By Raymond Wolfe
A federal court has blocked a Biden administration policy requiring doctors to perform transgender procedures and abortions regardless of religious or conscience objections.
Judge Reed O’Connor of the U.S. District Court for the Northern District of Texas, Wichita Falls Division, permanently enjoined the federal government from implementing the so-called transgender mandate in a ruling handed down Monday.
The Obama administration first issued the transgender mandate in 2016, compelling healthcare providers to offer “sex change” procedures to any patient, regardless of age, upon the referral of a mental health professional. The rule, which did not include conscience exemptions, relied on an interpretation of a nondiscrimination clause of the Affordable Care Act (ACA).
The Department of Health and Human Services (HHS) finalized a repeal of the mandate last year under President Trump, though the Biden administrated has since reinstated it. Biden health secretary Xavier Becerra sued to defend the policy after another ruling against it this year.
Judge O’Connor barred HHS “from interpreting or enforcing” the ACA “in a manner that would require [the plaintiffs] to perform or provide insurance coverage for gender-transition procedures or abortions, including by denying Federal financial assistance because of their failure to perform or provide insurance coverage for such procedures or by otherwise pursuing, charging, or assessing any penalties, fines, assessments, investigations, or other enforcement actions.”
He also granted a permanent injunction to the plaintiffs in the case, a Christian association of more than 19,000 medical professionals and a Catholic hospital association, “to be exempt from the government’s requirement to perform abortions and gender-transition procedures.”
O’Connor held that the transgender mandate violates the Religious Freedom Restoration Act “by placing substantial pressure” on the plaintiffs to violate their religious beliefs.
“No party disputes that the [mandate] threatens to burden Christian Plaintiffs’ religious exercise … by placing substantial pressure on Christian Plaintiffs, in the form of fines and civil liability, to perform and provide insurance coverage for gender-transition procedures and abortions.”
“When the RFRA violation is clear and the threat of irreparable harm is present, a permanent injunction exempting Christian Plaintiffs from that religion-burdening conduct is the appropriate relief,” wrote O’Connor.
“Today’s decision rightly says the mandate violates federal law,” said Luke Goodrich, vice president and senior counsel at Becket Fund for Religious Liberty. “Today’s ruling protects patients, aligns with current medical research, and ensures doctors aren’t forced to violate their religious beliefs and medical judgment–a victory for common-sense, conscience, and sound medicine,” he added.
The case, Franciscan Alliance, Inc. et al. v. Xavier Becerra, is one of several involving legal challenges to the rule.
Since 2016, nine states and several religious organizations have sued to block the transgender mandate in court, according to the Becket Fund.
Judge O’Connor initially blocked the mandate in 2016, before striking it down in 2019. The U.S. Court of Appeals for the Fifth Circuit sent the case back to O’Connor in April, without ruling on the merits of the Franciscan Alliance lawsuit. The North Dakota Eastern Division court also ruled against the policy in February.
Secretary Becerra in April appealed the North Dakota ruling, in a lawsuit targeting the Catholic Benefits Association and a group of Catholics nuns.
The Biden administration has 60 days to decide whether to appeal O’Connor’s latest decision.