A federal judge recently overturned a rule from the Biden administration that aimed to extend federal health anti-discrimination protections specifically to gender-affirming care.
Judge Luis Guiroroa Jr. of the U.S. District Court for the Southern District of Mississippi ruled in favor of a coalition of 16 Republican-led states that challenged the rule. This regulation sought to expand the definition of sex discrimination by including sex and gender identity among the characteristics protected in certain health programs and activities.
Guiroroa determined that the Department of Health and Human Services had “overstepped its authority” by redefining sex discrimination in this way and enforcing regulations against gender identity discrimination.
This ruling represents a notable setback for the transgender community, especially amid a broader trend of state and federal policies as well as court rulings that are rolling back previously recognized rights.
The case focused on a section of the Affordable Care Act, specifically Section 1557, which the Biden administration interpreted as bolstering protections against discrimination targeting gay and transgender individuals.
This rule prohibited covered entities from discriminating against specific protected groups in the provision of health care services, insurance coverage, or program participation.
The contentious provision sought to include gender identity in Title IX’s definition of discrimination “on the basis of sex,” which previously encompassed discrimination based on sexual characteristics, pregnancy, sexual orientation, and gender stereotypes.
Released in 2024, the Biden administration’s final rule asserted that organizations receiving federal health funds or insurance companies involved in government programs must not refuse to provide gender-affirming care services for individuals based on other reasons.
The original rule was established in 2016 during the Obama administration, later revoked by President Trump, and then reinstated by Biden. Trump’s initial policy did offer protections against discrimination concerning race, color, national origin, sex, age, and disability but limited the definition of sex to “biological sex,” excluding transgender individuals from its protections.
Guiroroa remarked that the law “cannot be divorced from the circumstances in which it was enacted.” He noted that, since “sex” isn’t specifically defined in the law, it should be interpreted as it was understood around 1972 when the legislation was passed, which emphasized the biological differences between male and female reproduction.
The ruling broadly invalidated this rule, meaning it affects more than just the plaintiffs in those 15 Republican-led states. However, since the rule isn’t currently in effect, the practical implications may be somewhat limited.
Tennessee Attorney General Jonathan Scumetti praised the ruling, stating, “Our 15-state coalition worked together to protect the rights of health care providers across the country to make decisions based on evidence, reason, and conscience. This decision not only restores common sense but also constitutional limits on federal overreach, and I’m proud of the talented team of lawyers who fought this case to the end.”
