The debate over fetal tissue has been controversial for years, but Equity Forward's Carter argues that the steps being taken now are especially worrisome.
"It's a difference of how we're seeing it talked about -- the very direct actions we are seeing by high-level HHS officials to take these requests seriously," she said. "All the science says this is ethical and scientific study."
Liberal groups have spoken out against the administration's expansion of religious freedom policies, saying that could restrict health care access for LGBT people.
In a recent interview with CQ Roll Call, Severino said that he was not aware of any claims filed to OCR regarding LGBT discrimination. "Everything has been really very hypothetical in saying that conscience protection statutes are implicating a whole range of issues that we have not yet seen out in the world," he said.
Carter said that Severino's approach could become problematic, noting papers he authored at Heritage, including one that said "maleness and femaleness are biological realities to be respected and affirmed, not altered or treated as diseases."
"He's been very, very clear that he believes that gender is something you're born with and that it's black and white," Carter said. "He doesn't believe in the concept of being transgender, which is a medical fact."
Equity Forward also questioned recent HHS actions on foster care.
In January, HHS granted approval for a South Carolina-based religious foster agency to continue to receive federal funding. The Protestant agency, Miracle Hill, risked losing its licensing because it used religious criteria in placing children with families. Advocates worry this could negatively impact same-sex couples and individuals of other faiths in the state hoping to foster children.
In May 2018, HHS Center for Faith and Opportunity Initiatives Director Shannon Royce previewed the Trump administration's policy at a Heritage event where she encouraged attendees to seek waivers for faith-based adoption and fostering.
"If you are engaged in fostering and adoption care, and there is something you believe substantially burdens your religious expression, we would encourage you to file," said Royce.
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