The Trump administration has finalized a regulation rolling back Obama-era protections for transgender Americans against sex discrimination in health care. According to the new version of the policy, the Department of Health and Human Services will be “returning to the government’s interpretation of sex discrimination according to the plain meaning of the word ‘sex’ as male or female and as determined by biology”. The Obama regulation defined gender as a person’s internal sense of being male, female, neither or a combination. The policy shift, long sought by Donald Trump’s religious and socially conservative supporters, would allow healthcare providers and insurance companies that receive federal funding to refuse to provide or cover transition-related care for trans Americans. Several organizations have announced they will challenge the change. The Human Rights Campaign announced it would file a lawsuit. The ACLU has also said it would sue to overturn the Trump rule. Under the Obama-era federal rule, a hospital could be required to perform gender-transition procedures such as hysterectomies if the facility provided that kind of treatment for other medical conditions. The rule was meant to carry out the anti-discrimination section of the Affordable Care Act, which bars sex discrimination in healthcare but does not use the term “gender identity”. Roger Severino, head of the health department unit that enforces civil rights laws, has said trans people continue to be protected by other statutes that bar discrimination in healthcare on account of race, color, national origin, age, disability and other factors. But LGBTQ+ groups have long argued protections are needed for people seeking gender confirmation treatment, and for trans people who need medical care for common conditions such as diabetes or heart problems. Women’s groups say the new regulations also undermine access to abortion, which is a legal medical procedure. “No one should fear being turned away by a medical provider because of who they are or the personal health decisions they have made,” said Fatima Goss Graves, president of the National Women’s Law Center. For the administration, it is the latest in a series of steps to revoke newly won protections for LGBTQ+ people in areas ranging from the military to housing and education. The administration also has moved to restrict military service by trans men and women, proposed allowing certain homeless shelters to take gender identity into account in offering someone a bed for the night, and concluded in a 2017 justice department memo that federal civil rights law does not protect trans people from discrimination at work. Friday’s announcement came on the fourth anniversary of the Pulse nightclub shooting, when a shooter killed 49 people at a gay nightclub in Orlando, Florida.