Federal Judge Strikes Down Obamacare Transgender Health Care Provisions
Under Biden-era rule, medical providers accepting federal funds would have been prohibited from denying “gender-affirming care“
A federal judge in Mississippi has invalidated a Biden-era regulation that sought to extend healthcare protections to transgender individuals. The decision came after a multistate lawsuit challenged the administration’s interpretation of federal anti-discrimination law.
Judge Louis Guirola Jr. of the U.S. District Court for the Southern District of Mississippi sided with a coalition of 15 Republican-led States in Tennessee et al. v. Kennedy et al. The plaintiffs argued that the Department of Health and Human Services (HHS) overstepped its bounds by redefining “sex” in federal law to include gender identity.
The rule in question interpreted Section 1557 of the Affordable Care Act to bar discrimination in healthcare not only on the basis of biological sex but also on the basis of gender identity. Under that regulation, medical providers accepting federal funds would have been prohibited from denying “gender-affirming care.”
In his ruling, Judge Guirola held that HHS "exceeded its authority" by expanding the meaning of “sex discrimination” to include gender identity—something neither Title IX nor the ACA explicitly defined. He wrote that when Title IX was enacted in 1972, Congress had understood “sex” to refer to biological distinctions between males and females—not to gender identity or “transition-related treatment.”
The 15-state coalition included Tennessee, Mississippi, Alabama, Georgia, Indiana, Kentucky, Louisiana, Nebraska, Ohio, Oklahoma, South Carolina, South Dakota, Virginia, and West Virginia.
Tennessee Attorney General Jonathan Skrmetti, one of the lead litigants, welcomed the decision. He said,
“When Biden-Era bureaucrats tried to illegally rewrite our laws to force radical gender ideology into every corner of American healthcare, Tennessee stood strong and stopped them … This decision restores not just common sense but also constitutional limits on federal overreach.”
The ruling vacates the rule nationwide, though the regulation had already been blocked from going into effect by earlier court orders.
Because the regulation was under injunction, its practical impact may be limited in the short term. Still, legal analysts say the ruling could ripple into other areas where federal agencies have sought to reinterpret “sex” in civil rights laws.
At issue is a key question: can federal agencies redefine long-standing laws to reflect changing social norms, or must Congress act explicitly? Judge Guirola’s decision leans toward the latter, concluding executive efforts cannot rewrite core legal definitions decades after a statute’s passage.
This case joins a broader wave of court decisions pushing back on expansive interpretations of sex discrimination in education, employment, and healthcare. In recent months, federal courts have struck down or paused rules that would have protected gender identity under Title IX and other statutes.
The decision marks a notable shift in federal policy on transgender rights—one with real consequences for patients across the country that healthcare providers, insurers, and advocacy groups on both sides of the issue are closely watching.
The Final Judgement may be found HERE, and a longer Memorandum Opinion & Order explaining the court’s reasoning is at THIS LINK.
