Multi-State Lawsuit Challenges HHS Rule on Gender Identity

Tennessee and Mississippi lead a lawsuit against HHS over a rule redefining sex discrimination to include gender identity.

NASHVILLE – Tennessee Attorney General Jonathan Skrmetti and Mississippi Attorney General Lynn Fitch have announced a multi-state lawsuit against the U.S. Department of Health and Human Services (HHS). The lawsuit challenges a new rule that redefines the Affordable Care Act’s prohibition against sex discrimination to include gender identity.

The rule mandates that medical providers perform surgeries and administer hormone treatments for gender transitions to both children and adults, disregarding a doctor’s medical judgment about the appropriateness of such treatments. Additionally, it requires medical providers to admit patients into sex-segregated spaces, such as hospital areas reserved for women, based on gender identity rather than biological sex. It also enforces the use of gender-affirming pronouns by healthcare workers, with penalties for using biologically accurate pronouns.

A similar rule was established by the Obama Administration in 2016, prioritizing gender identity over medical judgment. This rule was struck down by federal courts. The states involved in the current lawsuit expect a similar outcome.

“By filing this lawsuit today, we’re sending a simple message: the Biden Administration has no legal authority to impose this radical ideological agenda on American healthcare,” said Attorney General Skrmetti. He cited examples from Europe where irreversible gender transition treatments for minors are being banned or limited after reviewing medical evidence. Skrmetti argued that the Biden Administration’s rule is an illegal imposition on healthcare providers to adopt extreme versions of gender ideology, contrary to the United States Constitution and Section 1557 of the Affordable Care Act.

The rule could significantly impact Tennessee and other states that restrict gender-transition interventions for minors and do not use public funds to pay for these procedures. Non-compliance with the new HHS rule could result in the loss of substantial federal funding, including state Medicaid funds, and expose entities to civil liability through private lawsuits.

Tennessee and Mississippi have filed the lawsuit in the U.S. District Court for the Southern District of Mississippi. They are joined by Alabama, Georgia, Indiana, Kansas, Kentucky, Louisiana, Nebraska, Ohio, Oklahoma, South Carolina, South Dakota, Virginia, and West Virginia.

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