Christian medical providers seek to head off transgender mandate

Christian doctors and hospitals are asking an appeals court to preemptively stop the federal government from requiring them to perform gender reassignment surgeries. Their attorneys squared off against the federal government and American Civil Liberties Union in oral arguments on Wednesday. The case highlights concern among Christian healthcare workers that President Joe Biden’s administration will require them to participate in practices that violate their faith.

In 2016, two nationwide Christian healthcare organizations challenged an Obama-era rule requiring medical facilities to provide gender transition surgeries on request—even when providers object on religious or moral grounds. U.S. District Court Judge Reed O’Connor of Texas, an appointee of President George W. Bush, vacated the rule in December 2019, sending it back to the Department of Health and Human Services for reconsideration. But he did not bar HHS from enforcing a similar rule in the future. The plaintiffs in the case, the Franciscan Alliance and the Christian Medical and Dental Society have asked the appeals court to protect them from any such requirements.

During Wednesday’s arguments, the judges questioned whether a ruling was necessary, noting the Trump administration finalized a rule in June 2020 that includes conscience protections for healthcare workers. But an attorney for the two organizations, Joseph Davis of Becket, said the Biden administration will likely take a different approach. He said HHS has already signaled it may not defend those new conscience protections against lawsuits, some of which have been successful. The agency may even interpret the rule as requiring the controversial procedures. Davis also highlighted the widespread fallout from the Supreme Court’s decision in June 2020 extending employment protections under Title VII of the Civil Rights Act to sexual orientation and gender identity.

“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,” Becket counsel Luke Goodrich said.

Research demonstrates that gender transition procedures pose serious physical and psychological risks to children and adolescents. Studies have shown that children who experience gender dysphoria often grow out of it before adulthood, but some physical interventions are irreversible.

The panel of three judges did not say when it would rule on the case.