A federal judge has ruled that federal anti-discrimination protections for transgender people in health care are unconstitutional, allowing legal discrimination in health care against trans individuals in the U.S.

Judge Louis Guirola, Jr., of the U.S. District Court for the Southern District of Mississippi sided with a coalition of 15 GOP-led states that sued over the rule, which broadened sex discrimination to include sexual orientation and gender identity in health care, the Hill reported.

The U.S. Department of Health and Human Services “exceeded its authority by implementing regulations redefining sex discrimination and prohibiting gender identity discrimination,” Guirola wrote.

The expanded definition of sex discrimination to include sexual orientation and gender identity was part of Section 1557 of the Affordable Care Act. The Biden-Harris administration implemented it to strengthen protections against health care discrimination for LGBTQ people. It previously prevented discrimination in health care services, insurance coverage, and program participation.

This is not the first time such protections have faced legal challenges. In 2016, the Obama-Biden administration advanced similar rules to prevent health care providers from denying services — particularly gender-affirming care — that they would otherwise offer to other patients.

During President Donald Trump’s first term, those protections were reversed when his administration redefined Title IX protections to apply only to race, color, national origin, “biological sex,” age, or disability — explicitly excluding trans people.

In 2024, the Biden-Harris administration reinstated these protections, only for them to be struck down by Republican-appointed Guirola.

Tennessee Attorney General Jonathan Skrmetti celebrated the ruling, saying 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.”

The decision comes as the U.S. Supreme Court recently heard arguments on banning so-called conversion therapy, and may soon take up a case involving the right to same-sex marriage.

The Supreme Court’s new term begins this week, with multiple cases on the docket that could have serious consequences for the civil rights of the LGBTQ community.

Many issues are being debated this term, including the scope of civil rights protections under the Equal Protection Clause, Title IX, and the Voting Rights Act—all of which could leave LGBTQ Americans less protected.

This Supreme Court is different from years past. Its right-wing supermajority is utilizing a more activist approach to legal interpretation—siding more often with President Trump’s preferred interpretation of laws rather than a more constitutional evaluation. One Supreme Court Justice, Clarence Thomas, even went so far as to publicly state he has a problem with the way judges are restricted by past decisions, saying he is against the concept of stare decisis (or sticking to prior judges’ decisions) and that they are “not the gospel.”

There are three major cases that in some way impact—or have the possibility of impacting—the rights of LGBTQ Americans: West Virginia v. B.P.J., Little v. Hecox, and Chiles v. Salazar. The first two deal with the rights of transgender girls participating in sports. The last one, Chiles v. Salazar, centers around the legality of banning conversion therapy.

West Virginia v. B.P.J.

In West Virginia v. B.P.J., a transgender girl, known as B.P.J., takes gender-affirming medication and has since the onset of puberty. She wants to compete on her school’s cross-country and track teams. In 2021, West Virginia passed the “Save Women’s Sports Act,” which requires public school and collegiate sports teams to designate their players’ genders by “biological sex” rather than gender identity.

In this case, the Court will determine whether this act violates Title IX—a federal law prohibiting discrimination based on sex in education or any institution that receives federal funding—or the Equal Protection Clause, which prohibits unfair and unequal discrimination, by requiring B.P.J. to be on a team based on her biological sex.

As Joshua Block, senior counsel with the American Civil Liberties Union’s (ACLU) LGBT & HIV Project, explained, “In terms of the legal issues before the court, the West Virginia case presents both the Title IX issue and the equal protection issue.” He also highlighted the broader impact: “Some of the lower courts are actually holding their cases pending BPJ, the Seventh Circuit recently did that in one of their restroom cases.”

Little v. Hecox

In Little v. Hecox, the Court will similarly evaluate the legality of Idaho’s transgender sports law—the “Fairness in Women’s Sports Act,” which, since its passage in 2020, has barred any transgender girls from participating on public school-affiliated sports teams. There is specific wording in the law that says the hormones present in transgender women, regardless of their stage of transition, make them predisposed to winning and create an unfair playing field—even if transgender people take Gender-Affirming Hormone Therapy (GAHT).

