A federal court has ruled that Christian healthcare workers cannot be forced to perform elective, body-disfiguring surgeries for individuals who identify as trans despite a mandate from the Biden administration.

In an order released on Monday, the United States District Court of the District of North Dakota granted partial summary judgment in favor of the Christian Employers Alliance.

At issue were two mandates from the U.S. Equal Employment Opportunity Commission and the U.S. Department of Health and Human Services that interpret Title VII antidiscrimination protections based on “sex” to include sexual orientation and self-declared gender identity.


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It would require religious employers to provide health insurance that covers body-mutilating trans surgeries and force surgeons with religious objections to perform such procedures as castration for males and elective double mastectomies for females or face charges of discrimination based on gender identity.

The court concluded that “CEA will succeed on the merits,” adding that “if CEA had to comply with these mandates, its members would have to violate their sincerely held religious beliefs which is an impermissible exercise under the First Amendment and [the Religious Freedom Restoration Act].”

“CEA’s sincerely held religious belief is that male and female are immutable realities defined by biological sex and that gender reassignment is contrary to Christian Values,” reads the order.

“As a result, performing or providing health care coverage for gender transition services under the EEOC and HHS coverage mandates impinges upon CEA’s beliefs. CEA must either comply with the EEOC and HHS mandates by violating their sincerely held religious beliefs or else face harsh consequences like paying fines and facing civil liability.”

The decision added that although “protecting the right of transgender patients to access crucial healthcare and protecting workers from sex discrimination is certainly a compelling interest, the Defendants here have done nothing more than identify a broadly formulated interest in an attempt to justify the general applicability of the government mandates.”

The Alliance Defending Freedom, a conservative law firm that is helping to represent the CEA, celebrated the order, viewing it as a victory for religious liberty.

“All employers and healthcare providers, including those in the Christian Employers Alliance, have the constitutionally protected freedom to conduct their business and render treatment in a manner consistent with their deeply held religious beliefs,” said ADF Senior Counsel Matt Bowman in a statement.

“The employers we represent believe that God purposefully created humans as either male or female, and so it would violate their religious beliefs to pay for or perform life-altering medical procedures or surgeries that seek to change one’s sex. The court was on firm ground to stop the administration from enforcing these unlawful mandates that disrespect people of faith.”

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