Court Rules Christian Nonprofit Does Not Have to Cover Gender Transition

The court ultimately ruled that “providing health care coverage for gender transition services under the EEOC and HHS coverage mandates impinges upon CEA’s beliefs.”

Several states are also banning transgender surgeries. (Photo: Wunschemedien)

In a “resounding victory” for religious freedom, a court in North Dakota ruled this week that the federal government cannot compel religious employers and health care providers to pay for or perform “gender transition” procedures that go against their religious beliefs.

The North Dakota District Court found that the religious beliefs of Christian Employers Alliance (CEA) — a nonprofit group that unites Christian-owned businesses around the cause of religious freedom — were “substantially burdened by the monetary penalties [the group] faces for refusing to violate its beliefs.”

“We are overjoyed our members will not have to choose between the biblically based employee benefits and quality health care they provide, and the threat of federal enforcement and massive costs for practicing their faith,” Shannon Royce, president of CEA, said in a statement on Monday. 

The lawsuit, Christian Employers Alliance v. U.S. Equal Employment Opportunity Commission (EEOC), filed in October 2021, argued against two federal mandates compelling Christian employers to fund or perform “gender transition” procedures. 

The Patient Protection and Affordable Care Act, enforced by the U.S. Department of Health and Human Services (HHS), prohibited a federally funded health program from denying benefits to an individual based on Title IX

The second federal mandate, Title VII of the Civil Rights Act of 1964, bars sex-based discrimination, and per a 2020 Supreme Court decision, also bans discrimination based on “gender identity.” 

However, the federal Religious Freedom Restoration Act (RFRA) prevents the government from “substantially burden[ing]” a person’s religious exercise “unless imposing such a burden is the least restrictive means of furthering a compelling government interest.” 

Alliance Defending Freedom (ADF) argued on behalf of CEA in court. The nonprofit legal organization defends religious freedom, free speech, parental rights, and the sanctity of life.

ADF argued in the lawsuit that the EEOC misinterpreted Title VII to compel religious employers to provide health insurance coverage for “gender transition” surgeries. The lawsuit also challenged the HHS’ reinterpretation of sex in federal law to include gender identity.

“The court was on firm ground to stop the administration from enforcing these unlawful mandates that disrespect people of faith,” Matt Bowman, senior counsel and director of Regulatory Practice at ADF, said of the verdict.

“All employers and health care providers … have the constitutionally protected freedom to conduct their business and render treatment in a manner consistent with their deeply held religious beliefs,” Bowman said. 

“The employers we represent believe that God purposefully created humans as either male or female, and so it would violate their religious beliefs to pay for or perform life-altering medical procedures or surgeries that seek to change one’s sex.”

The court ultimately ruled that “providing health care coverage for gender transition services under the EEOC and HHS coverage mandates impinges upon CEA’s beliefs.” 

“CEA must either comply with the EEOC and HHS mandates by violating their sincerely held religious beliefs or else face harsh consequences like paying fines and facing civil liability,” the ruling stated, further noting that “religious freedom cannot be encumbered on a case-by-case basis.”

Royce called the North Dakota District Court’s decision “a resounding victory for all present and future members of the Christian Employers Alliance.”

“This victory is amazing; however, not universal,” Royce continued. “There are thousands of other Christian-owned, -operated, or -led businesses and ministries that still endure intense pressure and scrutiny by agencies, financial firms, and even employees to acquiesce to the culture’s attempt to redefine biology.”

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