A CNN report that sensationalized Vice President Kamala Harris' 2019 position on access to care for incarcerated trans people has continued to drive the election cycle — prompting an extensive ad campaign — even though gender-affirming surgery was available to incarcerated trans people under Donald Trump's presidency. 

CNN's reporting instigated coverage from right-wing media figures and debate commentary from the former president. Even though the Supreme Court has held for half a century that denying incarcerated people medically necessary care is a violation of constitutional rights, right-wing media figures have continued to promote the issue as a supposed indication of Harris' radicalism. 

According to The New Republic and AdImpact, Trump's campaign has invested nearly half of its advertising spending — over $30 million — on ads that emphasize Harris' former position on care for incarcerated trans people. At least one of these ads explicitly references CNN's report. 

However, CNN failed to note — as reported by The New York Times — that “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.”

According to the Times, the amount the Bureau of Prisons spent on hormone therapy ranged “from $60,000 to $95,000 a year during Mr. Trump’s term” — just .8% of the $12 million the campaign spent in the last few weeks on the ad referencing CNN's report. 

While it is true that no incarcerated trans people in federal prisons received gender-affirming surgeries under Trump's term, such cases would not have violated the bureau's policy while he was in office. Both the first and second — and to date the only, according to an agency spokesperson — trans people to receive gender-affirming surgeries while incarcerated under the Federal Bureau of Prisons first filed suits demanding such care under Trump. 

Additionally, the first two incarcerated people to successfully sue a prison for access to gender-affirming surgery won cases against state facilities while Trump was in office.

In 2015, the state of California settled a case brought by a trans inmate demanding access to surgical care. The case marked “the first person in the U.S. to receive state-funded sex reassignment surgery while incarcerated,” and while it was settled under Harris' tenure as state attorney general, the state-funded surgery actually took place in 2017, while Trump was president. 

A second case, brought in Idaho during Trump’s presidency, rose all the way to the Supreme Court, resulting in state-funded care provided in July 2020. 

Contrary to the implication that incarcerated trans people have unfettered access to gender-affirming care, trans people often have to sue state and federal prisons in order to access necessary care. Only about 1% of those in federal prisons are transgender, and denial of care is often only a part of the conditions they face — including disproportionate rates of violence —  while incarcerated. Both cases through which an incarcerated trans person successfully sued the Bureau of Prisons for access to gender-affirming surgery were the result of lengthy legal battles.