A federal judge overturned a 2016 Obama era policy that protected transgenders against healthcare providers who used religious freedom to deny treatment.
Judge Reed O'Connor in the Northern District of Texas overturned the 2016 ObamaCare protections for transgenders on Tuesday.
The Obama era policy prevented insurers and providers who receive federal funds from denying patients on the basis of sex, gender identity or termination of pregnancy.
The policy required doctors and hospitals to provide "medically necessary" services to transgender individuals as long as those services were the same ones provided to other patients.
President Obama's Department of Health and Human Services defended a challenge by a group of Christian providers as well as five conservative states.
But President Trump's administration dropped the defense in 2017 after Trump took office.
LGBT advocates complain that overturning the policy will allow doctors and hospitals to deny treatment to transgenders.