HHS Appeals Nationwide Pause on Trans Health Protection Rule

The Biden administration is challenging orders from two federal judges blocking enforcement of federal discrimination protections for transgender health care.

The Department of Justice, on behalf of Department of Health and Human Services, filed a notice of appeal Friday in the US District Court for the Southern District of Mississippi, seeking to reverse a judge’s nationwide injunction on Section 1557 of the Affordable Care Act.

The July order, which came in a lawsuit filed by Tennessee and more than a dozen other states, prevented the HHS from implementing the provision prohibiting health-care discrimination based on sexual orientation or gender identity.

The federal government also filed a notice to appeal in a separate case out of the US District Court for the Middle District of Florida, where a judge paused enforcement of the rule in Florida while the litigation continues.

The Florida case now heads to the US Court of Appeals for the Eleventh Circuit, while the Tennessee case goes to the US Court of Appeals for the Fifth Circuit.

The actions mark the continuation of the Biden administration’s attempt to defend its authority to use rulemaking to apply civil rights protections to transgender health services. The injunctions were issued days after the US Supreme Court’s decision in Loper Bright Enters. v. Raimondo, in which justice overturned a decades-old legal doctrine that deferred to federal regulators to interpret unclear laws and complex regulatory matters.

Nearly 20 states have filed lawsuits against the HHS challenging the 1557 rule that was set to go into effect July 5. They claim it forces physicians to perform gender-affirming surgeries, threatening “the livelihood of doctors who refuse to provide experimental, sterilizing, ‘gender-change’ interventions” with “huge financial penalties.”

The attorneys general offices in Florida and Tennessee didn’t immediately respond to requests for comment.

A total of 26 states have enacted bans on gender-affirming care for minors, including surgeries, puberty blockers, and hormone therapy, according to the Movement Advancement Project, an organization that tracks the laws.

The Tennessee case is Tennessee v. Becerra, S.D. Miss., No. 1:24-cv-00161, notice of appeal filed 8/30/24.

The Florida case is Florida v. Department of Health and Human Services, M.D. Fla., No. 8:24-cv-01080, notice of appeal filed 8/30/24.