A federal judge in the Southern District of Mississippi has ruled against the Biden administration’s rule expanding anti-discrimination protections to transgender individuals in healthcare settings. The decision, issued by Judge Louis Guirola Jr., cited the Department of Health and Human Services (HHS) as exceeding its authority by redefining sex discrimination to include gender identity as part of its regulatory expansion.
The ruling comes in response to a lawsuit from 15 Republican-led states, including Tennessee, Mississippi, Alabama, Georgia, Indiana, Kansas, Kentucky, Louisiana, Nebraska, Ohio, Oklahoma, South Carolina, South Dakota, Virginia, and West Virginia. These states argued that the HHS rule represented an illegal overreach by federal agencies, as it sought to include gender identity under anti-discrimination provisions of Title IX, which was enacted in 1972. The judge’s opinion emphasized that the term ‘sex’ in Title IX was intended to refer to biological sex, and that federal agencies could not unilaterally redefine it to advance political agendas.
Tennessee Attorney General Jonathan Skrmetti, who spearheaded the lawsuit, praised the ruling as a victory for states’ rights. He stated that the 15-state coalition fought to protect healthcare providers from being forced to implement ‘experimental treatments’ for gender dysphoria, which he argued could be risky and unproven. The HHS rule, implemented in May 2024, had proposed that healthcare facilities could no longer maintain sex-segregated spaces, required certain procedures for gender dysphoria, and forced states to subsidize those treatments through Medicaid. The judge agreed that these provisions constituted a significant intrusion on state authority over healthcare.
The HHS rule was first introduced during the Obama administration in 2016 but was reversed by Trump in 2018. It was reinstated by Biden in 2021 but had already been stayed since July 2024 following a court order. The judge’s decision now vacates the rule entirely, returning the issue to a potential legislative or regulatory solution. While the outcome may impact the future of transgender healthcare protections in the U.S., it does not immediately affect the status of existing healthcare policies in the 15 states that filed the lawsuit.