Federal judge strikes down Biden-era ban on transgender care discrimination
A federal judge on Wednesday struck down a former President Biden-era rule that extended federal health anti-discrimination protections to transgender health care.
U.S. District Court Judge Louis Guirola Jr. for the Southern District of Mississippi ruled in favor of a coalition of 15 GOP-led states that sued the rule, which expanded sex discrimination by adding sexual orientation and gender identity to the list of characteristics protected in certain health programs and activities.
The Department of Health and Human Services “exceeded its authority by implementing regulations redefining gender discrimination and prohibiting gender identity discrimination,” Guirola ruled.
The decision is a significant blow to the transgender community, which has faced a wave of state and federal policies and court decisions rolling back previously established rights.
The complaint centers on provisions of Section 1557 of the Affordable Care Act, which the Biden administration interpreted to strengthen health care protections against discrimination for LGBTQ people.
The rule prevents covered agencies from discriminating against certain protected groups in health care services, insurance coverage, and program participation.
The challenged provision added gender identity “on the basis of sex” to Title IX’s definition of discrimination, which previously included discrimination based on gender characteristics, pregnancy and sexual stereotypes.
The Biden administration’s final rule, which was released in 2024, said agencies with federal health funds and health insurers that do business with government plans cannot refuse to provide health care services, especially gender-affirming care, that would otherwise be provided to an individual.
The rule was first created under former President Obama in 2016. President Trump then reversed it in his first term before the Biden administration reversed it again.
The first Trump policy protects against discrimination based on race, color, national origin, sex, age or disability. But the administration narrowed the definition of sexuality to include only “biological sex,” leaving transgender people out of protections.
Guirolo ruled that a law “cannot grant divorce under circumstances existing at the time of its passage.”
The term “sex” is not defined in the statute, so the court said it must interpret the term according to its meaning in or around 1972, when the statute was enacted. At the time, the definition focused on reproductive differences between men and women.
Guirola vacated the rule universally, meaning it is not limited to 15 red state plaintiffs. But the impact is likely to be limited because the rules have not been implemented.
In a statement, Tennessee Attorney General Jonathan Scormetti celebrated the decision.
“Our fifteen-state coalition has worked together to protect the right of health care providers across America to make decisions based on evidence, reason and conscience. This decision restores not only common sense, but constitutional limits on federal overreach, and I am proud of the team of excellent attorneys who fought to see it through,” he said in a statement.
