A federal judge has struck down a Biden-era regulation that expanded federal anti-discrimination protections to cover transgender healthcare, ruling the Department of Health and Human Services went beyond its authority. The decision came after a lawsuit brought by a coalition of 15 Republican-led states, and the court found HHS had attempted to redefine longstanding legal terms. The move is being hailed by state officials as a check on federal overreach into medical decisions and state-run healthcare programs.
The challenge was filed by a coalition of 15 Republican-led states: Tennessee, Mississippi, Alabama, Georgia, Indiana, Kansas, Kentucky, Louisiana, Nebraska, Ohio, Oklahoma, South Carolina, South Dakota, Virginia, and West Virginia. Those states argued the rule intruded on state authority over healthcare and Medicaid policy and forced providers and programs to adopt policies they had not agreed to. The case drew sharp attention because it centered on who gets to set rules for medical care and how federal agencies interpret existing civil rights laws.
Judge Louis Guirola Jr., a George W. Bush appointee to the U.S. District Court for the Southern District of Mississippi, issued the ruling against HHS. The court concluded the agency exceeded its authority when it attempted to impose a broader definition of sex discrimination tied to gender identity. That legal finding underscores the separation between Congress’s lawmaking role and federal agencies’ rulemaking powers.
Tennessee Attorney General Jonathan Skrmetti released a pointed statement after the decision, stressing states’ role in health policy and criticizing federal attempts to rewrite law. He said, “When Biden-era bureaucrats tried to illegally rewrite our laws to force radical gender ideology into every corner of American healthcare, Tennessee stood strong and stopped them. Our fifteen-state coalition worked together to protect the right of healthcare providers across America to make decisions based on evidence, reason, and conscience.” He also emphasized the victory for limits on federal power, noting, “This decision restores not just common sense but also constitutional limits on federal overreach, and I am proud of the team of excellent attorneys who fought this through to the finish.”
The plaintiffs focused on the rule’s practical consequences for healthcare facilities, arguing it would interfere with sex-segregated spaces and could require providers to deliver treatments they consider experimental or risky. The legal fight hinged on statutory interpretation and on whether an agency may alter decades-old meanings in statutes without congressional action. The states argued that Congress, not agencies, should make such fundamental changes to federal law.
HHS’s 2024 rule represented a disturbing federal intrusion into the States’ traditional authority to regulate healthcare and make decisions about their own Medicaid programs. Specifically, the rule would have prohibited healthcare facilities from maintaining sex-segregated spaces, required certain healthcare providers to administer unproven and risky procedures for gender dysphoria, and forced states to subsidize those experimental treatments through their Medicaid programs. In vacating the rule, Judge Louis Guirola determined that when Congress passed Title IX in 1972, ‘sex’ meant biological sex and that federal agencies cannot unilaterally rewrite laws decades later to advance political agendas.
The court accepted the argument that Title IX and similar protections historically referred to biological sex, not to a broader gender identity definition imposed by regulation. That interpretation reshapes how federal agencies may apply civil rights statutes to care settings and schools. By returning to the statutory text and legislative history, the judge aimed to keep major policy shifts in the hands of Congress rather than unelected agency officials.
This rule’s history stretches across three administrations: originally issued under President Obama, reversed under President Trump, and later reinstated under President Biden. That back-and-forth highlights the instability that can come when agencies interpret laws in ways that shift with changing administrations. For critics on the right, it also shows why they argue for clearer Congressional action rather than shifting agency directives that change policy overnight.
The ruling has immediate implications for state Medicaid programs, hospitals, and clinics that had expressed concern about being forced into new protocols. It also signals to other agencies that courts are willing to check reinterpretations of long-standing statutes when those reinterpretations reach into areas traditionally governed by the states. Supporters of the decision see it as defending medical judgment, patient safety, and state sovereignty against federal regulatory expansion.
Editor’s Note: The Schumer Shutdown is here. Rather than put the American people first, Chuck Schumer and the radical Democrats forced a government shutdown for healthcare for illegals. They own this.
