The Catholic Medical Association has joined a lawsuit against a Biden administration rule that it says tramples the conscience rights of doctors opposed to gender-transitioning procedures.

In May, the Department of Health and Human Services (HHS) issued a notice effectively reinstating the “transgender mandate,” requiring doctors to perform gender-transitioning procedures upon the referral of a mental health professional. The requirement does not include exemptions for doctors opposed to the procedures for medical or conscience reasons.

“Biological identity must remain the basis for treating patients,” the association’s president Dr. Michael Parker stated on Aug. 26. The "transgender mandate" interprets unlawful sex discrimination in health care to include discrimination on the basis of self-determined gender identity.

“This mandate not only puts the health and safety of our patients in jeopardy, but it in effect also mandates that health care providers give up their fundamental right to conscience. This sets a dangerous precedent with incalculable implications for the ethical practice of medicine,” added Dr. Parker.

The legal group Alliance Defending Freedom filed the lawsuit on behalf of the Catholic Medical Association and the American College of Pediatricians, in a federal district court in Chattanooga, Tennessee. The Catholic Medical Association is a national network of Catholic doctors and health care workers; the American College of Pediatricians is a national network of pediatricians. Together, the groups say they represent 3,000 doctors and health care workers.

“Forcing doctors to prescribe transition hormones for 13-year-olds or perform life altering surgeries on adolescents is unlawful, unethical, and dangerous,” Ryan Bangert, senior counsel with Alliance Defending Freedom, stated on Thursday.

The lawsuit says that under the mandate, “doctors now face an untenable choice: either act against their medical judgment and deeply held convictions by performing controversial and often medically dangerous gender-transition interventions, or succumb to huge financial penalties, lose participation in Medicaid and other federal funding, and, as a practical matter, lose the ability to practice medicine in virtually any setting.”

The May 2021 HHS notice is an interpretation of the Affordable Care Act, which forbids sex discrimination in health care.

The Obama administration first issued the mandate when, in 2016, it interpreted the health care law's prohibition on sex discrimination to include discrimination against gender identity. It required doctors to provide gender-transitioning procedures upon referral, without exemptions for doctors' religious or medical objections.

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Catholic health care institutions and several states sued, and won an injunction from the mandate in federal court in 2016. The Trump administration in 2020 allowed doctors to opt out of the mandate, and re-interpreted the Affordable Care Act’s prohibition on sex discrimination. Two federal courts halted parts of that rule from going into effect, however.

In May, the Biden administration issued its notice reinstating the mandate, and on Aug. 9, a federal district court judge granted permanent relief from the mandate for the Catholic hospital network Franciscan Alliance and the Christian Medical & Dental Associations.

The lawsuit filed by Thursday seeks a permanent nationwide injunction from the mandate for other health care groups as well.