Neese v. Becerra

Case Number: 2:21-cv-00163 N.D. Tex.


The Department of Health and Human Services issued an edict that interpreted section 1557 of the Affordable Care Act as prohibiting discrimination based on sexual orientation or gender identity. Practically speaking, this meant that a man who claimed to be a woman could seek medical treatment from a doctor—treatment that would only be provided to a woman—and then file a claim of discrimination against the doctor with the Biden Department of Health and Human Services. A finding by HHS that a doctor engaged in discrimination could result in disastrous consequences for that doctor, including financial penalties and the loss of access to any insurance providers that receive funding from the federal government. The HHS edict would have led to Doctors across the United States having to provide transgender medical services–including prescribing “puberty blockers,” “hormone therapy” for children, and referrals for surgeries that result in castration, sterilization, and genital mutilation.


AFL filed a lawsuit on behalf of a class of doctors across the United States, seeking to have a federal court declare unlawful and set aside the Biden Administration’s edict.


On November 22, 2022, the U.S. District Court for the Northern District of Texas issued a final judgment in AFL’s clients’ favor. It held unlawful and set aside HHS’s edict. As a result, it is not currently in effect, and doctors across America will not be forced to provide these services because of the HHS interpretation.

The Biden Administration has appealed the decision to the U.S. Court of Appeals for the Fifth Circuit, and the case is currently pending there.

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