Initially implemented in 2016 under former President Barack Obama, the regulation was reversed during President Donald Trump's first term. When ...Joe Biden took office, he reinstated the rule, only for it to face new challenges. At the start of Trump's second term, he issued two executive orders (EOs) that directly conflicted with the regulation.

One EO affirmed the recognition of "two sexes, male and female," stating, as Trump described, that "all sex-protective laws" would "promote this reality." The second EO declared it federal policy to "not fund, sponsor, promote, assist, or support the so-called 'transition' of a child from one sex to another, and it will rigorously enforce all laws that prohibit or limit these destructive and life-altering procedures."

As a result, the regulation never took effect, leaving the practical impact of the recent ruling uncertain. Mississippi Judge Louis Guirola's decision, which seems to have received little public attention, addressed the core of the dispute. The court document outlined the regulation's expansive definition of sex discrimination, stating: "Discrimination on the basis of sex includes, but is not limited to, discrimination on the basis of: (i) Sex characteristics, including intersex traits; (ii) Pregnancy or related conditions; (iii) Sexual orientation; (iv) Gender identity; and (v) Sex stereotypes." The 15 states that filed the lawsuit specifically requested the court to "vacate" these provisions of the May 2024 Department of Health and Human Services (HHS) rule.

The ruling further noted that the regulation prohibited "state-created health benefit exchanges, recipients of Medicaid and Medicare, and others from denying or limiting health services sought for purpose of gender transition or other gender-affirming care that the covered entity would provide to an individual for other purposes if the denial or limitation is based on an individual's sex assigned at birth, gender identity, or gender otherwise recorded." In other words, the controversial rule effectively would have barred medical professionals from refusing to give trans-related "treatment" if requested.

Judge Guirola's decision hinged on the legal scope of the Patient Protection and Affordable Care Act, which grants the HHS Secretary authority to regulate healthcare discrimination based on grounds outlined in Title IX of the Education Amendments of 1972. The court found that "Congress only contemplated biological sex when it enacted Title IX in 1972. Therefore, the Court finds that HHS exceeded its authority by implementing regulations redefining sex discrimination and prohibiting gender identity discrimination."

The ruling also acknowledged the direct conflict between Trump's EOs and the HHS rule. It emphasized that a "statute cannot be divorced from the circumstances existing at the time it was passed, and from the evil which Congress sought to correct and prevent." The court clarified that "when it enacted Title IX, Congress' concern was prohibiting sex discrimination in education. It was particularly concerned with inequality that female students experienced. It did not at that time contemplate gender identity, transgender status, or 'gender-affirming care.'" Furthermore, the ruling stated that "the refusal to provide procedures or medications for gender transition is not sex discrimination."

At the time of filing the suit in the summer of 2024, Missouri Attorney General Andrew Bailey (R), a co-leader of the lawsuit, had already voiced his concern that "Joe Biden is once again exceeding his legal authority in order to force his radical transgender ideology onto the American people." As he had emphasized: "I am filing suit because I will not allow out-of-touch federal bureaucrats to force Missouri healthcare providers into performing experimental and dangerous gender transition procedures on the taxpayer dime." Even ADF Senior Council Julie Marie Blake had described the HHS rule as an "unlawful overreach" and an "attempt to hijack medicine."

The 15 states that were ultimately a part of the lawsuit included Alabama, Georgia, Indiana, Kansas, Kentucky, Louisiana, Mississippi, Nebraska, Ohio, Oklahoma, South Carolina, South Dakota, Tennessee, Virginia, and West Virginia.

The Heritage Foundation's Roger Severino, vice president of Domestic Policy, emphasized that this ruling "is a tremendous vindication." He elaborated to The Washington Stand: "While leading the HHS Office for Civil Rights during Trump's first term, we repealed Obama's transgender mandates in medical care as being against science, biology, and the law. Biden reimposed gender ideology healthcare mandates and judge Guirola has now smacked them down yet again in a well-reasoned opinion applying relevant case law."

According to Severino, the "LGBT Left will never stop trying to impose their agenda through litigation," as such, "SCOTUS should end the ping-pong game and more emphatically say that sex refers to immutable, binary, human biology and not gender identity and related concepts under all federal law." If the high court were to do this, it "would remove any doubt liberals continue to sow about how Title IX and the Equal Protection clause apply to schools, female sports, pronoun mandates, and sex-specific intimate spaces."

Severino concluded resolutely: "Our women and girls deserve that level of clarity and protection." Subscribe for free to Breaking Christian News here

Sarah Holliday is a reporter at The Washington Stand.

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