“The federal government has no right to force Texans to pay for medical procedures designed to change a person’s sex,” Paxton wrote in a statement.

Those rules would be enforced “even if a doctor believes such procedures are harmful to the patient,” according to the lawsuit.

The lawsuit was filed by Texas, Wisconsin, Nebraska, Kentucky and Kansas as well as several faith-based provider groups, including the Christian Medical & Dental Associations.

Under ObamaCare, patients are protected from discrimination on the basis of race, color, national origin, sex, age or disability.

The Obama administration issued a final regulation in May to expand its previous definition of “gender identity” to help clarify the medical rights for transgender patients. Those rules meant that providers could not refuse to offer gender transition surgery and that insurers could not deny coverage outright.

The states argue that the rule has “created a massive new liability” for healthcare providers to decline to perform the procedures.