Federal judge strikes Biden-era rule including gender identity in sex discrimination prohibition

WASHINGTON (OSV News) -- A federal judge recently struck down a rule issued by former President Joe Biden's administration that sought to include gender identity and sexual orientation in regulations seeking to prevent discrimination in health care settings.

Judge Louis Guirola Jr. of the U.S. District Court for the Southern District of Mississippi issued a ruling Oct. 22 in favor of a coalition of 15 GOP-led states that sued over the rule, finding the Department of Health and Human Services "exceeded its authority by implementing regulations redefining sex discrimination and prohibiting gender identity discrimination," when it issued the rule in 2024.

Section 1557 of the Affordable Care Act mirrors language from Title IX's education discrimination prohibitions, which prohibits sex-based harassment, sexual violence, pregnancy discrimination and other types of discrimination.

Attorney General Lynn Fitch argued in an Oct. 23 statement, "The Biden administration attempted to import its radical theories on gender identity into ObamaCare, forcing healthcare providers to perform surgeries or prescribe drugs even if it violated their best medical judgment."

"I am proud to stand with my colleagues from across the country as we fight to undo the Biden administration's extremist political agenda," Fitch said.

Matt Bowman, senior counsel and director of regulatory practice for Alliance Defending Freedom, a legal organization that opposed the rule, said the case concerned "whether doctors can be forced to provide harmful drugs and dangerous surgeries for gender transition and especially for children."

"The statute doesn't say anything about gender identity," Bowman told OSV News in an Oct. 27 interview.

The Obama administration first sought to advance similar rules in what it called an effort to prevent discrimination against transgender and LGBTQ+ individuals. The first Trump administration sought to rescind the rule, and the Biden administration sought to reissue it. However, all of those actions were met with challenges, either in court or from their successor in the White House.

The Catholic Benefits Association is among the groups that challenged the interpretation of Section 1557 to include gender identity and sexual orientation in separate legal cases.
Bowman said the new court ruling could prompt legal questions about whether one of the previous rules -- or any at all -- would fill the void.

"The question of, what is the rule after this rule is vacated? What rule is left?" he said. "That's kind of a sleeper issue."

In guidance on health care policy and practices released in March 2023, the U.S. Conference of Catholic Bishops’ Committee on Doctrine stated the church’s opposition to interventions that "involve the use of surgical or chemical techniques that aim to exchange the sex characteristics of a patient’s body for those of the opposite sex or for simulations thereof."

"Any technological intervention that does not accord with the fundamental order of the human person as a unity of body and soul, including the sexual difference inscribed in the body, ultimately does not help but, rather, harms the human person," the document states.