Victory for Medical Judgment and Conscience Protections

Oct 18, 2019

A federal court in Texas struck down an Obama-era rule that forced doctors across the nation to perform “gender-transition surgeries” even if such procedures were against their medical judgment or religious beliefs.

The decision by U.S. District Judge Reed O'Connor reversed a rule from the Obama administration that required doctors to perform “gender transition” procedures upon request on any patient, including a child, even if they had a religious objection or believed the procedure could harm the patient. Doctors who refused to violate their conscience would have faced penalties, including losing their jobs.

Judge O’Connor had issued a preliminary injunction at the end of 2016 against the enforcement of the rule in the case of Franciscan Alliance v. Azar, after doctors around the country filed suit against the mandate on religious freedom grounds. More than 19,000 health care professionals, nine states, and several religious organizations combined in two lawsuits against the mandate, saying that it unlawfully required doctors to, in cases of objection, violate their religious beliefs or the Hippocratic Oath to do no harm to the patient. The regulation stemmed from Section 1557 of the Affordable Care Act, which prohibits discrimination in health care on the basis of race, color, national origin, sex, age, or disability. HHS interpreted “sex discrimination” under this rule to include gender identity, thus mandating the provision of “gender-transition surgeries.”

In June 2019, the Office of Civil Rights issued a Notice of Proposed Rulemaking directly pertaining to Section 1557 and the sex discrimination issue. Just prior to that in May, the U.S. Department of Health and Human Services finalized the Conscience Rule which is expected to go into effect next month. 

The court concluded that the Obama-era rule violated the Administrative Procedures Act because it was contrary to the federal law known as Title IX, and it violated the federal Religious Freedom Restoration Act. The court then vacated the Obama-era rule.

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