AUSTIN, Texas (CNS)—A federal judge in Texas Dec. 31 blocked a regulation by the Department of Health and Human Services requiring Catholic hospitals and health care providers to perform or provide gender transition services, saying it would place “substantial pressure” on the plaintiffs—a coalition of religious medical organizations who said the ruling was contrary to their religious beliefs.

“Plaintiffs will be forced to either violate their religious beliefs or maintain their current policies, which seem to be in direct conflict with the rule and risk the severe consequences of enforcement,” U.S. District Judge Reed O’Connor wrote.

The injunction comes four months after the same judge blocked a federal directive requiring public schools to let transgender students use bathrooms consistent with their gender identity.

The regulation from the Department of Health and Human Services requires that Catholic hospitals and health care providers perform or provide gender transition services, hormonal treatments and counseling as well as a host of surgeries that would remove or transform the sexual organs of men or women transitioning to the other gender. The HHS regulation requires group health plans to cover these procedures and services.

In the suit filed in U.S. District Court for the Northern District of Texas in Wichita Falls, the Washington-based Becket Fund represented two groups against the new government regulation: Franciscan Alliance, a religious hospital network sponsored by the Sisters of St. Francis of Perpetual Adoration and the Christian Medical and Dental Association. The states of Texas, Kansas, Kentucky, Nebraska and Wisconsin also joined in the suit.

“This court ruling is an across-the-board victory that will ensure that deeply personal medical decisions, such as gender transition procedures, remain between families and their doctor,” said Lori Windham, senior counsel at Becket Law.

She also said the judge’s decision was “a common-sense ruling” noting that the government “has no business forcing private doctors to perform procedures that the government itself recognizes can be harmful, particularly to children, and that the government exempts its own doctors from performing.”

A similar lawsuit was filed against the HHS ruling Dec. 28 by the Catholic Benefits Association, the Diocese of Fargo and Catholic Charities North Dakota in U.S. District Court in North Dakota.

“We ask only for the freedom to serve consistent with our conscience and our Catholic faith,” Bishop John T. Folda of Fargo said in a statement, released by the Catholic Benefits Association. “While we do not discriminate against individuals because of their orientation, our Catholic values will not permit us to pay for or facilitate actions that are contrary to our faith.”

The Catholic Benefits Association is made up of Catholic dioceses, hospitals, school systems, religious orders and other entities that offer their employees insurance and benefit programs that adhere to Catholic teaching.

The regulation, which also mandates abortions be performed, affects health insurers, hospitals and health plans administered by or receiving federal funds from HHS. There is no religious exemption.

The final HHS regulation was published in May. It applies to implementing Section 1557 of the Affordable Care Act, which provides that individuals cannot be subject to discrimination based on their race, color, national origin, sex, age or disability.