A depressing reality of contemporary American politics is that the hits to the religious freedom of Catholics just keep on coming — even when our nation’s courts reaffirm that such an assault on religious liberty is flagrantly unconstitutional.

A glaring example of this occurred in late August, when the 5th U.S. Circuit Court of Appeals upheld a permanent injunction against the Department of Health and Human Services (HHS), preventing the federal agency from forcing a Catholic hospital network to provide abortions and so-called gender-reassignment treatments “in violation of its sincerely held religious beliefs.” It’s an important win for religious liberty and for sound medical practices — and one that should provide some measure of protection against the ongoing bid by the Biden administration to force all health-care institutions to provide these profoundly immoral procedures.

The legal action that gave rise to the permanent injunction actually dates back to 2016, when the Department of Health and Human Services issued an administrative rule asserting that both gender-reassignment treatments and abortions were mandatory, with no conscience objections, under the non-discrimination provisions articulated in Section 1557 of the Affordable Care Act. 

To defend itself against this Obama-era trampling of their religious-liberty rights, the Franciscan Alliance, a Catholic health-care organization that operates a dozen hospitals, filed suit against the HHS in federal court in Texas. The Texas court subsequently sided with the religious plaintiffs, issuing a summary judgment striking down the mandate regarding abortions and gender-reassignment medical procedures on the grounds it violated the Religious Freedom Restoration Act.

However, while the matter remained largely dormant during the Trump administration, it reemerged in the wake of the Supreme Court’s 2020 Bostock v. Clayton County decision, which interpreted Title VII’s definition of prohibited discrimination on the basis of sex to include homosexuality and gender identity. That decision triggered an array of legal actions targeted at similarly reinterpreting the HHS non-discrimination rule to include gender-reassignment procedures. 

Because of this changed legal landscape, in early 2021, the 5th Circuit instructed the Texas district court to reconsider Franciscan Alliance’s request for a permanent injunction to protect it against any effort to reimpose the offending elements of the 2016 HHS rule. After the district court granted the permanent injunction, HHS appealed that decision to the 5th Circuit, which has now upheld the injunction.

Alongside of the appeal of the district court’s ruling in favor of Franciscan Alliance, the Biden administration has undertaken several other actions in recent months signalling its intent to undermine the rights of religious medical providers in this area, as the 5th Circuit pointedly noted in its decision upholding the permanent injunction. These include President Biden’s January 2021 executive order instructing all federal agencies to apply Bostock’s reasoning; a subsequent May 2021 HHS notification advising it would interpret Section 1557 to prohibit “discrimination on the basis of gender identity”; a March 2022 HHS “Notice on and Guidance on Gender Affirming Care” that stated that efforts to “restrict” gender-reassignment surgeries are “dangerous” and in likely violation of Section 1557; and most notably, the announcement last month of a proposed new HHS non-discrimination rule that would seek to formally reinstate the 2016 mandate requiring hospitals to provide gender-reassignment treatments, including to minors.

If enacted, this sweeping new rule that was crafted in collaboration with activist groups could represent the gravest threat yet by HHS against the religious liberty and conscience rights of Catholic medical professionals.

It’s crucial to note that the stance of faithful Catholic health-care institutions, and of faithful Catholic medical professionals, regarding the evil of these procedures is completely anchored in sound science as well as in the teachings of our faith. 

It’s an indisputable scientific fact that gender-reassignment treatments cause permanent harm to the individuals who receive them — and that this is particularly true in the case of minors. Moreover, it’s a known fact that the vast majority of children who identify as having a gender opposite to their biological sex will outgrow this unfortunate delusion by the time they are adults, so long as they haven’t been permanently injured by unwarranted hormonal and surgical interventions.

But these facts are being completely ignored by HHS, under the current leadership of Xavier Becerra, a dissenting Catholic who has consistently ignored throughout his political career what the Church teaches regarding human life and sexuality. Instead, the federal agency has accepted without question the “LGBT” lobby’s claims that contemporary medical “best practices” mandate these often-irreversible medical interventions — making the U.S. increasingly an outlier, given that a number of other developed nations are rapidly backtracking away from gender-reassignment treatments for minor children, in the face of the growing body of evidence about the grave harm they cause. 

Recent revelations about the University of Washington medical school’s support for gender reassignment for minors further highlights that these policies are grounded in politics, not science.

However, many political leaders are completely unswayed by such medical facts and continue to pressure Catholic health-care entities to provide immoral services, even after our nation’s courts seemed to have definitively ordered a halt to these egregious violations of religious liberty and conscience rights. 

Perhaps the most notable example of this is the ongoing effort by the Pennsylvania state government to compel the Little Sisters of the Poor to provide contraception in their employee health plans, despite the U.S. Supreme Court’s 7-2 decision in favor of the Catholic nuns’ right to refuse to provide such services to employees of the homes for the disadvantaged elderly that the sisters operate.

In light of these unending political attacks against the rights of faithful Catholic health-care providers, it’s imperative that we redouble our prayers on their behalf. We also need to increase our efforts to push back against these unjust government efforts in the new legal actions that are inevitably going to arise.

God bless you!