A federal judge in Texas has ordered a halt to another Obama administration effort to strengthen transgender rights, this time over health rules that social conservatives say could force doctors to violate their religious beliefs.

US district judge Reed O’Connor on Saturday granted a temporary injunction that stops federal health officials from enforcing rules that are intended to ban discrimination by doctors and hospitals against transgender persons.

O’Connor wrote in a 46-page ruling that the rules “likely violate” the federal Religious Freedom Restoration Act and “places substantial pressure on plaintiffs to perform and cover transition and abortion procedures”.

That 1993 legislation, signed into law by a Democratic president, Bill Clinton, is meant to defend “persons whose religious exercise is substantially burdened by government”.

O’Connor is the same judge who in August sided with Republican-controlled states over transgender protections in public schools sought by the Obama administration.

That lawsuit centered on a federal directive requiring schools to let transgender students use bathrooms consistent with their gender identity.

The suit in which O’Connor issued the injunction on Saturday contends that the rules regarding doctors and hospitals, which were finalized in May, could force doctors to help with gender transition contrary to their religious beliefs or medical judgment.

Transgender rights advocates called that a far-fetched hypothetical, saying a person would not approach a doctor who lacked suitable experience and expertise.

Joining Texas in thesuit were Wisconsin, Kentucky, Nebraska and Kansas, with the Christian Medical and Dental Association and Franciscan Alliance, an Indiana-based network of religious hospitals.

The Obama administration finalized the regulations around the time it issued its directive to public schools regarding transgender students. Thirteen states signed on to fight that directive, including three involved in the latest lawsuit.

Undeterred by national controversy over North Carolina’s “bathroom bill”, HB2, which says people must use bathrooms in public facilities consistent with the gender on their birth certificate, Texas looks set to pursue a similar “Women’s Privacy Act” in the forthcoming legislative session.

Lieutenant governor Dan Patrick included it at No6 in a list of 10 priorities.

The North Carolina bill remains on the books after a bipartisan attempt to repeal it collapsed this month. It has prompted companies, sporting bodies and artists to boycott the state in protest.