Restoring Medical Judgment and Conscience on Gender Issues

Case: Franciscan Alliance v. Azar
Represented by: Becket
Case Start Date: August 23, 2016
Decision: October 15, 2019; pending in Fifth Circuit
Deciding Court: U.S. District Court for the Northern District of Texas
Original Court: U.S. District Court for the Northern District of Texas

A federal mandate issued in 2016 required doctors to perform gender transition procedures on any patient, including a child, even if the doctor believed the procedure would be harmful. That rule was struck down in court after it was challenged by nine states, several religious organizations, and an association of over 19,000 healthcare professionals. In May 2019, HHS proposed bringing its regulations into compliance with those decisions and ensuring that the personal decision to undergo gender transition procedures is kept between patients and their doctors, free from government interference.


  • On May 24, 2019, HHS proposed a new rule that follows a court ruling, complies with accepted medical research and protects both the medical judgment of the doctor and the unique, individual needs of the patient.
  • On October 15, 2019, a federal judge confirmed his earlier ruling that the government’s 2016 HHS mandate is unlawful, ensuring that doctors can continue practicing in their field of medicine without being forced to perform procedures that violate their faith.
  • On September 21, 2020, Becket filed our opening brief before the Fifth Circuit Court of Appeals, asking for a final ruling to make sure any future HHS rules comply with the law and respect the rights of medical practitioners.
  • Read more about the decision.
  • Read more about the transgender mandate.
  • Track at Becket: CMA / Freedom2Care lawsuit restoring medical judgment and conscience on gender issues