AUSTIN, Texas (AP) — A federal judge in Texas on Saturday 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.

U.S. District Judge Reed O’Connor granted a temporary injunction stopping 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 Religious Freedom Restoration Act and “places substantial pressure on Plaintiffs to perform and cover transition and abortion procedures.”

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

O’Connor is the same judge who sided with Republican-controlled states earlier this year 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 lawsuit in which O’Connor issued the injunction Saturday contends that the rules, which were finalized in May, could force doctors to help with gender transition contrary to their religious beliefs or medical judgment.

Joining Texas in the lawsuit were Wisconsin, Kentucky, Nebraska and Kansas, along 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, and won a temporary injunction in August from U.S. District Judge Reed O’Connor.

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