Doctors fight federal rule prescribing transgender ideology

Two medical professional organizations have challenged an Obama-era rule that has forced many healthcare workers into conflicts with their ethical or religious beliefs about sex and gender. On Jan. 13, the American College of Pediatricians and the Catholic Medical Association appealed an earlier court decision, calling the rule an attempt to squelch debate on controversial and experimental procedures.

The appeal stems from an August 2021 lawsuit filed by the two groups and an OB-GYN against the U.S. Department of Health and Human Services, challenging the rule prohibiting discrimination in healthcare on the basis of gender identity. Medical professionals experienced a brief reprieve from the rule’s requirements during the Trump administration, but the Biden administration reintroduced it and issued notice in 2021 that HHS would begin to enforce it.

On Nov. 18, a federal court dismissed the groups’ lawsuit before considering its merits. Judge Travis R. McDonough, an Obama appointee, decided not to hear the case, saying the medical professionals had not suffered harm from the government mandate.

Alliance Defending Freedom senior counsel Julie Blake called the ruling an outlier. She said it deviates from other district court decisions nationwide as well as recent rulings by two federal appeals courts in favor of medical professionals whose beliefs prevented them from prescribing or performing transgender interventions. Blake thinks the decision will likely be reversed on appeal.

The lawsuit says the administration policy violates healthcare workers’ rights of conscience and free speech. The rule asserts that physicians who tell patients that all “transition-related treatment” is dangerous or experimental are expressing views that are “outdated and not based on current standards of care.” The plaintiffs argue that, under the rule, doctors are not permitted to express concerns that transgender interventions can cause permanent and irreversible damage. They also cannot inform patients that some people later regret undergoing transgender interventions.

The plaintiffs assert that human sexuality is an “objective biological binary trait: ‘XY’ and ‘XX’ are genetic markers of sex—not genetic markers of a disordered body.”

The lawsuit also disputed the presumption that an individual can be born in the wrong body, and it raised concerns that puberty blockers could harm children’s development. “When normal puberty is artificially arrested, valuable time is forever stolen from these children, time that should be spent in normal development,” the plaintiffs wrote. “This time period, during which highly significant and irreplaceable advances in bone, brain, and sexual development occur, is time—and development—that can never be recovered.”

The Food and Drug Administration has not officially authorized any hormones or puberty blockers for gender dysphoria treatment of children, though some providers prescribe them for off-label use in kids. Some medical groups outside of the United States discourage doctors from prescribing transgender interventions like puberty blockers or cross-sex hormones to children.

The lawsuit seeks a permanent ruling for current and future members of the organizations to practice medicine in a way that is consistent with their ethical and religious beliefs, free of government interference regarding gender identity.

The government should promote the common good and dignity of all people while upholding constitutional freedom, said Blake of ADF. Doctors and their patients deserve that from their elected leaders.

“That is why the government should not be forcing doctors to perform controversial, often dangerous procedures that try and alter or disfigure the healthy organs of people simply because that person identifies as a member of the opposite sex,” she said. “All of this is even more true when it comes to performing these life-altering procedures on children.”