A proposed rule change under the Department of Health and Human Services (HHS) could remove transgender health protections from the Affordable Care Act. It would also give medical professionals and other healthcare providers the right to refuse to treat any transgender person for any condition if they cite their religious beliefs.

Under the Obama Administration, transgender rights expanded in large part due to an interpretation of “sex discrimination” as being inclusive of gender identity, which many faith-based health care providers feared would mean they’d end up required to provide medical care, including gender confirming surgery, for transgender people.

In reaction to the change, many of these groups filed suit, arguing that including transgender people — as well as abortion care — violated their religious freedoms.

Under Trump, HHS appears to be inclined to agree with these organizations, saying that they are rewriting their policy.

Related: Meet the rabidly anti-gay HHS official behind Trump’s plan to defund Planned Parenthood

“The United States has returned to its long-standing position that the term ‘sex’… does not refer to gender identity,” said attorneys for HHS in an 18-page filing on a case currently making its way through Texas courts.

The move comes amongst similar moves by the administration, including the ban on transgender military personnel as well as moves within other departments to roll back transgender affirming language and rules.

The administration has made it clear that they do not want to recognize transgender people, saying in a 2018 memo that and definition of “gender” must be based “on a biological basis that is clear, grounded in science, objective and administrable.”

It is also worth noting that, this Monday, the United States Supreme Court took up three LGBTQ cases, including one transgender-specific case, that could potentially strip away transgender anti-discrimination laws in employment policy.