Eager to finish as many regulations as possible before his term in office ends, President Joe Biden and the Department of Health and Human Services have issued a regulation that could force doctors to perform gender-transition surgeries, even if it violates their conscience.

The regulation, titled “Nondiscrimination in Health Programs and Activities,” is HHS’s new rule for applying Section 1557 of the Affordable Care Act, which prohibits discrimination on the basis of a protected class in providing health services. Any hospital or doctor that is found to have engaged in discrimination would forfeit access to federal funding, including Medicare and Medicaid.