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Franciscan Alliance

Transgender health directive halted

One last kick in the rear from the annus horribilis that was 2016.

A Texas judge issued an injunction Saturday against a federal mandate aimed to protect transgender people, finding that the federal health rule violates existing law.

The preliminary injunction, granted by U.S. District Judge Reed O’Connor, is in response to a lawsuit filed by Texas, on behalf of religious hospital network Franciscan Alliance, and four other states in August.

In the suit, Texas and the other plaintiffs argued that a federal regulation prohibiting discrimination against transgender individuals in certain health programs would force doctors “to perform and provide insurance coverage for gender transitions and abortions, regardless of their contrary religious beliefs or medical judgment,” according to the order. The plaintiffs also claim they could be required to perform gender transition procedures on children. Texas asked the court to block the federal government from enforcing the regulation.

Transgender rights activists have refuted claims that the health rule prevents doctors from using sound medical judgment, arguing instead that it clarifies that health care providers can’t deny services or insurance to someone because that person is transgender.

In Saturday’s ruling against the federal government, the judge indicated that a preliminary injunction was appropriate because the federal health mandate violates the Administrative Procedure Act, which governs how federal agencies develop and issue regulations, and likely violates federal religious freedom protections for the plaintiffs that are private entities.

“While this lawsuit involves many issues of great importance—state sovereignty, expanded healthcare coverage, anti-discrimination protections, and medical judgment—ultimately, the question before the Court is whether Defendants exceeded their authority under the ACA in the challenged regulations’ interpretation of sex discrimination and whether the regulation violates the Religious Freedom Restoration Act as applied to Private Plaintiffs,” the order reads.

See here and here for the background. The Chron adds on.

Ezra Young, director of Impact Litigation at Transgender Legal Defense and Education Fund, challenged both rulings as misinterpretations of federal law. He called Saturday’s “flatly contrary to law,” “morally repugnant,” and predicted it would be overturned on appeal.

“The U.S. Supreme Court has long recognized that sex discrimination takes many forms, and our nation’s expansive and unyielding nondiscrimination laws necessarily reach sex discrimination whenever and wherever it strikes,” Young said in a statement Saturday.

[…]

Young said the impact could be damaging to transgender people seeking care, who for years have faced denial of insurance benefits or access to doctors they chose because of their gender identity. Young said while some states have similar rules protecting transgender rights, Obama’s move was “groundbreaking.”

“The benefit of the federal law is it sort codifies things and it gave one unifying rule all across the country,” he said.

I’m sure this will be appealed. At least with the intervention of the ACLU, the defense of the lawsuit can’t be tanked by a corrupted Justice Department. I don’t know enough to speculate about the legalities going forward, but I do know this: Some day, and I hope to live long enough to see it, people will look back at the actions of Ken Paxton and the other obstructers of progress, and wonder what the hell they were doing. Paxton and those like him will be seen as the George Wallace and Bull Connor of the early 21st century. I don’t know when that day will come, I just know that it will.

ACLU intervenes in transgender health care suit

Good for them.

RedEquality

The ACLU and ACLU of Texas are getting involved in a lawsuit over a regulation in the Affordable Care Act. In August, Texas filed a lawsuit against federal regulations that prohibit healthcare discrimination against people who are transgender. The lawsuit was announced by the Becket Fund for Religious Liberty, representing the Franciscan Alliance. The lawsuit will be heard in Wichita Falls.

The rules state that healthcare entities are not allowed to deny or limit services – including gender transition services – based on race, national origin, sex, age or disability.

But the State of Texas, along with four other states, says the regulation in would force doctors to perform medical procedures to change the gender of children.

The ACLU says the lawsuit would have the larger implication of allowing providers to use religion to deny medical care.

Josh Block, a senior staff attorney with the ACLU’s LGBT project, says the lawsuit echoes the recent attempt to strike down guidance from the U.S. Department of Education to allow public school students to use the bathroom that is in line with their gender identity.

Block says the ACLU got involved because no one else had intervened to represent the interest of the people who are being discriminated against.

“It’s really crucial that the people who are being discriminated against have a voice in that courtroom to explain why the law is so necessary,” he says.

[…]

Individual doctors and hospitals are saying they should not be required to perform gender transition procedures because they violate their religious beliefs. Block says the regulations aren’t targeted at individual doctors; instead, they require the medical institution to follow the rules.

“They don’t require anyone to perform any surgery or give any treatment that the doctor doesn’t want to,” Block says. “The obligations are on the entity that’s employing the doctors. The burden isn’t on anyone’s individual conscience – this is an organization that is claiming the right to have federal funds to provide healthcare to the general public but then discriminate based on their religious beliefs.”

See here for the background. I sincerely hope the ACLU has some company in its involvement here. I put in those last two paragraphs to address a comment from my earlier post on this topic. If the rule in question really applies to institutions and not individual doctors, I’m hard pressed to see what the objection is. Truth be told, though, I believe this rule should apply to individual doctors, for the same reason why individual firefighters should respond to an alarm at an LGBT person’s house regardless of that firefighter’s personal feelings. If you can’t treat every person you serve with equal respect, dignity, and effort, then you really ought to consider another occupation, and that’s before we take the Hippocratic Oath into account for the docs. Every person deserves equal treatment. What is so freaking difficult about that?

