This week, Tennessee Gov. Bill Lee (R) signed legislation allowing healthcare professionals in the state to deny care to patients if it conflicts with the providers’ personal morals, ethics, or religious beliefs.

That includes the use of pronouns in a medical setting.

The new law, which applies to doctors, nurses, pharmacists, and insurance companies, went into effect with the governor’s signature.

The legislation’s Republican sponsor is a physician who cited the threat of “moral injury” posed to healthcare professionals who may not share their patients’ personal or religious beliefs.

“Patients and providers have rights. Providers should not give up their rights to best serve their patients,” Terry said. 

The law could result in women being denied medically necessary abortions and LGBTQ+ people being turned away for preventative care like pre-exposure prophylaxis, or PrEP.

Denying care for any reason is a clear violation of the Hippocratic Oath, which prioritizes patients’ well-being and mandates healthcare professionals “do no harm,” said Dr. Amy Gordon Bono, a primary care physician in Tennessee.

“When legislation is not patient-centered, it’s morally compromised to begin with,” Dr. Bono told WKRN News.

“Politicians need to stop dictating medical care, and this bill allows politicians to take their intrusive efforts even further to dictate medical conscience. In my opinion and the way I like to practice medicine is to honor the patient first. That’s where my conscience lies,” Bono said.

The so-called “conscience clause” does not apply in emergency situations or if an insurance provider is contractually obligated to cover the cost of a specific treatment.

But it could be used in the case of a healthcare professional asked by a patient to share their pronouns.

“I used the term ‘conscientious objection’ to describe my position on the practice of being forced to announce my own pronouns, but this was seen as a barrier to patient care,” said Dr. Jonathan Shaw, an OBGYN who testified before the House Health Committee as the bill made its way through the Tennessee Legislature.

“The ability to do my job was called into question, and human resources were consulted,” Dr. Shaw said. “The implication was clear: conscience needs to be limited — or consider an alternative career path. I decided to look for a job elsewhere.”

Tennessee became the ninth state to enshrine a “conscience clause” for medical professionals into law. Florida Gov. Ron DeSantis (R) signed similar legislation in April 2023.

The anti-LGBTQ+ organization Alliance Defending Freedom (ADF) has been an active proponent in the passage of those laws and several others moving through state houses.

How those laws affect insurance coverage is a question that’s currently under consideration at the U.S. Supreme Court. Last week, the Court heard oral arguments in Kennedy v. Braidwood, a case to decide whether the plaintiff, Texas business Braidwood Management, must provide insurance coverage to employees for PrEP.

The company claims that doing so would conflict with their religious beliefs because the preventative care “encourages and facilitates homosexual behavior.”