“[D]enying an injunction would impede the public interest by threatening the health of LGBTQ individuals at large,” the judge wrote in his ruling.

This week, a federal judge appointed by former President Barack Obama ruled in favor of LGBTQ activists fighting against the Trump administration’s legal doctrine permitting discrimination of transgender individuals seeking medical care. 

The rule, implemented in June, effectively allowed insurance companies and healthcare providers to refuse treatment and services for transgender patients based on the providers’ religious beliefs. According to the 2015 US Transgender Survey, one-third of respondents said they’d had at least one negative experience in a healthcare setting related to their gender identity, including verbal harassment or the refusal of treatment. 

Presiding over Whitman-Walker Clinic v. HHS, US District Judge James Boasberg of Washington, DC, ordered a temporary injunction Wednesday against the Trump administration’s repeal of an Obama-era mandate prohibiting discrimination “on the basis of sex.” 

In other words, Boasberg blocked the Department of Health and Human Services (HHS) from revoking a rule in the Affordable Care Act (ACA) that made it illegal for medical providers to deny health care to patients because of their sex. The ACA defined “sex” as “an individual’s internal sense of gender, which may be male, female, neither, or a combination of male and female, and which may be different from an individual’s sex assigned at birth.” But the Trump administration attempted to revoke the protections of transgender and gender-nonconforming patients by defining sex as “male or female as determined by biology.” 

“[D]enying an injunction would impede the public interest by threatening the health of LGBTQ individuals at large, some of whom will likely develop increasingly acute conditions on account of their delaying necessary care or refraining from transparent communication with providers out of fear of discrimination,” Judge Boasberg wrote in his 101-page opinion, which limited the number of religious exemptions permissible to medical providers as the case continues. “There is clearly a robust public interest in safeguarding prompt access to health care. The COVID-19 pandemic only reinforces the importance of that public interest and the concomitant need to ensure the availability and provision of care on a nondiscriminatory basis.”

Three days after the HHS issued the policy, the US Supreme Court ruled in a separate court case to protect LGBTQ persons from workplace discrimination.

RELATED: How Trump’s Rollbacks Are Going to Risk Trans Patients’ Lives

The current court case—filed by the Steptoe & Johnson law firm on behalf of Lambda Legal, TransLatin@ Coalition, and other advocacy groups—is just one of five legal disputes brought against the Trump administration over its efforts to revoke protections of LGBTQ-identifying patients in the American healthcare system.

“This administration’s health care discrimination rule is just another example of its disdain for LGBTQ lives and the law,” Omar Gonzalez-Pagan, a senior attorney for Lambda Legal, said in a statement. “We are gratified that the court in an extensive and detailed decision put key aspects of the disastrous and discriminatory health care rule on hold while our challenge moves forward.”

In addition to the HHS, the Department of Education and Department of Housing and Urban Development have also revoked other LGBTQ protections since Donald Trump assumed office, virtually authorizing the discrimination of transgender and gender non-conforming students and homeless people.

Boasberg is the second federal judge to rule against the anti-LGBTQ healthcare provision. In a separate court case challenging the HHS policy, another federal judge also temporarily blocked the rule. In his decision, Brooklyn-based US District Judge Frederick Block—appointed by former President Bill Clinton—said the Trump administration “acted arbitrarily and capriciously” in implementing the discriminatory law despite a Supreme Court ruling broadening LGBTQ protections.

The legal win for LGBTQ rights serves as a key reminder of just how critical judicial appointments are beyond the US Supreme Court. A case can result in crucial—sometimes devastating—outcomes without ever reaching the highest court of the land. 

This was proven to be true when a federal district judge ordered a temporary halt on Trump’s ban on immigrants and asylum seekers from Muslim-majority countries and again when a circuit court of appeals upheld a dangerous rule prohibiting medical professionals from discussing with patients about abortion.

RELATED: 1 in 4 Circuit Court Judges Have Been Appointed By Trump. Here’s Why That Matters For Your Rights.

“While Democrats play by the rules, Republicans are shredding the rule book, and the result is a partisan [judicial system] that works for corporations and the Republican Party and against everyone else,” Christopher Kang, counsel for Demand Justice, a progressive activist group, said in a statement. 

Over the course of his term as president, Trump has appointed more than 200 judges, which makes up nearly a quarter of all active judges in the federal judiciary system. In comparison, Obama appointed only 312 federal judges over his eight years in office; George W. Bush appointed 166, and Clinton appointed 87. 

In addition to being overwhelmingly conservative, the majority of Trump’s appointees are white and male. 

The expectation now is the courts will continue to sway toward conservative ideologies as long President Trump gets to nominate more judicial appointees—thus, making the federal judiciary system an issue of the highest stakes in the 2020 presidential election.