A federal district court judge in Jackson, Mississippi has temporarily halted certain aspects of a nondiscrimination rule that would have prohibited insurers and healthcare providers from refusing services like hormone therapy and gender transition surgeries for transgender individuals. U.S. District Judge Louis Guirola Jr. granted an injunction nationwide to the Affordable Care Act rule, which was set to take effect soon. The judge’s decision came in response to arguments from 15 states contending that the 1972 Title IX nondiscrimination law refers to biological sex rather than gender identity.
This ruling marks another setback for the Biden administration’s initiatives to extend protections against discrimination. Over recent weeks, federal judges in multiple states have hindered a rule that aimed to safeguard LGBTQ+ students by broadening the definition of sexual harassment in educational institutions under Title IX.
Healthcare protections based on gender identity were initially introduced during the Obama administration, later revoked under former President Donald Trump, and recently reinstated by the Department of Health and Human Services under the Biden administration. The updated Affordable Care Act rule encompassed discrimination related to “sex stereotypes, sexual orientation, gender identity, and sex characteristics.”
Republican attorneys general in numerous states, predominantly in the South and Midwest, argued against the new rule, citing potential financial burdens for states adhering to it under Medicaid or other federal health programs, or the risk of losing federal funding for non-compliance. These officials also criticized the rule for favoring “gender ideology over medical reality.”
Testimony during the hearing included remarks by Cody Smith, an attorney for the Mississippi Division of Medicaid, highlighting restrictions on gender transition procedures for minors under 18 and the exclusion of “operative procedures to treat a mental condition” from the state’s Medicaid and Children’s Health Insurance Program coverage.
Mississippi Governor Tate Reeves praised the judge’s decision, stating that the Biden administration had attempted to reinterpret Title IX to incorporate gender identity, thereby undermining its original purpose. Reeves expressed gratitude for the judge’s support of Mississippi and other states defending Title IX as currently interpreted.
Requests for comments from the U.S. Department of Health and Human Services, the U.S. Office for Civil Rights, and the attorneys general for Tennessee and Mississippi were not immediately answered. Tennessee Governor Bill Lee’s office declined to comment on the ongoing legal matter.
