North Dakota Doctors are Free to Refuse Certain Treatments to Trans Individuals 

American doctors often find themselves at the forefront of religious lawsuits – and for obvious reasons. The freedom to refuse or provide treatment based on religious belief is one of those legal “grey areas” that has confounded the highest courts for decades. What is more important? The right of the patient to healthcare or the right of the doctor to religious freedom? In at least one case regarding trans patients, this question seems to have been answered by a recent ruling in North Dakota. 

Christian Employers Alliance Successfully Sues the Equal Employment Opportunity Commission over Trans Patients

In 2021, the Christian Employers Alliance (CEA) sued the Equal Employment Opportunity Commission (EEOC). Three years later, they achieved victory. Under instruction from the Biden administration, the EEOC had previously sought to implement policies that forced all employee health plans to provide coverage for gender-affirming surgeries for trans employees. The CEA objected to these mandates, arguing that making an employer pay for gender-affirming surgeries would force them to go against their Christian beliefs. Many interpret orthodox Christianity to define only two genders and believe gender surgeries are contrary to Christian values. 

This case was further complicated by the conflicting policies and laws put in place by North Dakota and the federal government. On one hand, the EEOC bans all sex-based discrimination under the Affordable Care Act. According to a US Supreme Court ruling from 2020, gender-based discrimination falls under the general category of sex discrimination. 

However, North Dakota criminalized all gender-affirming surgeries in 2023, and they even made it a felony to perform these surgeries on minors. In addition, it is a misdemeanor in North Dakota to prescribe hormone-blocking therapies for the purpose of transitions by trans individuals. 

Whatever you think about these diametrically opposed stances on gender surgeries, they clearly left employers in a very difficult situation. On one hand, they risked being involved in a potential felony if they paid for employees’ gender-affirming surgeries. On the other hand, they risked an EEOC lawsuit for sexual discrimination if they refused to pay for this surgery. Although the outcome of this particular lawsuit has led to a clear victory for Christian employers in North Dakota, this confusing situation will continue to inspire lawsuits at the federal level.

EEOC Accused of “Taxing” Faith

Some have interpreted this situation as an effective “tax” on Christianity. Employers who refused to comply with these gender-affirming surgeries would inevitably face a lawsuit and subsequent financial fines. In effect, one might argue that this is exactly the same as taxing someone for the “crime” of practicing their faith. Charging someone a fee to practice Judaism or Islam in the United States would be completely unthinkable – not to mention unconstitutional. And yet, this is what Christian employers in North Dakota would have experienced if they had refused to comply with the EEOC. 

One has to wonder how this ruling will affect Christian employers in other states. If it is unconstitutional in North Dakota, then it could be unconstitutional in other states as well. 

Keep Informed with the Universal Life Church

Each month, various cases test the nature of religious rights in this country. While the basis for many religious rights is the United States Constitution, there are still countless cases that question the exact nature of these rights. The Universal Life Church’s blog is focused on documenting the most noteworthy of these cases in an objective manner that can be easily understood by readers.