A federal judge in Texas issued another crushing blow to President Obama’s transgender agenda Saturday: The judge granted a temporary injunction halting federal health officials’ efforts to enforce rules that would “likely violate” the Religious Freedom Restoration Act.

In a 46-page decision, U.S. District Judge Reed O’Connor sided with the state and ruled that the Obama administration’s attempts to tailor health regulations while bolstering trans individuals’ rights would “likely violate” the RFRA by placing “substantial pressure on Plaintiffs to perform and cover transition and abortion procedures.” The rule, which was geared toward preventing discrimination against trans persons, failed to persuade O’Connor as he weighed its implementation against the possibility of violating doctors’ religious beliefs.

“The beauty of the ruling is it returns those sensitive medical decisions to the doctor and the patient without government intervention.”

“While this lawsuit involves many issues of great importance — state sovereignty, expanded healthcare coverage, anti-discrimination protections, and medical judgment — ultimately, the question before the Court is whether Defendants exceeded their authority under the [Affordable Care Act] in the challenged regulations’ interpretation of sex discrimination and whether the regulation violates the Religious Freedom Restoration Act as applied to Private Plaintiffs,” O’Connor wrote.

When the state of Texas filed the lawsuit in August, the states of Kentucky, Nebraska, Wisconsin, and Kansas filed as well, in addition to the Indiana-based Christian Medical and Dental Association and Franciscan Alliance.

Upon O’Connor’s ruling, transgender rights advocates cried out in protest.

“The U.S. Supreme Court has long recognized that sex discrimination takes many forms, and our nation’s expansive and unyielding nondiscrimination laws necessarily reach sex discrimination whenever and wherever it strikes,” Ezra Young, director of impact litigation at the Transgender Legal Defense and Education Fund, said in a statement Saturday.

Young also called O’Connor’s ruling “flatly contrary to law” and “morally repugnant.”

But as O’Connor noted, the rule would have “imposed a substantial burden” on private health care providers’ abilities to honor their religious exercise and expression because the rule contains no suitable exemptions.

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“The regulations at issue would force doctors to enforce gender transition procedures even on young children, even when doctors believe the procedure is harmful,” Luke Goodrich, an attorney with the Becket Fund for Religious Liberty representing the case’s plaintiff, told the Houston Chronicle.

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“The beauty of the ruling is it returns those sensitive medical decisions to the doctor and the patient without government intervention, and it respects ultimately the doctor’s medical judgment,” Goodrich added.

O’Connor’s Saturday decision marked the second time he has actively thwarted the Obama administration’s agenda in 2016. Back in October, the judge blocked the federal government’s move requiring public schools to allow trans persons to use whichever restroom suited their gender identities.