Two trans people hold hands while marching under a trans Pride flag in the New York City Pride Parade. (Alexi Rosenfeld/Getty Images)
A federal court has blocked efforts by the Biden administration to ensure trans people are never discriminated against by religious doctors when seeking healthcare.
In 2016, the Obama administration issued an interpretation of the Affordable Care Act, otherwise known as Obamacare, that said healthcare providers who receive federal funds must perform and provide insurance coverage for gender-affirming healthcare – no exceptions.
But the US Court of Appeals for the Fifth Circuit unanimously ruled Friday (26 August) that the Department of Health and Human Resources (HHS) mandate is “in violation of its sincerely held religious beliefs” by not letting medical providers withhold care “on the basis of sex”
The three-judge panel upheld a lower court’s ruling that Franciscan Alliance, a Catholic healthcare network covering Indiana and Illinois, was right to seek out a permanent injunction against the policy.
Franciscan Alliance said the network’s nearly 20,000 doctors and medical providers should not have to provide gender-affirming healthcare or abortion treatments.
The group’s lawyers from the religious liberty group Becket said stopping health professionals from discriminating and denying care to trans people was an unlawful overreach, the Washington Times reported.
To do so, they claimed, would also go against the Religious Land Use and Institutionalized Persons Act (RLUIPA) and the Religious Freedom and Restoration Act (RFRA).
And the judges, two of whom were appointed by Donald Trump, agreed.
“We have recognised that the loss of freedoms guaranteed by the First Amendment, RLUIPA, and RFRA all constitute per se irreparable harm,” wrote Trump appointee judge Don Willett in the ruling.
Fellow Trump-appointee judge Kurt Englehardt and George Bush appointee judge Jennifer Walker Elrod joined him in the ruling.
The appeal ended a years-long battle between religious freedom and healthcare access.
Franciscan Alliance lodged a lawsuit against the policy in December 2016 with the district court for the Northern District of Texas, setting the stage for a legal back-and-forth between the network, federal officials and LGBTQ+ activists.
Though Trump scrapped the rule, president Joe Biden brought it back. The district court sided with Franciscan Alliance in 2019, prompting the federal government and the ACLU to appeal the court’s decision.
“This ruling is a major victory for conscience rights and compassionate medical care in America,” said Joseph Davis, counsel at Becket, in a statement.
“Doctors cannot do their jobs and comply with the Hippocratic Oath if the government requires them to perform harmful, irreversible procedures against their conscience and medical expertise.”
The Hippocratic Oath, an ancient oath of ethics, requires physicians, among other things, to “do no harm” and do everything they can to care for their patients.
Study after study has shown that trans people who receive gender-affirming healthcare are significantly less likely than those who have not to experience depression and anxiety, and consider suicide.