Lindsay Hecox, a transgender woman and student at Boise State University, attempted to join the school’s cross-country team but was denied, with the school citing that her participation violates the law. Hecox, along with a cisgender high school athlete identified in court documents as Jane Doe, filed a suit arguing that the “Fairness in Women’s Sports Act” violated both of their constitutional rights under the Equal Protection Clause of the 14th Amendment.

Block noted during the briefing, “Lindsay, unlike BPJ, is a young woman in college, and she has not had blockers. She suppressed testosterone after puberty at the same time, as I mentioned, she was not, frankly, good enough to make the team, and has just been playing club sports.” Regarding procedural concerns, he added, “Unlike other cases where a party has sought to insulate a favorable judgment from review, we obviously think the decision below needs to be vacated because it’s moot.”

Block went on to spotlight that both West Virginia v. B.P.J. and Little v. Hecox are clearly supported by Title IX, using the Court’s decision in 2020 in Bostock v. Clayton County as the basis. In that case, the Court found that the Civil Rights Act of 1964 protects not only on the basis of sex and race, but also on sexual orientation and gender identity.

“There’s obviously an overlap on the question of whether, as a general matter, the Supreme Court’s reasoning in Bostock applies to Title IX,” Block said. “Bostock says you can’t fire someone for being transgender. I think it should go without saying that a school principal can’t expel someone for being transgender either. Despite that, the states are trying to argue that Bostock doesn’t apply to Title IX at all.”

Chiles v. Salazar

While West Virginia v. B.P.J. and Little v. Hecox examine Title IX and the Equal Protection Clause, Chiles v. Salazar evaluates the legality of a Colorado House Act banning conversion therapy under the Free Speech Clause of the First Amendment. The Free Speech Clause has five parts, but this case focuses on the right to practice the religion of one’s choosing and the provision that the state may not establish a religion. Conversion therapy is defined in this case as any practice that “changes behaviors or gender expressions or seeks to eliminate or reduce sexual or romantic attraction or feelings toward individuals of the same sex.”

In Chiles v. Salazar, Kaley Chiles, a licensed counselor who identifies as a Christian, has argued that HB19-1129, also known as the “Prohibit Conversion Therapy for a Minor Act,” violates her First Amendment rights. Chiles practices “faith-informed” counseling that seeks to “reduce or eliminate unwanted sexual attractions, change sexual behaviors, or grow in the experience of harmony with [their] physical body.” She brought forward a pre-enforcement lawsuit against the state, arguing that the law has made her refrain from discussing possible gender- and sexuality-related topics with her clients and has dampened her ability to provide counseling services in line with her and her clients’ religious preferences.

Josh Rovenger, the legal director at GLAD Law, an LGBTQ+ legal services and civil rights organization, explained what Chiles v. Salazar could mean for the future of LGBTQ rights in America.

“Fundamentally, what’s at stake… is whether a state like Colorado and the 23 other states, plus the District of Columbia that have similar laws have the ability to protect LGBTQ plus youth from disproven conversion therapy practices that cause lasting trauma to the individuals, their families, and entire communities.”

He went on, explaining that the scope of the law is so specific that the plaintiff’s concerns may not apply.

“The law here is really quite narrow, aimed at a very specific, specific prohibition, and a lot of the activities that the plaintiff says that she wants to engage in, as Colorado points out in its brief, just aren’t covered by the law,” Rovenger said. In addition, he added there are multiple states that have banned the practice of conversion therapy with little issue. “Multiple states which have bipartisan laws that were passed with widespread support, including support from religious communities, would potentially be invalidated as a result of that type of decision, and that would be overruling an overwhelming medical consensus about the evidence of conversion therapy practice harms.”

As GLAAD noted in a press release, “Every major medical and mental health association in the country condemns the practice and supports efforts to prevent practitioners from violating their oath to do no harm.”

The Bigger Picture

These cases, Rovenger explained, don’t collectively signal that the Supreme Court will side in one particular way, but rather that some of the justices are interested in the cases.

“The first is the fact that they took these cases only means that four justices were interested in hearing them,” Rovenger said. “It does not tell us anything about where they’re going to come out on the cases ultimately. And there was no reason for the court to take either of or any of these cases.”

