North Dakota Court rules that doctors can refuse gender-affirmation care for religious reasons

A North Dakota federal judge ruled that religious doctors don’t have to perform gender-affirmation surgeries, in a ruling which could provide another barrier for trans and non-binary people to access treatment.

On 4 March, the court ruled that the Equal Employment Opportunity Commission (EEOC) violated the First Amendment by trying to make gender-affirmation surgeries compulsory for healthcare workers to provide in the state for those in the LGBTQ+ community.

In 2021, the Christian Employers Alliance (CEA) filed a lawsuit against the EEOC for two mandates which required religious employers to provide health insurance which covered gender-affirming treatment to their employees, as well as requiring religious doctors to perform life-saving affirmation surgery, or face gender identity discrimination charges.

The Alliance Defending Freedom (ADF) represented CEA and argued that the mandates required employers and doctors to speak positively of gender-affirmation treatment, even if they objected.

However, the District Court of North Dakota ruled in favour of the CEA under the argument that the rules would violate an employer’s or doctor’s religious beliefs.

Legislators in the state have been widely criticised in recent moments, after passing a record number of anti-LGBTQ+ bills last year. 

In April 2023, the state senate passed ten bills with bans on trans students joining sports teams that match their gender identity, sweeping bans on gender-affirming healthcare for young people and a ban on public drag performances. 

Alarmingly, a bill also advancing at the time would see the removal of trans individuals from state data collection.

The passing of 10 anti-LGBTQ+ bills represents the most legislation of its kind advanced in a single day, according to the Human Rights Campaign (HRC), via NBC News.

North Dakota state senator Ryan Braunberger – a Democrat and out gay man – denounced the wave of anti-LGBTQ+ bills being put forward during a stirring senate speech in which he recalled how he’d tried to take his own life in his youth.

“I was lucky to survive that suicide attempt – to be here – but many others have not and will not,” Braunberger said at the time.

The politician added that if the bills were to be passed, “kids like me across the state will feel like the world is against them. They’ll eventually feel like they can no longer go on.”