

The February–March 2025 Change Notice wave was broader than these two. The same formula — “removes language to ensure consistency with Executive Orders” or “to remove references to any concept that may conflict with the January 20, 2025, Executive Order” — appears on the face of PS 5310.16, Treatment and Care of Inmates with Mental Illness, CN-1 (2/18/2025); PS 5324.10, Sex Offender Programs, CN-1 (2/18/2025); PS 5521.06, Searches, CN-1 (3/6/2025); and PS 5394.01, Certification and Civil Commitment of Sexually Dangerous Persons, CN-1 (2/27/2025).

The Patient Care manual dropped its transgender section. PS 6031.06, Patient Care (6/22/2026), rescinded PS 6031.05 CN-2 (3/14/2025) per its own Summary of Changes at p. 1. The superseded 6031.05 had a “Section 31. TRANSGENDER INMATES,” which directed readers to the Transgender Offender Manual and to “the Medical Director’s published guidance on transgender inmates.” PS 6031.06 contains no corresponding section.

The PREA program statement was reissued and narrowed on this point. PS 5333.01 (3/19/2026) rescinded PS 5324.12 CN-1 (2/18/2025) per its Summary of Changes at p. 1. As described above, its reproduction of the regulation stops short of § 115.42(c)–(g) and § 115.15(e)–(f).

The litigation. PS 5260.01’s own transmittal memo, PS 5260.01 at p. 1, states:

Today the Director signed a new policy entitled Management of Inmates with Gender Dysphoria. However, BOP remains obligated to comply with the preliminary injunction issued on June 3, 2025, by the United States District Court for the District of Columbia in Kingdom v. Trump et al., 25-cv-691, which requires BOP to provide hormones and social accommodations to inmates diagnosed with gender dysphoria under the policy that existed before Executive Order 14168, Defending Women from Gender Ideology Extremism and Restoring Biological Truth to the Federal Government, issued on January 20, 2025.

The memo adds that the pre-January 2025 practice “is outlined in the attached guidance memo issued by the Reentry Services Division, Health Services Division, Correctional Programs Division and the Administration Division on July 16, 2025,” and asks chief executive officers to “ensure all staff are reminded of these ongoing obligations.” That attached guidance memo is not part of the posted Program Statement PDF.

The case has moved several times since. Working only from the courts’ own records: on June 17, 2026, the D.C. Circuit granted the government’s motion for a stay pending appeal of a renewed preliminary injunction the district court had entered on May 26, 2026, in an order reasoning that “the district court’s order appears to have been an administrative injunction” and that “[t]he Government is likely to succeed on the merits” of its challenge to that particular injunction; Judge Pillard dissented. Kingdom v. Trump, No. 26-5181 (D.C. Cir. June 17, 2026) (per curiam order). On August 26, 2026, the district court granted a further renewed preliminary injunction, ordering “that Program Statement 5260.01 is stayed and that Defendants are ENJOINED from enforcing Program Statement 5260.01 from September 15, 2026 to December 14, 2026” (No. 1:25-cv-00691, Dkt. 242). The government noticed an interlocutory appeal on August 28, 2026 (Dkt. 245), docketed as D.C. Circuit No. 26-5310 on September 1, 2026. Docket entries 248 through 252 were filed on September 2, 2026; their content is not available to us.

We are reporting the docket, not predicting it. The state of this litigation should be re-checked before anyone relies on this page.

Where people get stuck under this policy

Four problems recur. Each has a route, and the route matters more than the complaint.

“My care level was never changed after I was diagnosed.” This is the cleanest paper issue in the policy, because it is a number. PS 5260.01 at p. 5 states that on diagnosis, at a minimum the person “will be classified and maintained as a Mental Health Care Level 2.” Write a BP-A0148 Inmate Request to Staff addressed to the Chief Psychologist, state the date of diagnosis and your current care level, quote the sentence, and ask for the Diagnostic and Care Level Formulation note that documents it. If nothing comes back, the formal ladder starts with a BP-9 to the Warden under 28 C.F.R. part 542, subpart B, then BP-10 to the Regional Director and BP-11 to the Office of National Inmate Appeals. Watch the clock: 28 C.F.R. § 542.14(a) sets “20 calendar days following the date on which the basis for the Request occurred,” subject to an extension “[w]here the inmate demonstrates a valid reason for delay.” BOP publishes BP-A0148 but does not publish the BP-9, BP-10 or BP-11 forms; you get those from the unit team. See Administrative Remedy Program and Request to Staff.

