Judge rules that Christian businesses can refuse to provide full health care for trans employees

A federal judge in North Dakota has ruled that a Christian business group does not have to include gender-affirming care in its employee health care plan or provide gender-affirming care for trans folks due to its religious beliefs.

The decision was the result of a case filed by the Christian Employers Alliance (CEA) against the Equal Employment Opportunity Commission (EEOC) and the U.S. Department of Health and Human Services, both of which interpreted the Supreme Court’s decision in Bostock v. Clayton County to ban employers from discriminating against trans folks in health insurance plans under the Affordable Care Act.

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The CEA describes itself as “driven by the purpose of courageously defending the freedoms of Christian business owners.” It claimed that the government’s interpretation of Bostock violates its religious freedom under the First Amendment.

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The ruling from U.S. District Judge Daniel Traynor stated that “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” and as such, “CEA’s religious beliefs are substantially burdened by the monetary penalties it faces for refusing to violate its beliefs.”

“Therefore,” the judge declared, “CEA has met its initial burden of showing the government substantially burdens a sincere religious exercise or belief.”

The judge banned the federal government from imposing any financial penalties on CEA for refusing to cover or provide gender-affirming care. The decision also stated that the government cannot penalize “anyone acting in concert or participation with them.”

This means doctors associated with the group do not have to provide gender-affirming care and associated businesses do not have to cover it.

CEA celebrated the ruling, calling it a victory against “radical transgender mandates.” The group was represented by the anti-LGBTQ+ hate group Alliance Defending Freedom (ADF), which has played a key role in cases around the world attacking LGBTQ+ rights.