Pediatricians Appeal Case to Protect Conscience Rights

It seems the Biden administration’s high-handed reinterpretation of federal law will leave virtually nothing and no one untouched—including scientific fact and those in the medical profession.

Shortly after President Joe Biden took office, he issued an executive order instructing his administration to reinterpret “sex” in federal law to include “sexual orientation” and “gender identity.”

As it turns out, the Biden administration’s radical reinterpretation of the law affects section 1557 of the Affordable Care Act (ACA). That means that doctors could be forced to act against their medical judgment, religious beliefs, and conscience in performing dangerous gender-transition interventions on all kinds of patients—including children.

Otherwise, they could face huge financial penalties, loss of federal funding, and even the removal of their ability to practice medicine in most settings.

That’s why Alliance Defending Freedom has filed suit in federal court against the Department of Health and Human Services on behalf of the American College of Pediatricians and the Catholic Medical Association.

Doctors should be free to follow the science, respect sound medical judgment and their consciences, and do no harm to their patients.

Who are the doctors suing the Biden administration?

The American College of Pediatricians (ACPeds) is “a national organization of pediatricians and other healthcare professionals dedicated to the health and well-being of children.”

Founded in 2002, it is a group of concerned physicians who wanted to base its policies upon “scientific truth” and “a framework of ethical absolutes,” not “the politically driven pronouncements of the day.”

The Catholic Medical Association (CMA) is the largest association of Catholic individuals in health care. Its goal is to help members to “grow in faith, maintain ethical integrity, and provide excellent health care in accordance with the teachings of the [Catholic] Church.”

Together, these two medical associations represent 3,000 physicians and health professionals.

Members of ACPeds and CMA and are dedicated to providing health care for all their patients, regardless of their race, ethnicity, religion, ideology, sexual attractions, or gender identity.

Yet they also have deep, substantial, science-based concerns about transgender interventions, including surgery and drug regimens such as puberty-blockers and hormone administration to facilitate a patient’s “transition” from their biological sex to the opposite sex or to another gender (or genders) with which the patient identifies. That is why they object to providing, participating in, offering, or referring for medical transitions, which are required by the government’s interpretation of the ACA and related regulations.

ADF is representing them to ensure that the federal government cannot make medical doctors perform gender-transition surgeries, prescribe gender-transition drugs, and speak and write about patients according to gender identity (rather than biological reality) in contradiction to the doctors’ medical judgment or conscientious objections.

How did the Biden administration overstep its authority?

On Jan. 20, 2021, President Joe Biden issued an executive order that sought to reinterpret the word “sex” in federal laws to include sexual orientation and gender identity.

This new interpretation affects the Affordable Care Act. Section 1557 of that law bans sex discrimination, but the administration has expanded that to create a scenario in which doctors and other health-care professionals could be forced to act against their medical judgment, religious beliefs, and conscience by performing dangerous “gender transition” interventions on patients—including children.

On Aug. 26, 2021, Alliance Defending Freedom challenged the reinterpretation, citing the Administrative Procedure Act because HHS exceeded its statutory authority, the Religious Freedom Restoration Act as it burdens religious medical professionals, and the Free Speech and Free Exercise Clauses of the First Amendment.

A federal district court dismissed the case in January 2023, but ADF appealed to the U.S. Court of Appeals for the 6th Circuit. ADF attorneys presented oral arguments to the 6th Circuit in December 2023.

Who is harmed by the Biden administration’s order

The government is essentially telling those in the medical profession that they need to ignore the scientific fact that there are two sexes—male and female.

The biological reality is that women’s and men’s bodies are not the same. They react differently to different medications. They are at greater risks for different types of cancer. And, of course, only women are capable of being pregnant. Ignoring these facts creates inaccurate, dangerous, and potentially lethal situations for patients of all ages in health care.

These unconstitutional mandates don’t just threaten doctors. They threaten their patients as well—children, in particular.

Gender-transition procedures are dangerous, and in the vast majority of cases, children come to accept their sex without having to use experimental interventions to “transition.” But the Biden administration’s reinterpretation of the law keeps doctors from diagnosing and treating these children in a manner consistent with their expertise and conscience.

The government should promote the common good and dignity of all people while upholding the constitutional freedoms of all Americans. Doctors, and those whom they serve, deserve no less. The government should not force doctors to perform dangerous gender transition procedures that go against their deeply held convictions—especially when they involve children and adolescents.

Case timeline

• May 2016: The Obama/Biden administration issued a regulation reinterpreting sex in Obamacare to include sexual orientation and gender identity. A court blocked the regulation, but other courts later declared it is still in effect.
• January 2021: President Joe Biden issued an executive order for federal agencies to reinterpret “sex” in federal law to include sexual orientation and gender identity.
• May 2021: The Department of Health and Human Services announced it would implement the executive order by immediately enforcing its reinterpretation of sex for all doctors and health-care entities that receive federal health funding.
• August 2021: ADF attorneys filed a complaint in federal court against the Department of Health and Human Services on behalf of the American College of Pediatricians and the Catholic Medical Association.
• January 2023: ADF attorneys appealed to the U.S. Court of Appeals for the 6th Circuit after the district court dismissed the case.
• December 2023: ADF attorneys presented oral arguments before the 6th Circuit.

Learn more:

See how the Biden administration’s reinterpretation of the law could affect doctors around the country: