Yes, gender-affirming care for transgender prisoners was available during the Trump administration

In September, former President Donald Trump’s campaign released an ad claiming Vice President Kamala Harris supports funding gender transition surgeries for prison inmates and migrants in the United States.

“Kamala supports taxpayer-funded sex changes for prisoners,” the ad’s narrator says. “Kamala is for they/them. President Trump is for you.”

Multiple VERIFY readers asked us to fact-check the ad’s claims. We found that it’s true that Harris supported transition-related care for transgender prisoners in the past, but the policy is not part of her current platform ahead of the 2024 presidential election.

Harris later addressed the ad’s claims in an Oct. 16 interview with Fox News’ Bret Baier.

“Are you still in support of using taxpayer dollars to help prison inmates or detained illegal aliens to transition to another gender?” Baier asked Harris.

“I will follow the law, and it’s a law that Donald Trump actually followed,” Harris claimed in response. “You’re probably familiar with it now — it’s a public report that under Donald Trump’s administration, these surgeries were available on a medical necessity basis to people in the federal prison system.”

The Lincoln Project, an anti-Trump political action committee, made a similar claim in its own political ad while citing a recent New York Times report titled “Under Trump, U.S. Prisons Offered Gender-Affirming Care.”

VERIFY readers Bill, Mary and Stacey sent us messages asking if these claims are true.

Was gender-affirming care available to transgender prisoners during the Trump administration?

Yes, gender-affirming care was available to transgender prisoners during the Trump administration.

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The Federal Bureau of Prisons, an agency under the U.S. Department of Justice, offered gender-affirming care to transgender prisoners during the Trump administration. That’s because federal prisons are required by law to provide adequate medical care to all inmates, including those transitioning to another gender.

Gender-affirming care, which is also referred to as transition-related care, is life-saving health care for transgender people of all ages, according to the Human Rights Campaign, an LGBTQ+ advocacy group based in Washington, D.C. Gender-affirming care can include a range of services, such as mental health care, medical care and social services.

By law, federal and state prisons must provide adequate medical care to all prisoners. However, transgender inmates often have to advocate for several years or sue to get gender-affirming care, including surgery, while incarcerated.

In 2018, the Federal Bureau of Prisons under the Trump administration acknowledged in a budget memo to Congress that it was obligated to pay for gender-affirming care, including surgery if deemed medically necessary, for “offenders who self-identify as transgender.”

“Transgender offenders may require individual counseling and emotional support. 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 memo says.

This policy was based on guidelines issued by the Obama administration just days before Trump’s inauguration in January 2017. The Trump administration rolled back many Obama-era transgender inmate protections in May 2018, but it kept most of the previous administration’s guidelines in its “Hormone and Medical Treatment” section.

The only change the Trump administration made to the section was adding the word “necessary” ahead of medical treatment. In its report, the New York Times says that this change “created a higher but not insurmountable barrier to federally funded surgeries.”

In the U.S., there are nearly 2,260 transgender people incarcerated in federal prisons and nearly 5,000 transgender people incarcerated in state prisons, according to the Federal Bureau of Prisons and a 2020 NBC News report that compiled data from 45 states and Washington, D.C.

As of today, only two transgender inmates in federal custody have received gender-affirming surgeries following lengthy court battles. The first surgery was in 2022 and the second was in 2023, both after Trump left office.

VERIFY reached out to the Trump campaign for comment but did not hear back by the time of publication.