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Explainer: The Biden administration backs down from transgender mandate

Baptist Press photo


On June 21, the Biden administration passed on its final opportunity to appeal the Eighth Circuit Court of Appeal’s ruling that struck down the “transgender mandate” in Sisters of Mercy v. Becerra. Counsel in the case, Luke Goodrich, said, “after multiple defeats in court, the federal government has thrown in the towel on its controversial, medically unsupported transgender mandate.”

The case was brought by the Sisters of Mercy, the University of Mary, and the SMP Health System in 2016 challenging the mandate that would require them to provide gender transition care against their religious convictions and medical expertise. The court struck down the mandate in December.

A similar case named Franciscan Alliance v. Becerra also succeeded in challenging the transgender mandate in August after the Fifth Circuit Court of Appeals ruled that it violated religious freedom. The group represented an association of over 19,000 healthcare professionals, eight states, and two religious hospitals. The Biden administration declined to appeal this decision, as well. 

In response to the decision, ERLC President Brent Leatherwood said, “The Biden administration’s decision to back down from the transgender mandate marks a significant victory in safeguarding the rights of medical professionals to operate in a manner consistent with their deepest held beliefs. This is an important development we should take note of because it not only represents a win for conscience rights but also furthers efforts to shield vulnerable individuals who should never become pawns in the sexual revolution.”

What is the transgender mandate?

In 2016, as a part of the implementation of Section 1557 of the Patient Protection and Affordable Care Act (ACA), the Obama Administration’s Department of Health & Human Services (HHS) promulgated a rule requiring medical providers to perform and ensure abortions and gender-transition procedures or face penalties. Section 1557 of the ACA is the nondiscrimination provision of the ACA, and the scope was broadened by redefining “sex” to include sexual orientation and gender identity.

The regulations came to be called the transgender mandate because they would require physicians to provide gender reassignment surgeries and administer hormones to facilitate gender reassignment, including to children, even if the doctor believed the procedure would be harmful.

In 2021, upon taking office, Biden reversed the Trump administration’s conscience protections by continuing to amend the language in the ACA to force doctors to perform gender-transition surgeries. The litigation was still in the courts pending a final decision, both of which came in 2022. The expiration of the appeal deadline terminates the Biden administration’s attempts to force the transgender mandate through the ACA. 

How has the ERLC been involved?

From the beginning, the ERLC has been an outspoken opponent of the transgender mandate because of its harmful implications for those undergoing these procedures as well as its flagrant violations of religious liberty and conscience protections for healthcare professionals.

Opposing the transgender mandate has been a top public policy priority for the ERLC, and in 2022, the ERLC filed public comments opposing the Department of Health and Human Services’ (HHS) most recent attempt to steamroll the consciences of these medical professionals. Today’s failure to appeal is a final victory after many years of dedicated advocacy from the ERLC and religious liberty allies.

Why does this matter to Southern Baptists?

As Southern Baptists, we believe that God, in his good design, has created us to be male and female to promote our flourishing. Despite how culture’s views of sexuality and gender may change over time, our commitment to this truth remains steadfast. 

Similarly, religious liberty and the protection of conscience is a bedrock principle for Baptists. As the Baptist Faith and Message describes, “God alone is Lord of the conscience.” Mandates from the government that force individuals to choose between their deeply held beliefs and their duties in the workplace must be opposed. The ERLC will always work to promote the dignity of all people and protect the religious liberty of all people of faith.

Following the decision, ERLC President Brent Leatherwood said, “Whether it is championing the preservation of individual consciences rooted in faith or defending the well-being of all image-bearers, the ERLC stands resolute, advocating tirelessly on behalf of our SBC churches. In doing so, we will not yield in our mission to protect and defend those who need it most.”

    About the Author

  • Hannah Daniel

    Hannah Daniel serves as a Policy Associate in the ERLC’s Washington, D.C. office.

    Read All by Hannah Daniel ›
  • Timothy Mackall