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Two Courts Throw Out Trump’s Anti-Trans “Conscience” Health-Care Rule

The law would have had striking repercussions for LGBTQ people seeking health care.

In a critical blow to the Trump Administration’s march to roll back LGBTQ rights, two courts have struck down a law shielding health-care workers from turning away transgender patients based on moral or religious objections.

On Wednesday, the Southern District Court of New York threw out Trump’s “Conscience Protections.” The move comes just two weeks before the rule would have taken effect on November 22, and is seen is a major win for LGBTQ rights groups aiming to halt the rapid rollback of trans health-care protections.

On Thursday, the Eastern District Court of Washington also vacated the rule. That opinion has not yet been written.

Both courts determined that the Trump administration had overreached in issuing the rule, which LGBTQ advocates said enshrined discrimination against transgender people.

“This is a core defeat of a tool that the Trump administration is using, not just in health care but across the entire administration,” Gillian Branstetter, media relations manager at the National Center for Transgender Equality, told NewNowNext.

Lambda Legal senior attorney Jamie Gliksberg asserts the ruling will save countless lives. "The Denial of Care Rule was deeply rooted in animus against some of our most marginalized and vulnerable communities, and that has no place in our society,” Gliksberg said in a statement. “We are thrilled about today’s decision.”

The law, born out of the Department of Health and Human Services, would have had striking repercussions for LGBTQ people seeking health care. Under the rule, health-care workers could refuse to treat trans patients, those seeking abortions, and people living with HIV and AIDS on the basis of religious or moral objections.

While LGBTQ opponents have long used religious beliefs to justify their bias, the additional category of “moral objections” created new cover for discrimination, one that LGBTQ advocates feared would be so broad it would be impossible to challenge in court.

Ruling in favor of 19 states and Washington D.C., which challenged the rule, Judge Paul A. Engelmayer said HHS substantially violated Title VII of the Civil Rights Act of 1964. That rule bans sex discrimination (which LGBTQ advocates have argued covers LGBTQ people). It also protects workers based on their religious beliefs, which HHS has argued applies to doctors, nurses, and others who may not want to treat trans patients.

HHS, however, was overly broad in interpreting that law and the preexisting Conscience Provisions passed by Congress to justify the new rule, Engelmayer said.

“Simply put, the Rule’s definition of ‘discrimination’ is game-changing,” he wrote. “Relative to the status quo, it would materially expand the rights of employees articulating objections to covered procedures, and correspondingly enhance the duties of health-care employers in this area.”

Furthermore, Engelmayer said, HHS justified the new rule by lying about an uptick in complaints it received regarding conscience provisions.

“[They] conceded, at argument, that only around 20 complaints implicate any of the Conscience Provisions,” Engelmayer wrote.

That, he continued, was “fatal” to the agency’s justification for implementing the rule.

HHS is expected to appeal the ruling.

The rule is one of a handful of major moves the current administration has made against LGBTQ health care since Trump took office. In May, HHS proposed redefining the Affordable Care Act’s 1557 anti-discrimination protections by removing “gender identity” and stripping transgender protections. NCTE estimates that if HHS prevails in that rule, two million trans Americans will face increased challenges in accessing health care. Hundreds of thousands have submitted comments against the proposal.

Late last week, HHS also announced it was ceasing enforcement of anti-discrimination protections at federally funded health centers, a move that allows doctors to treat same-sex spouses as unmarried.

“It has been made clear to them by [NCTE], by other advocates like us, by public health experts, and by medical providers the harm posed by this and other attacks on the LGBT community,” says Branstetter. “Yet they continue to pursue it as well as expressing an optimistic, sunshiny demeanor about their recognition of civil rights.”

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