Court Permanently Blocks Biden Administration’s Transgender Mandate

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A federal appeals court has permanently blocked the Biden administration’s bid to force doctors and insurers to perform or pay for gender-transition procedures even if they object on grounds of conscience and medical judgment, with the court basing its decision on constitutional protections of religious freedom.

The U.S. Court of Appeals for the 8th Circuit issued a unanimous ruling (pdf) on Dec. 9 blocking the controversial U.S. Department of Health and Human Services (HHS) transgender mandate.

Issued in 2016, the mandate interpreted the Affordable Care Act in a way that required doctors to perform gender-transition procedures on any patient, including children, even if the doctor was convinced the procedure could harm the patient.

Controversial Mandate

The mandate also required the vast majority of private insurance companies and many employers to cover the costs of gender-transition therapy or face penalties.

The HHS’s own panel of medical experts acknowledged that gender-transition procedures can be harmful and in many cases not medically justified, with HHS determining that Medicare and Medicaid should not be forced to cover such procedures.

Research has shown that gender-transition procedures carry significant risk for children, including loss of bone density, heart disease, and cancer.

‘Do No Harm’

Religious organizations and states sued to block the mandate, with the Becket Fund for Religious Liberty and the North Dakota Attorney General’s office representing some of the groups.

“The federal government has no business forcing doctors to violate their consciences or perform controversial procedures that could permanently harm their patients,” Luke Goodrich, vice president and senior counsel at Becket, said in a statement.

“This is a common-sense ruling that protects patients, aligns with best medical practice, and ensures doctors can follow their Hippocratic Oath to ‘do no harm,’” he added.

Becket filed the lawsuit in 2016 on behalf of a coalition of Catholic hospitals, a Catholic university, and Catholic nuns who run health clinics for the poor.

By Tom Ozimek

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