The same federal judge who blocked a federal regulation that dictated free bathroom choice at public schools has now blocked a ruling by the Department of Health and Human Services (HHS) that required Catholic hospitals to perform gender transition services as well as abortions.

“Plaintiffs will be forced to either violate their religious beliefs or maintain their current policies, which seem to be in direct conflict with the rule and risk the severe consequences of enforcement,” U.S. District Judge Reed O’Connor wrote in blocking implementation of the regulation.

The Dec. 31 ruling by Judge O’Connor comes four months after he issued an injunction against a joint federal regulation that mandated school bathroom use be open to student choice by gender identity rather than by birth gender.

The HHS rule in question, issued in May, applied to any hospital, health insurer or health plan that accepts funding from the federal government. There was no religious exemption.