A federal appeals court on Friday permanently blocked the Biden administration from requiring religious doctors and hospitals to perform transgender medical services that violate their conscience, becoming the second court to do so. 

The U.S. Court of Appeals for the Eighth Circuit affirmed a lower court ruling in favor of the plaintiffs in Sisters of Mercy v. Becerra, a case concerning a coalition of Catholic groups who have challenged the Biden administration's attempt to invoke the Affordable Care Act to prohibit doctors and hospitals from discriminating against transgender patients. The Catholic groups, which include hospitals, a university and nuns who run health clinics, say the Biden administration's rule violates their free exercise of religion. 

An August ruling from the Fifth Circuit Court of Appeals similarly held that the federal government cannot force Christian medical organizations to perform abortions or gender transition surgeries under the Affordable Care Act.

US GOVERNMENT CAN'T FORCE CHRISTIAN GROUPS TO PERFORM ABORTIONS, GENDER REASSIGNMENT SURGERY, COURT RULES

Xavier Becerra, secretary of Health and Human Services (HHS), speaks during a news conference at the HHS headquarters in Washington, D.C., on Tuesday, June 28, 2022. Under the White House's direction, Becerra unveiled an action plan in response to the U.S. Supreme Court's decision to overturn Roe v. Wade.  (Amanda Andrade-Rhoades via Getty Images)

In 2016, the Department of Health and Human Services promulgated a rule implementing the probation of discrimination under Section 1557 of the Affordable Care Act, also called Obamacare. The rule prohibits discrimination on the basis of sex in all health programs and requires doctors and hospitals who receive funding from HHS (including hospitals that accept Medicare or doctors who accept Medicaid) to treat individuals consistent with their gender identity. 

Any doctor or hospital who violates the rule could face severe financial penalties.

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People hold signs during a joint board meeting of the Florida Board of Medicine and the Florida Board of Osteopathic Medicine gather to establish new guidelines limiting gender-affirming care in Florida, on Nov. 4, 2022. (Ricardo Ramirez Buxeda/Orlando Sentinel/Tribune News Service via Getty Images)

Catholic employers sued, arguing that the government's mandate "forces doctors to perform controversial and sometimes harmful medical procedures" and violates their religious conscience. The lawsuit was joined by the state of North Dakota and the Becket Fund for Religious Liberty, which is representing the plaintiffs, Sisters of Mercy, the University of Mary and SMP Health System. 

On January 21, 2021, U.S. District Court Judge Peter D. Welte ruled in favor of the Catholic groups, blocking the transgender rule from taking effect. Welte, a Trump appointee, also blocked the Equal Employment Opportunity Commission (EEOC) from requiring the Catholic employers to provide insurance coverage for sex-change surgeries or cross-hormone therapies. 

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Demonstrators protest in support of rights for transgender youth. (WHD News )

The Biden administration appealed to the Eighth Circuit, but a three-judge panel of Republican appointees upheld the lower court's ruling that "intrusion upon the Catholic Plaintiffs’ exercise of religion is sufficient to show irreparable harm." 

"The federal government has no business forcing doctors to violate their consciences or perform controversial procedures that could permanently harm their patients," said Luke Goodrich, vice president and senior counsel at the Becket Fund for Religious Liberty. 

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"This is a common-sense ruling that protects patients, aligns with best medical practice and ensures doctors can follow their Hippocratic Oath to ‘do no harm,'" he added.

The Biden administration may next ask the full Eighth Circuit to rehear the case or make an appeal to the Supreme Court.