Judges on the U.S. Court of Appeals for the Fifth Circuit seemed to doubt that two doctors have standing to challenge guidance from the Biden administration that the federal Affordable Care Act prohibits discrimination based on gender identity and sexual orientation.

The physicians from Amarillo, Texas, sued the Secretary of the Department of Health and Human Services after the agency issued a notice in 2020 that it will interpret the prohibition on sex discrimination in the ACA as including a bar on discrimination based on sexual orientation and gender identity.