“I am having withdrawal symptoms and nobody is responding.” The policy anticipates this exact situation and creates a request channel for it: requests for additional care during tapering “shall be considered in a reasonable amount of time in accordance with standard procedure” (p. 9). It also directs that medical and mental health professionals evaluate the person before tapering starts and develop a monitoring and follow-up plan (p. 9), and that anyone who was in mental-health treatment before tapering “shall continue to receive counseling and pharmacological treatment as appropriate” (p. 9). Ask in writing for the monitoring and follow-up evaluation plan by name. If symptoms are acute, ask for a same-day sick-call encounter under Patient Care rather than filing paper. If the response is that nothing can be done because of the policy, note that the policy itself says at p. 9 that tapering plans “may be adjusted as necessary based on monitoring and follow-up evaluations.”

“Property was taken and I do not know under what authority.” PS 5260.01 at p. 9 directs staff, where a person currently has social accommodations, to “no longer provide the social accommodations and, when practicable, remove or confiscate the social accommodations,” while preserving access “to purchase items on the standardized list of Commissary items available to inmates in their facility.” Two different tracks follow, and confusing them wastes months. Whether the removal was proper is a policy-and-property question, on the inmate personal property track through the administrative-remedy ladder. Whether the Bureau owes money for property lost or destroyed is a tort question, filed on an SF-95 under the Federal Tort Claims Act, not on a BP-9 — see Federal Tort Claims Act. Ask for the confiscation paperwork and a receipt at the time, in writing.

“The real problem is safety, not treatment.” Then this Program Statement is the wrong document, and saying so plainly is the most useful thing on this page. Safety runs through the PREA screening and placement rules at 28 C.F.R. §§ 115.41 and 115.42 — cite them by section number — and through the PREA program, the unit team, and where necessary a separation request. Our plain-language pages are Protective Custody and Violence and Sexual Assault in Prison. Be aware that involuntary segregated housing is itself regulated: 28 C.F.R. § 115.43 limits placing someone at high risk of sexual victimization in involuntary segregated housing, requires documentation, and provides that such an assignment “shall not ordinarily exceed a period of 30 days,” with a review every 30 days.

Where the underlying issue is designation, sentence computation, medical care or a discipline problem, the administrative remedy is necessary but rarely sufficient by itself. Those belong in a consult — see Federal Prison Consulting Services or contact us.

Related BOP policy on gender dysphoria and protective custody

The paired page is Protective Custody, which explains separation, the Special Housing Unit, and what asking for protection actually involves. It names this policy in its first screen and links back here for the clinical rule; this page links there for the safety route.

The regulations and policies that meet this one directly: PREA and Sexual Abuse Prevention (PS 5333.01) for the screening, placement and search standards; Searches of Housing Units, Inmates, and Inmate Work Areas (PS 5521.06) for the current pat-search instruction; Patient Care (PS 6031.06) for how medical care is delivered generally; Treatment and Care of Inmates With Mental Illness (PS 5310.16) for what a mental health care level means and what it entitles a person to; and Security Designation and Custody Classification (PS 5100.08) for how the institution was chosen in the first place.

Routes and records: Administrative Remedy Program (PS 1330.18) for the grievance ladder that PS 5260.01 points to at p. 10; Request to Staff (PS 5511.08) for the BP-A0148 that starts it; FOIA and Privacy Act Requests (PS 1351.05) for getting medical and psychology records; Inmate Central File, Privacy Folder, and Parole Mini-Files (PS 5800.17) for where records live; and Non-Discrimination Towards Inmates (PS 1040.04), the internal counterpart to 28 C.F.R. § 551.90.

Adjacent subjects: Special Housing Units (PS 5270.12) and Solitary Confinement and Special Housing Units; Suicide Prevention Program (PS 5324.08), which PS 5260.01 cross-references twice; Mental Health Programs for Inmates and Medical and Dental Care in Prison for the plain-language versions; Management of Inmates with Disabilities (PS 5200.06); Female Offender Manual (PS 5200.09); and What Rights Do Prisoners Have? for the constitutional frame.

Frequently Asked Questions About Gender Dysphoria Management

Reviewed for legal accuracy by Elizabeth Franklin-Best, Esq., Principal Attorney·September 2026