Bloomberg Law
Dec. 9, 2022, 5:04 PMUpdated: Dec. 9, 2022, 6:30 PM

Catholic Groups Secure Block on Transgender Care Mandate (1)

Martina Barash
Martina Barash

Enforcement of a federal requirement that health-care and insurance groups perform or pay for gender-transition care would violate the religious rights of several Catholic organizations, the Eighth Circuit affirmed Friday.

The Religious Sisters of Mercy and the other groups are entitled to a permanent injunction, the US Court of Appeals for the Eighth Circuit said in a unanimous decision.

The US Health and Human Services Department and Equal Employment Opportunity Commission’s interpretation of how the Affordable Care Act’s Section 1557 and Title VII apply to transgender care conflicts with the Religious Freedom Restoration Act, the court said.

The decision echoes one by the Fifth Circuit in August affirming an order permanently blocking the government from requiring Christian doctors and hospitals to provide gender-confirming care to transgender people.

The government said at oral argument that religious groups lacked standing to challenge the policy.

But an attorney for the Catholic groups argued they faced a credible threat that HHS or EEOC would bring actions against them for allegedly violating Section 1557 or an EEOC provision requiring employers to include transgender care in their employee health plans.

The Eighth Circuit resolved standing and ripeness issues in favor of the plaintiffs, except that it said one group, the Catholic Benefits Association, hadn’t shown standing through its membership.

And the court affirmed the lower court’s permanent injunction barring enforcement against the groups, saying they had shown imminent irreparable harm through a likely RFRA violation.

Judge Lavenski R. Smith wrote the opinion, which Raymond W. Gruender and Jonathan A. Kobes joined.

The Becket Fund for Religious Liberty and the North Dakota Attorney General’s office represented the Religious Sisters of Mercy and some of the other groups. Nussbaum Speir Gleason PLLC represented the Catholic Benefits Association and other plaintiffs. The Department of Justice represented the government.

The case is Religious Sisters of Mercy v. Becerra, 8th Cir., No. 21-1890, 12/9/22.

(Adds information and court analysis throughout.)

To contact the reporter on this story: Martina Barash in Washington at

To contact the editors responsible for this story: Rob Tricchinelli at; Andrew Harris at