Christian Employers Alliance, a nonprofit representing Christian-owned businesses and protecting religious freedom in the workplace, is suing the Equal Employment Opportunity Commission (EEOC) and Department of Health and Human Services (HHS) for issuing mandates the group argues would require religious employers and providers to pay for and perform, respectively, gender transition surgeries.

The HHS mandate was issued in May by the department’s Office for Civil Rights, invoking its responsibility for enforcing Section 1557 of the Affordable Care Act “protecting the civil rights of individuals who access or seek to access covered health programs or activities,” a responsibility that includes prohibiting discrimination “on the basis of sexual orientation or gender identity.”

The EEOC mandate, citing Title VII of the Civil Rights Act of 1964, requires employers with over 14 employees to “provide employee health plans or health insurance coverage that cover gender transition surgeries and services, such as medical procedures to transition a biological male to a transgender female or to transition a biological female to a transgender male” and “requires coverage for other gender transition services such as supportive counseling/psychotherapy and cross-sex hormone therapy and treatment.”

The EEOC’s mandate has been “for many years now misinterpreted and improperly enforced,” argues the lawsuit filed on behalf of Christian Employers Alliance in U.S. District Court of North Dakota’s Western Division by Alliance Defending Freedom, a Christian legal advocacy group. 

The EEOC’s misinterpretation and improper enforcement of Title VII “force[s] religious employers to pay for and provide health insurance coverage for gender transition surgeries and procedures,” according to the complaint.

The lawsuit challenges HHS’ “reinterpretation of ‘sex’ in federal law to include gender identity, thereby forcing religious healthcare providers to physically perform or facilitate gender transition surgeries and procedures, contrary to their deeply held beliefs.”

“Many religious employers — including the Christian Employers Alliance and all of its members —hold sincere beliefs that gender transition surgeries and procedures are morally wrong and  contradict their beliefs that God purposefully created humans as either a biological male or female and that a person’s biological sex is immutable,” said ADF Senior Counsel Matt Bowman. “By misinterpreting and improperly enforcing federal law, President Biden has far overreached his constitutional authority, to the detriment of people of faith across the country.”

Per the Constitution’s religious freedom protections, Bowman said, “The government cannot force Christian employers to pay for, or physically perform, harmful medical procedures that contradict their religious beliefs.”

In the lawsuit, ADF likened its case to a similar lawsuit by the Religious Sisters of Mercy that was likewise filed against both the EEOC and HHS and decided by the same court in January, but has since been appealed by the federal government to the Eighth Circuit Court of Appeals.

ADF argues that the court, which “permanently enjoined the EEOC and HHS” from enforcing their mandates on the Religious Sisters of Mercy, should issue “a similar declaratory judgment and permanent injunction” for the Christian Employers Alliance.

“Employers and entrepreneurs, like many Americans, are growing increasingly concerned by rising costs that can be blamed in part on oppressive government mandates,” said Christian Employers Alliance President Shannon Royce.

“These gender transition mandates greatly exacerbate this problem by threatening religious employers with punishing fines, burdensome litigation costs, the loss of federal funds, and even criminal penalties,” she continued. “Additionally, the mandate creates a unique quagmire of concerns for religious healthcare providers by forcing them to speak positively about gender transition procedures even if they disagree with them.”

ADF’s legal argument is that the mandates violate both the First Amendment and the Religious Freedom Restoration Act (RFRA), as “HHS currently recognizes no RFRA exemptions under its interpretation of Section 1557 except those ordered by a court.”

The government, meanwhile, argues that the Supreme Court decision in Bostock v. Clayton County last year, which held that Title VII of the Civil Rights Act of 1964 prohibiting discrimination based on sex applies to sexual orientation and gender identity, should be applied to the mandates.