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US Agencies’ Trans Care Mandates Paused in Christian Group Suit

May 17, 2022, 4:05 PM

The Christian Employers Alliance showed it and its members risk irreparable harm under the Biden administration’s re-imposition of rules that effectively require employers to underwrite gender transition services, a North Dakota federal judge ruled, temporarily blocking enforcement of the requirement.

Issuance of a preliminary injunction in the Oct. 18 lawsuit is also proper because the CEA showed it’s likely to prevail on the merits of at least some of its claims under the Religious Freedom Restoration Act and the free exercise of religion and free speech clauses, the US District Court for the District of North Dakota said Monday.

The ruling bars the Equal Employment Opportunity Commission from interpreting or enforcing Title VII of the 1964 Civil Rights Act against the CEA in a way that would require the organization or its members to provide insurance coverage for gender transition services for employees and their families. It also bars the Department of Health and Human Services from similarly interpreting or enforcing the nondiscrimination provisions of the Affordable Care Act against the CEA and its members.

It’s the latest round in the back-and-forth between the last three presidential administrations over how to define “sex” under the anti-bias requirement of the ACA, Title VII, and related federal laws and regulations.

HHS documents issued during the Biden administration put a rule implemented under the Obama administration in 2016, which defined sex to include gender identity, “back into effect” and negated a contrary 2020 Trump administration rule, the court said.

“It is completely undisputed that the Plaintiffs, compelled by fines and civil liability, must perform or provide coverage for gender transition procedures” under the revived rule, Judge Daniel M. Traynor said. They also face revocation of federal funding they receive under Title IX of the 1972 Educational Amendments Act, civil enforcement proceedings, debarment from doing business with the US government, monetary and criminal penalties, and lawsuits, he said.

The risk of such penalties for an entity’s refusal to violate its religious beliefs places “a substantial burden” on the constitutional rights of the CEA and its members, the judge said.

The EEOC and HHS said it was too early to predict that the revived definition of sex will apply to the CEA or its members because they might be eligible for exceptions under the RFRA.

But religious freedom can’t be encumbered on a case-by-case basis as that’s likely not the least restrictive means of meeting the government’s interest, the court said.

The guidance issued by the HHS encourages parents to file complaints if a medical provider refuses gender transition services to their child, even a newborn, Traynor said.

Alliance Defending Freedom represents the CEA. The Justice Department represent the EEOC and the HHS.

The case is Christian Emp’rs All. v. EEOC, D.N.D., No. 1:21-cv-00195, preliminary injunction granted 5/16/22.

To contact the reporter on this story: Patrick Dorrian in Washington at

To contact the editor responsible for this story: Rob Tricchinelli at