President Donald Trump’s administration finalized a new policy Friday that ends an Obama-era protection for transgender patients facing discrimination in the health care system.

The now-revoked provision of the Affordable Care Act had broadened bans on sex discrimination in health care to include transgender patients, ensuring they could receive services at all hospitals and be covered under all insurance plans.

Now the Department of Health and Human Services is “returning to the government’s interpretation of sex discrimination according to the plain meaning of the word “sex” as male or female and as determined by biology,” the department wrote in its announcement. The overturned section concerning transgender patients also banned discrimination against women who’d had abortions.

That decision comes despite the American Medical Association, the American Psychological Association and the National Association of Social Workers all endorsing non-discrimination policies for transgender patients.

The Trump administration vowed to take this action just over a year ago. After a group of states and religious health care providers sued over that Obama rule, a federal judge agreed in 2016 to block it on a temporary basis. However, the judge has yet to issue a final ruling.

The Trump administration has declined to enforce the rule since that 2016 injunction, so Friday’s announcement is more symbolic than anything. Throughout his time in office, Trump has worked to severely narrow the legal definition of sex discrimination, leaving fewer people covered under civil rights protections across several industries.

Activist groups said the news was especially painful to receive during Pride Month, on the fourth anniversary of the mass shooting at Pulse, a gay nightclub in Orlando, Florida.

“On a day the world remembers and mourns the 49 lives lost in a senseless attack on our community four years ago in Orlando, the Trump administration has decided to continue its campaign to further discriminate and attack LGBTQ Americans, specifically transgender people,” GLAAD tweeted.

“Trump and his allies never fail to show that their extreme ideology comes before people’s health, safety, and lives,” NARAL Pro-Choice America’s communications officer Adrienne Kimmell said in a statement. “This rule will hurt Americans and fall hardest on people who already face barriers to accessing healthcare. The cruelty of this administration knows no bounds.”

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