Tennessee Attorney General Jonathan Skrmetti applauded a ruling handed down Wednesday by the U.S. District Court for the Southern District of Mississippi striking down a final rule implemented by the Biden administration’s U.S. Department of Health and Human Services (HHS) redefining the Affordable Care Act’s prohibition against discrimination based on “sex” to include “gender identity.”
In May 2024, Skrmetti and Mississippi Attorney General Lynn Fitch led a coalition of 13 other states in filing a lawsuit challenging the HHS rule, which would have required medical providers to perform surgeries and administer hormone drugs to both children and adults for the purpose of gender transition, without regard for a doctor’s medical judgment as to whether that treatment was appropriate.
When Biden-era bureaucrats tried to illegally rewrite our laws to force radical gender ideology into every corner of American health care, Tennessee stood strong and stopped them.
15-state coalition secures nationwide victory.
Read the release and order: https://t.co/ltV2E7igeW pic.twitter.com/pOdSAz2PH6
— TN Attorney General (@AGTennessee) October 23, 2025
The rule would also have required medical providers to allow patients into sex-segregated spaces, such as parts of a hospital reserved only for women patients, based on their gender identity rather than their biological sex.
Furthermore, the rule would have mandated that every healthcare worker use gender-affirming pronouns and punish providers for using biologically accurate pronouns.
The rule would have accomplished the new requirements by interpreting Section 1557 of the Affordable Care Act, which is cross-referenced to Title IX, to “prohibit gender identity and sexual orientation discrimination by covered health programs.”
The plaintiff states argued that HHS exceeded its statutory authority by expanding the meaning of “sex” beyond what Congress originally intended in 1972, emphasizing how only Congress, not an executive agency, could redefine such a fundamental term.
On Wednesday, the U.S. District Court agreed with the states, ruling that when Congress enacted Title IX, it “only contemplated biological sex” and, therefore, HHS acted beyond its legal authority by redefining sex discrimination to include gender identity.
The court granted the plaintiffs’ motion for summary judgment, meaning the states won without a trial, and denied HHS’s cross-motion to dismiss.
Skrmetti said the court’s decision “restores not just common sense but also constitutional limits on federal overreach” and that he is “proud of the team of excellent attorneys who fought this through to the finish.”
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Kaitlin Housler is a reporter at The Tennessee Star and The Star News Network. Follow Kaitlin on X / Twitter.
Photo “A.G. Jonathan Skrmetti” by A.G. Jonathan Skrmetti.