Rovenger, who served as Associate Counsel to President Biden in the White House for Racial Justice & Equity, went on, emphasizing the importance of the broader political context in this legal targeting of trans kids.

“Before 2020, decisions about sports were being left to school districts and sports organizations, the people who know these issues best… And then in 2020 we saw trans issues more generally, but sports in particular, being used as a wedge issue and a weapon to further a political agenda,” he said. “Since the beginning of 2025 that has been on steroids from the federal administration, which has really targeted transgender individuals, generally, and transgender kids who just want the opportunity to play school sports for the same reason other kids do — to be part of a team where they feel like they belong.”

He continued, saying that these cases would mostly impact some of the most vulnerable LGBTQ population—LGBTQ youth.

“These cases are going to have significant implications for LGBTQ youth, for LGBTQ individuals more generally, for school environments, for the ability of states to protect LGBTQ youth from discredited medical practices. And so when we think about the day-to-day experience of LGBTQ folks in this country, particularly youth, these cases will have a direct impact on those lived experiences.”

A fourth case concerns marriage equality and a decade-old effort by former Kentucky county clerk Kim Davis to overturn the Obergefell ruling. Legal experts have called the effort a long shot. Justices will likely decide whether to hear the case later this fall.

More than 200 people gathered in front of the U.S. Supreme Court on Friday and demanded the Trump-Vance administration return to the U.S. a gay Venezuelan asylum seeker who it “forcibly disappeared” to El Salvador.

Lindsay Toczylowski, president of the Immigrant Defenders Law Center, a Los Angeles-based organization that represents Andry Hernández Romero, is among those who spoke alongside U.S. Rep. Mark Takano (D-Calif.) and Human Rights Campaign Campaigns and Communications Vice President Jonathan Lovitz. Sarah Longwell of the Bulwark, Pod Save America’s Jon Lovett, and Tim Miller are among those who also participated in the rally.

“Andry is a son, a brother. He’s an actor, a makeup artist,” said Toczylowski. “He is a gay man who fled Venezuela because it was not safe for him to live there as his authentic self.”

(Video by Michael K. Lavers)

The White House on Feb. 20 designated Tren de Aragua, a Venezuelan gang, as an “international terrorist organization.”

President Donald Trump on March 15 invoked the Alien Enemies Act of 1798, which the Associated Press notes allows the U.S. to deport “noncitizens without any legal recourse.” The Trump-Vance administration subsequently “forcibly removed” Hernández and hundreds of other Venezuelans to El Salvador.

Toczylowski said she believes Hernández remains at El Salvador’s Terrorism Confinement Center, a maximum-security prison known by the Spanish acronym CECOT. Toczylowski also disputed claims that Hernández is a Tren de Aragua member.

“Andry fled persecution in Venezuela and came to the U.S. to seek protection. He has no criminal history. He is not a member of the Tren de Aragua gang. Yet because of his crown tattoos, we believe at this moment that he sits in a torture prison, a gulag, in El Salvador,” said Toczylowski. “I say we believe because we have not had any proof of life for him since the day he was put on a U.S. government-funded plane and forcibly disappeared to El Salvador.”

“Andry is not alone,” she added.

Takano noted the federal government sent his parents, grandparents, and other Japanese Americans to internment camps during World War II under the Alien Enemies Act. The gay California Democrat also described Hernández as “a political prisoner, denied basic rights under a law that should have stayed in the past.”

“He is not a case number,” said Takano. “He is a person.”

Hernández had been pursuing his asylum case while at the Otay Mesa Detention Center in San Diego.

A hearing had been scheduled to take place on May 30, but an immigration judge the day before dismissed his case. Immigrant Defenders Law Center has said it will appeal the decision to the Board of Immigration Appeals, which the Justice Department oversees.

“We will not stop fighting for Andry, and I know neither will you,” said Toczylowski.

Friday’s rally took place hours after Attorney General Pam Bondi said Kilmar Abrego Garcia, a Maryland man who the Trump-Vance administration wrongfully deported to El Salvador, had returned to the U.S. Abrego will face federal human trafficking charges in Tennessee.