Judge blocks HHS from requiring religious providers to perform gender-transition, abortion procedures

In a win for some religious providers, a federal judge has issued a permanent injunction that prevents the government from requiring them to perform gender-transition procedures or abortions.

Issued last week by Reed O’Connor, a U.S. district judge in Texas, the injunction prohibits the Department of Health and Human Services from interpreting or enforcing Section 1557 of the ACA to require the plaintiffs — a Catholic health system and a Christian medical association — to perform or provide insurance coverage for gender-transition or abortion procedures. This includes banning HHS from forcing the plaintiffs to provide those services by denying federal financial aid or charging penalties. The injunction only applies to the plaintiffs.

Section 1557 of the ACA bans health programs and facilities that receive federal financial assistance from discriminating on the basis of race, color, national origin, sex, age or disability. When implementing this section in 2016, the Obama administration finalized a rule interpreting “on the basis of sex” to include gender identity and pregnancy status, according to an article in Health Affairs. The current plaintiffs filed a legal challenge in the same year and were granted a preliminary injunction. Later, O’Connor also eliminated parts of the rule.

In 2020, the Trump administration vacated the 2016 definition of “on the basis of sex.”

But, in May of this year, the government said it would interpret the rule in accordance with a Supreme Court decision, which held that the federal law banning discrimination based on sex includes gender identity. HHS also said it would accept previous court decisions related to the rule, including O’Connor’s that vacated parts of it.

O’Connor argued that these are contradictory statements, and thus, “the promise is hollow.”

“The Court agrees and concludes that enforcement of the 2021 Interpretation forces Christian Plaintiffs to face civil penalties or to perform gender-transition procedures and abortions contrary to their religious beliefs — a quintessential irreparable injury,” O’Connor wrote in his order.

Becket, an organization focused on supporting religious liberty that represented the plaintiffs, praised the injunction ruling.

“Today’s ruling is a victory for compassion, conscience, and common sense,” said Luke Goodrich, vice president and senior counsel at Becket, in a news release. “No doctor should be forced to perform controversial, medically unsupported procedures that are contrary to their conscience and could be deeply harmful to their patients.”

LGBTQ and reproductive rights activists, however, expressed their dismay.

“Gender-affirming care is life-saving care and doctors agree that it is medically necessary for many transgender people,” said Lindsey Kaley, staff attorney with the ACLU Center for Liberty, in an email. “This is a disappointing decision, but it does not change the fact that transgender people who have been turned away from healthcare can continue to pursue litigation.”

The push-and-pull regarding Section 1557 and its interpretation is also ongoing. Not only can the Biden administration file an appeal, but there are currently several other lawsuits winding their way through the courts, including ones against the 2020 interpretation, Health Affairs reports.

Photo: Chris Ryan, Getty Images