The Department of Health and Human Services (HHS) opened a new and novel front in its crusade against trans people with the announcement last week of an investigation into hospitals over gender-affirming care and a claim that health workers may refuse to administer this care based on their religious beliefs.The Office of Civil Rights for HHS launched a probe on June 20 investigating the University of Michigan Health system, based on allegations that the hospital fired a nurses aide for exercising her Federally protected rights of conscience. Related Senate drops anti-trans provisions to barely pass major budget bill that cuts Medicaid The Big Beautiful Bill Act passed the Senate by so little that the vice president had to go to the Senate to break the tie. The Civil Rights Office has framed the probe as a review of the hospitals compliance with the Church Amendments, a set of laws written to address health workers religious objections to reproductive rights. The law has never been used in the context of gender-affirming care for trans people. Never Miss a Beat Subscribe to our newsletter to stay ahead of the latest LGBTQ+ political news and insights. Subscribe to our Newsletter today HHS is committed to enforcing Federal conscience laws in health care, said Paula M. Stannard, director of the departments Office for Civil Rights, in a statement announcing the investigation. Health care workers should be able to practice both their professions and their faith.HHS said the investigation of the University of Michiganis the third probe in a larger effort to strengthen enforcement of laws protecting conscience and religious exercise for medical providers. The Michigan probe follows a lawsuit filed by the nurses aide, Valerie Kloosterman, who claims she was compelled to pledge against her sincerely held religious convictions and her medical conscience, that she would speak biology-obscuring pronouns and make referrals for gender transition drugs and procedures. Her lawsuit was dismissed in 2024 and then appealed by Kloostermans counsel, the First Liberty Institute, which advocates for religious liberty plaintiffs. The U.S. Court of Appeals for the 6th Circuit heard arguments in February and has yet to issue a decision.The second and third cases under review involve ultrasound technicians who refused to abet pregnancy terminiation procedures that were contrary to their religious beliefs or moral convictions, and a nurse who asked for a religious exemption to avoid administering puberty blockers and cross-sex hormones to children, according to HHS.The Church Amendments date to the 1970s and allow health care institutions and providers to refuse to participate in pregnancy termination or sterilization procedures.The new probes are the first time HHS has explicitly claimed the amendments allow providers to refuse gender-affirming care or to misgender patients, Elizabeth Sepper, a professor at the University of Texas (UT) who studies conscience laws, told Michigan Public for KFF News. Those laws primarily allow objections to performing abortions or sterilizations but dont apply to gender-affirming care, by their very own text, she said.Some of these also apply to end-of-life care and to physician aid in dying. So they have relatively narrow scope, Sepper said. They focus on a set of procedures. They dont allow health care providers or institutions to refuse to provide all kinds of care based on their religious or moral objections.The investigation sends a message that the administration will investigate or otherwise harass providers of gender-affirming care, even when that provision is legal in the states where they operate, said Sam Bagenstos, a general counsel at HHS during the Biden administration and a professor at the University of Michigan. This case is an extreme stretch of the conscience protections, and probably more than a stretch, he said.By taking up these investigations so publicly, UTs Sepper said, HHS is putting health systems in a very difficult situation. Antidiscrimination laws require them to treat transgender patients equally, she said, but now the administration is prioritizing employees that might want to make it more difficult for transgender patients to receive care.The new tactic, she added, is meant to offer red meat to the anti-LGBT rights movement, to tell them that HHS is squarely on their side. Subscribe to theLGBTQ Nation newsletterand be the first to know about the latest headlines shaping LGBTQ+ communities worldwide.