President Donald Trump’s administration on Friday finalized a rule that reverses Obama-era special rights for transgenders. The action has infuriated LGBTQ activists, Democrat House Speaker Nancy Pelosi, and the American Civil Liberties Union. The ACLU plans to sue the Trump administration over the issue. In an election year this issue may become a touchstone highlighting the differences between the Republican and Democrat parties on cultural issues and special rights for selected groups.

The Trump Department of Health and Human Services, led by Dr. Ben Carson, said it will enforce sex discrimination protections “according to the plain meaning of the word ‘sex’ as male or female and as determined by biology.” This rewrites Obama-era special rights that sought an unconventional understanding of gender definitions motivated by a person’s psychological sense of being male, female, of neither sex, pansexed, multisexed, quasisexed, neosexed, or a combination of all of the above, and not by their obvious biological gender.

LGBTQ pressure groups say special protections are needed for people seeking sex-change treatment and for transgenders who may need very different care even for common illnesses such as diabetes or heart problems.

But conservatives say the Obama administration overstepped its authority in elastically interpreting gender, “Under the old Obama rule, medical professionals could have been forced to facilitate gender reassignment surgeries and abortions even if they believed this was a violation of their conscience or believed it harmful to the patient,” said Mary Beth Waddell of the Family Research Council. However, Democrat House Speaker Nancy Pelosi responded to conservatives and others who define gender biologically by saying, “Religious freedom is no justification for hatred or bigotry, and every American has the right to seek and receive care without intimidation or fear.” That, by the definition of the Obama-era rules, includes biological men who seek abortions.

Fatima Goss Graves, president of the National Women’s Law Center, agrees with Pelosi, “No one should fear being turned away by a medical provider because of who they are or the personal health decisions they have made.” The ACLU says it has already acted to try to prevent the limitations of special rights for transgenders. The LGBTQ civil rights group Lambda Legal also said it will sue.

Roger Severino, head of the HHS department that enforces civil rights laws, said transgenders will continue to be protected by other laws that prohibit discrimination in health care on account of race, color, national origin, age, disability and other factors, “Everyone deserves to be treated with respect and according to the law. Our dedication to our civil rights laws is as strong as ever.”

The Biden campaign is expected to issue a statement on this issue and will, given Democrat party policy and stated ideals, likely press for a return to Obama administration policies on this matter.