Paxton continues his war on transgender people

This is just ugly.

RedEquality

Ramping up its fight over the rights of transgender people, Texas filed a lawsuit Tuesday against the federal government over a regulation prohibiting discrimination against transgender individuals in some health programs.

Texas, on behalf of Franciscan Alliance, a religious hospital network, and four other states are claiming the new federal regulation would force doctors to perform gender transition procedures on children and requested the court to block the federal government from enforcing the regulation. The federal rule on nondiscrimination in health care prohibits denying or limiting coverage for transgender individuals, including health services related to gender transition.

The lawsuit was announced by the Becket Fund for Religious Liberty, which is representing the Franciscan Alliance. It was filed Tuesday morning in the Wichita Falls-based District Court for the Western District of Texas.

The case was assigned to U.S. District Judge Reed O’Connor, who on Monday sided with the state and blocked the Obama administration’s guidelines to accommodate transgender students. Those guidelines say that schools must treat a student’s gender identity as the student’s sex for the purposes of complying with federal nondiscrimination statutes.

[…]

Among several legal claims, they argued that the new rule violates the federal Religious Freedom Restoration Act because it compels religiously affiliated health organizations to violate their sincerely held religious beliefs. The federal government is “forcing them to choose between federal funding and their livelihood as healthcare providers and their exercise of religion,” the wrote in a court filing.

You can see a copy of the lawsuit here. Think Progress pulls out some of the highlights:

Essentially, this suit is akin to Hobby Lobby, except it objects to transgender care instead of birth control.

The complaint repeatedly refers to standards of care, and the need for states and physicians to be able to maintain “standards of care that rely upon the medical judgment of health professionals as to what is in the best interests of their patients.” Requiring doctors to perform procedures that they do not believe are in the best interest of the patient would turn “the venerable medical oath to ‘do no harm’ on its head.” Physicians should have the ability “to offer a contrary view” to HHS’s conclusions that transition-related treatments are no longer “experimental.” The plaintiffs in the suit believe that transition care is not only still experimental, but also “ethically questionable and potentially harmful.”

Building standards of care around this belief, the complaint assures, does not compromise patients’ respect:

Every person should be treated with dignity and respect, especially when in need of medical attention. The standard of care established in Texas, and around the country, enables patients to obtain quality healthcare as determined by medical professionals, and not those outside the doctor-patient relationship. The Regulation, however, usurps this standard of care. It discards independent medical judgment and a physician’s duty to his or her patient’s permanent well-being and replaces them with rigid commands.

Nowhere, however, does the suit acknowledge the World Professional Association for Transgender Health (WPATH), which has maintained research-informed standards of care for transgender people for nearly 40 years. The WPATH standards, first proposed in 1979 and updated several times since, are based on “the best available science and expert professional consensus.” They recommend affirming transgender people’s identities and recognize that gender transition improves their well-being.

The plaintiffs in the suit make no secret of the fact that they reject this science in favor of their own religious beliefs. For example, the suit cites CMDA’s “Transgender Identification Ethics Statement,” which takes the literal opposite position of the WPATH standards, because validating transsexual “desires” is “contrary to a Christian worldview:

In contrast to the current culture, CMDA believes that finding one’s identity within God’s design will result in a more healthy and fulfilled life. CMDA believes, moreover, that social movements which contend that gender is decided by choice are mistaken in defining gender, not by nature, but according to desire. Authentic personal identity consists in social gender expression that is congruent with one’s natural biological sex. CMDA recognizes that this traditional view has become counter-cultural; however, CMDA affirms that God’s design transcends culture.

CMDA’s statement also claims that affirming children’s gender identity and allowing them to delay puberty has “lifelong physical, psychological, and social consequences,” even though the available evidence says the exact opposite — that delaying puberty is safe and totally reversible.

Like CMDA, Franciscan similarly rejects the existence of transgender identities:

Franciscan holds religious beliefs that sexual identity is an objective fact rooted in nature as male or female persons. Like the Catholic Church it serves, Franciscan believes that a person’s sex is ascertained biologically, and not by one’s beliefs, desires, or feelings. Franciscan believes that part of the image of God is an organic part of every man and woman, and that women and men reflect God’s image in unique, and uniquely dignified, ways. Franciscan does not believe that government has either the power or the authority to redefine sex.

The suit claims that even providing “psychiatric support” as part of a medical transition would violate its “best medical judgment and its religious beliefs.” Even simply providing insurance coverage for such procedures would “constitute impermissible material cooperation with evil.”

I can’t even wrap my mind around this. Substitute “gay” for “transgender” in the paragraphs above, and ask yourself if this would come close passing legal muster, let alone common decency and medical ethics. And yes, this is the same judge who granted a national injunction in the bathroom case. Give Ken Paxton his due – he knows who the friendly judges are. The Current has more.