A federal judge struck down a Biden administration regulation that gave federal health care anti-discrimination protections to those seeking transgender-related health care.

Responding to a lawsuit brought by 15 states, U.S. District Judge Louis Guirola of the Southern District of Mississippi issued the ruling on Oct. 22.

Guirola’s ruling affects the entire United States and is not limited to the states that filed the lawsuit.

It is unclear what impact the judge’s order will have, as the regulation had not yet taken effect at the time of the ruling.

The 15 states were Alabama, Georgia, Indiana, Kansas, Kentucky, Louisiana, Mississippi, Nebraska, Ohio, Oklahoma, South Carolina, South Dakota, Tennessee, Virginia, and West Virginia.

The decision concerns a May 2024 rule issued by the Department of Health and Human Services (HHS) that, among other things, redefined sex discrimination to compel health care providers, Medicaid, Medicare, and state health care insurance exchanges to provide transgender-related procedures and hormone therapies and surgeries, which supporters refer to as “gender-affirming care.”

Specifically, the states challenged only the rule’s provisions that addressed gender-identity discrimination.

The Obama administration first issued the rule in 2016. In President Donald Trump’s first term, his administration reversed it. After President Joe Biden took power, his administration reinstated the rule.

At the beginning of his second term, Trump issued two executive orders that conflicted with the HHS rule.

Executive Order 14168, dated Jan. 20, states it is the policy of the federal government “to recognize two sexes, male and female.”

“Under my direction, the Executive Branch will enforce all sex-protective laws to promote this reality,” Trump said in the order.

Executive Order 14187, dated Jan. 28, says it is federal policy to “not fund, sponsor, promote, assist, or support the so-called ‘transition’ of a child from one sex to another, and it will rigorously enforce all laws that prohibit or limit these destructive and life-altering procedures.”

Activist groups typically view transgender-related health care through the lens of civil rights, arguing that restricting access to treatment both harms patients and violates their rights.

The judge said when Congress passed the Patient Protection and Affordable Care Act, known as the Obamacare law, HHS was given authority to enact regulations prohibiting health care discrimination “on the ground prohibited under … Title IX of the Education Amendments of 1972.”

Title IX is a federal civil rights law that forbids sex-based discrimination at any school that receives federal funding.

Guirola said when Congress approved Title IX in 1972, it “only contemplated biological sex” and the word “sex” must today be interpreted according to its meaning in 1972.

This means that HHS exceeded its lawful authority when it implemented regulations under the Obamacare law that redefined sex discrimination and prohibited discrimination based on gender identity, he said in the order.

Guirola said a statute “cannot be divorced from the circumstances existing at the time it was passed,” quoting a 1951 Supreme Court precedent known as United States v. Champlin Refining Company.

At the time Congress enacted Title IX, it was concerned with prohibiting “sex discrimination” in education.

It was focused on the “inequality that female students experienced,” and did not at that time contemplate “gender identity, transgender status, or ‘gender-affirming care,’” the judge said.

Oklahoma Attorney General Gentner Drummond lauded the new court ruling.

“The Biden administration had no authority to impose its unlawful agenda on American health care,” Drummond told The Epoch Times.

“I am pleased the court agreed that health care providers should not be forced to go to such extremes as providing irreversible gender transition surgeries and care.”

Drummond said the rule could have had a significant impact on Oklahoma, which forbids minors from receiving puberty blockers, cross-sex hormones, and irreversible surgeries as part of a transgender-related procedure.

Tennessee Attorney General Jonathan Skrmetti also praised the new decision.

When the Biden administration “tried to illegally rewrite our laws to force radical gender ideology into every corner of American health care, Tennessee stood strong and stopped them,” he said in a statement.

“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.”

A spokesperson for the Department of Justice, which represents federal agencies in the courts, declined to comment.