HHS Can’t Force Catholic Hospital Network to Perform Abortions, Gender Transitions, Court Says

The court noted that other cases showed that permanent protections are warranted.

HHS secretary Xavier Becerra.
HHS secretary Xavier Becerra. (photo: Vasilis Asvestas / Shutterstock)

WASHINGTON — A federal appellate court on Friday blocked a push to force doctors to perform abortions or sex-reassignment surgeries.

The decision against such a federal mandate was made on religious freedom grounds.

“This ruling is a major victory for conscience rights and compassionate medical care in America,” Joseph Davis, counsel at the legal group Becket, said on Aug. 26.

“Doctors cannot do their jobs and comply with the Hippocratic Oath if the government requires them to perform harmful, irreversible procedures against their conscience and medical expertise,” he said.

The court case is known as Franciscan Alliance v. Becerra. Franciscan Alliance, a hospital network founded by the Sisters of St. Francis of Perpetual Adoration. Becket is the alliance’s legal representation. Nine states joined the suit, as did other groups including the Christian Medical and Dental Association.

The Fifth Circuit Court of Appeals on Friday sided with a lower court order and permanently enjoined the U.S. Department of Health and Human Services from requiring the Catholic hospital network to perform abortions or sex-reassignment surgeries “in violation of its sincerely held religious beliefs.”

The court noted that other cases showed that permanent protections are warranted. These include cases brought by the American Civil Liberties Union, whose Texas affiliate had sided with the government against the Franciscan Alliance and other plaintiffs.

Critics of gender transition have cited scientific, moral, and religious objections. Foes of abortion say the procedure kills an unborn human being, citing moral and scientific concerns as well as religious objections.

The mandate dates back to 2016 when the Obama administration interpreted a provision of the Affordable Care Act of 2010 to require procedures including abortion on request and purported gender-transitioning. The Obama administration interpreted a ban on “sex discrimination” to include refusal to perform abortion or to affirm gender identity.

The 2016 mandate did not include conscience exemptions, thus forcing almost all doctors and hospitals around the country to provide gender-transitioning procedures upon the referral of a mental health professional, regardless of their moral or professional opposition to doing so. 

According to Becket, this included procedures to be performed on children.

“For years, our clients have provided excellent medical care to all patients who need it,” Davis said. “Today’s ruling ensures that these doctors and hospitals may continue to do this critical work in accordance with their conscience and professional medical judgment.”

In August 2021, the Catholic Medical Association, represented by the Alliance Defending Freedom legal group, filed a lawsuit seeking a nationwide injunction against the mandate.

A mandate requiring religious non-profit and for-profit employers to pay for or perform gender transition surgeries has also drawn legal challenges. In January 2021, the Catholic Benefits Association secured an injunction against the HHS mandates and similar Equal Employment Opportunity Commission rules, which mandated insurance coverage or medical referrals for gender transition therapy.

In 2020 the Trump administration issued a rule protecting doctors who opposed the transgender mandate at issue in the Franciscan Alliance case, but a federal court enjoined that action.

President Joe Biden has said his administration will interpret federal anti-discrimination laws to prohibit gender identity discrimination, a move which has strengthened the push to mandate the provision of gender transition procedures and insurance coverage for these procedures.

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