A federal appeals court on Wednesday heard arguments in a major religious liberty case that could determine whether Christian doctors and religious hospitals can be forced to perform sex-reassignment surgery and treat gender dysphoria under Obamacare.
At issue is a 2016 Obama-era interpretation of the Affordable Care Act (Obamacare) that prohibits doctors and healthcare facilities from discriminating on the basis of gender identity, which is defined as an individual’s “internal sense of gender, which may be male, female, neither, or a combination of male and female.” Under the rule, doctors and healthcare facilities are required to treat gender dysphoria and perform gender-transition procedures in children and adults or be liable for discrimination.
The rule applies to any doctor or healthcare facility that is “receiving federal financial assistance.”
The Obama-era rule – which was issued by the Department of Health and Human Services – did not include religious exceptions.
The Becket Fund for Religious Liberty sued the government on behalf of the Franciscan Alliance, the Christian Medical and Dental Society, and Specialty Physicians of Illinois. Becket says the rule violates a federal law, the Religious Freedom Restoration Act.
Although a federal judge in 2019 issued a decision favorable to Becket and the coalition, he did not issue an injunction against the Department of Health and Human Services preventing it from enforcing the rule – or one like it – in the future. Thus, Becket appealed to the Fifth Circuit.
Becket calls the rule the “Transgender Mandate.” The Trump administration opposed the rule and sided with Becket. An attorney representing the Biden administration on Wednesday opposed Becket in court.
“Medical decisions related to gender transition have serious implications, and it is clearly in patients’ best interests to ensure that doctors are able to serve in keeping with their consciences and their medical judgment,” said Luke Goodrich, a senior counsel at Becket. “Government bureaucrats in Washington who want to force doctors to perform controversial, experimental procedures are putting children in harm’s way.
“The harmful Transgender Mandate undermines the federal government’s own medical experts’ advice on treating children with gender dysphoria,” Goodrich added. “Yet, politicians and activists are trying to force private doctors, on pain of severe punishment, to perform controversial procedures that can be deeply harmful to patients.”
The transgender mandate, Becket says, “threatens to drive religious doctors” from the profession.
“Notably, the court [Wednesday] asked the government's attorney point blank: Does the new administration have plans to go after these religious doctors and hospitals? And the government wouldn’t answer,” Goodrich tweeted. “This underscores why plaintiffs need full protection.”
A website set up by opponents of the Obama-era rule says that most children “referred for gender dysphoria” grow up not to be transgender. The Obama administration’s “own panel of medical experts concluded that these gender transition procedures can be harmful,” the website says.
Gender transition procedures are hotly disputed within the medical community. Many believe they are deeply harmful—especially when performed on children, who almost always overcome gender-identity struggles as they mature. https://t.co/mBKehvAVrI— Luke Goodrich (@LukeWGoodrich) March 4, 2021
Photo courtesy: ©Getty Images/Bulat Silvia
Michael Foust has covered the intersection of faith and news for 20 years. His stories have appeared in Baptist Press, Christianity Today, The Christian Post, the Leaf-Chronicle, the Toronto Star and the Knoxville News-Sentinel.