WASHINGTON — The Trump administration formally proposed on Friday to roll back Obama-era civil rights safeguards that had banned discrimination against transgender medical patients and health insurance customers.

The Department of Health and Human Services’s proposed regulation would replace a 2016 rule from the Obama administration that defined discrimination “on the basis of sex” to include gender identity. The Trump administration rule would no longer recognize gender identity as an avenue for sex discrimination.

Without the Obama-era language, health care workers would be free to object to performing procedures like gender reassignment surgery, and insurers would not be bound to cover all services for transgender customers. The new rule would fit into a broader agenda pushed by religious activists and is consistent with administration actions to limit civil rights protections for gay and transgender Americans in a variety of domains, including education, employment and housing.

The Obama administration adopted the health care discrimination rule to carry out a civil rights provision of the Affordable Care Act. It prohibits discrimination based on race, color, national origin, sex, age or disability in “any health program or activity” that receives federal financial assistance.