A Judge Blocked The Trump Administration's Effort To Roll Back Transgender Healthcare Protections

The court ruling is one of the first to apply the US Supreme Court's expansion of employment protections for LGBTQ individuals to other areas.

WASHINGTON — A federal judge on Monday blocked a Trump administration rule that would allow healthcare providers to discriminate against transgender individuals, one day before the rule was set to take effect.

US District Judge Frederic Block found that the landmark US Supreme Court ruling earlier this summer expanding workplace protections for LGBTQ individuals applied in a legal fight over anti-discrimination provisions of the Affordable Care Act. It's one of the first cases to apply the Supreme Court's decision to other areas of federal law — in this case, healthcare.

The Supreme Court ruled that workplace discrimination based on "sex" included discrimination based on sexual orientation and gender identity. Block, who sits in the federal district court in Brooklyn, found that the administration's plan to remove gender identity from the ACA's anti-discrimination provisions could not stand in light of the Supreme Court's decision in Bostock v. Clayton County.

"The Court reiterates the same practical concern it raised at oral argument: When the Supreme Court announces a major decision, it seems a sensible thing to pause and reflect on the decision’s impact," Block wrote. "Since HHS has been unwilling to take that path voluntarily, the Court now imposes it."

The case before Block involves Section 1557 of the Affordable Care Act, which prohibits discrimination in health programs that receive federal funding. Under the Obama administration, the Department of Health and Human Services adopted rules in 2016 that made clear that Section 1557 applied to discrimination based on gender identity.

A federal judge previously blocked the Obama-era rules from being enforced and sent the matter back to the Department of Health and Human Services. The Trump administration moved to get rid of the gender identity protections altogether. On June 12, the administration announced a final rule that would strip away the gender identity language.

But three days later, the Supreme Court issued its landmark decision in Bostock protecting LGBTQ individuals from discrimination in the workplace. In a 6–3 ruling, a majority of the justices concluded that the federal law that prohibits employment discrimination based on "sex" (Title VII of the Civil Rights Act of 1964) applied in cases involving allegations of discrimination based on sexual orientation and gender identity.

The Section 1557 case before Block is one of several pending legal fights — and more are expected to come — that will test how lower courts apply the Bostock decision in other areas where federal law prohibits sex-based discrimination, including healthcare, education, and housing.

The transgender plaintiffs who sued in the New York case alleged that they were subjected to discrimination when they tried to access healthcare, including misgendering, physical abuse, and some providers' refusal of care.

Block found that the administration's rule stripping away the gender identity protections failed on two fronts. He concluded that the rule was rooted in an interpretation of sex discrimination that the Supreme Court rejected in the Title VII case.

"Had the agency correctly predicted the outcome in Bostock, it may well have taken a different path. Instead, it continued on the same path even after Bostock was decided," Block wrote. "This satisfies the Court that the premise of the repeal was a disagreement with a concept of sex discrimination later embraced by the Supreme Court. Therefore, the repeal was contrary to law."

The judge also found that the rule violated the federal Administrative Procedure Act because the administration failed to address the effects of the Supreme Court case when it finalized the rule in the aftermath of the justices' decision.

"Instead, it did nothing. The timing might even suggest to a cynic that the
agency pushed ahead specifically to avoid having to address an adverse decision," Block wrote.

Human Rights Campaign President Alphonso David released a statement calling Block's decision "a crucial early victory for our plaintiffs, Tanya and Cecilia, and for the entire LGBTQ community, particularly those who are multiply marginalized and suffering disproportionality from the impacts of the twin pandemics of COVID-19 and racialized violence." The organization brought the lawsuit along with the law firm BakerHostetler.

"We are pleased the Court recognized this irrational rule for what it is: discrimination, plain and simple," David said.

A Justice Department spokesperson did not immediately return a request for comment.


Updated with additional information about the plaintiffs legal team.

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