WASHINGTON — Sixteen health care groups and doctors sued the Trump administration Tuesday to block a rule that enables health workers to refuse to perform abortion or sex reassignment surgery.

The 183-page lawsuit, filed in the US District Court in Santa Clara County, California, argues the rule sends a message to health care providers around the country that they should limit or stop providing abortion care and sex reassignment or risk losing vital government funding.

This, the advocates behind the suit argue, will make abortion and transgender services even less available in rural areas where state laws make it increasingly difficult to access that care.

Trump’s rule, released in early May, states that its aim is to protect “providers, individuals, and other health care entities from having to provide, participate in, pay for, provide coverage of, or refer for, services such as abortion, sterilization, or assisted suicide” if they have a moral or religious objection to those procedures.

It essentially expanded the Department of Health and Human Service’s definition of “workplace discrimination” to include workers who feel they are being made to perform these specific procedures against their religious beliefs. The rule also gives them a clear avenue to report this discrimination. If a hospital or health care organization receives too many of these complaints, they could lose their federal funding, a funding stream that many health care providers rely on for their survival. It is not scheduled to take effect until July.

“This rule is yet another example of the Trump administration turning religious freedom into a weapon to discriminate,” Genevieve Scott, a senior staff attorney for the Center for Reproductive Rights, told BuzzFeed News. “The rule encourages religious and moral views to overwhelm the medical needs of a patient … which has enormous consequences for the patient including the possibility of death.”

The lawsuit argues Trump’s rule could lead to serious and even fatal consequences, including in situations actually named in the text of the rule itself: nonviable pregnancies threatening the health or life of the mother where an emergency abortion needs to be performed. The rule says that these situations should be analyzed on a “case by case” basis, but Scott and the plaintiffs argue it could cause physicians to make the wrong call in emergency situations.

The rule is “so vague and confusing,” Scott argued, “that it is unworkable for health care facilities to be able to implement it.”

The suit claims that the rule violates several constitutional statutes including the separation of church and state, by valuing religious beliefs over the rights of patients to access care; the Fifth Amendment by violating patients’ “rights to privacy, liberty and equal dignity,” as a press release for the lawsuit put it; and the First Amendment, by “chill[ing] patients’ speech and expression” pertaining to their sexual orientation or gender.

Among the groups and doctors suing over the rule are several LGBT community centers and health groups, Medical Students for Choice, gynecological centers, and Santa Clara County, in conjunction with CRR, Americans United for the Separation of Church and State, and Lambda Legal, a legal defense fund focusing on LGBT issues.

They’re not the only ones suing, however. Last week two dozen states, counties, and cities sued the Trump administration over the rule as well, in a federal court in Manhattan, arguing that the rule aimed to “coerce” states into limiting access to abortion, assisted suicide, and transgender health services.

The rule is one of many aimed at LGBT individuals and women seeking abortions to come out of the Trump administration in the past month. On Friday, the Trump administration rolled back Obama-era health care protections for transgender people and those who have had abortions. A few days before that, on May 22, Trump announced plans to let homeless shelters and other groups receiving federal housing money legally turn away transgender people.