Tensions rise in Australia after a bishop and priest are wounded in a knife attack in a church

SYDNEY (AP) — A teenager has been accused of wounding a Christian bishop and a priest during a church service in the second high-profile knife attack to rock Sydney in recent days, leaving communities on edge, leaders calling for calm and a besieged church urging against retaliation.

The 16-year-old was overpowered by the shocked congregation at Christ the Good Shepherd Church after he allegedly stabbed Bishop Mar Mari Emmanuel and the Rev. Isaac Royel during a service on Monday night that was being streamed online.

Police have not commented on reports that the boy’s fingers were severed by parishioners in the Orthodox Assyrian church in suburban Wakeley, but confirmed his hand injuries were “severe.”

Video of the attack spread quickly on social media and an angry mob converged on the church demanding vengeance. They hurled bricks, bottles and fence boards at police, who temporarily barricaded the boy inside the church for his own safety. Many in the crowd chanted “an eye for an eye” and “bring him out.”

Several people including police officers required hospital treatment following the hourslong riot.

The church said in a statement on Tuesday it "denounced retaliation of any kind.” Police stood guard around mosques in parts of Sydney on Tuesday after reports that text messages were circulating urging the Assyrian Christian community to retaliate against Muslims.

Sydney's Lakemba Mosque, Australia's largest, has hired additional private security for the next week after receiving fire bomb threats on Monday night.

Police and community leaders said public anxiety had been heightened by a lone assailant’s knife attack in a Sydney shopping mall on Saturday that killed five women and a male security guard who attempted to intervene. The 40-year-old assailant, Joel Cauchi, had a history of mental illness and trouble with women and a fascination with knives. He was shot dead by police.

Prime Minister Anthony Albanese urged the public not to take the law into their own hands.

“We understand the distress and concerns that are there in the community, particularly after the tragic event at Bondi Junction on Saturday,” Albanese told reporters, referring to the Westfield Bondi Junction shopping mall.

"But it is not acceptable to impede police and injure police doing their duty or to damage police vehicles in a way that we saw last night," Albanese added.

News South Wales Police Commissioner Karen Webb on Tuesday declared the church attack a terrorist incident, but not the shopping mall rampage.

The declaration gives police expanded powers to stop and search people, premises and vehicles without a warrant.

Webb said the teen's comments and actions pointed to a religious motive for the attack. She didn’t detail the wording of the comments that led her to believe he had been religiously motivated.

Ten Network television reported the boy had told churchgoers who restrained him, in Arabic: “If they didn't insult my Prophet, I wouldn't have come here.”

New South Wales Premier Chris Minns said state police were urging social media platforms to shut down accounts posting misinformation that incited violence since Monday's stabbing.

“New South Wales Police and community leaders have been battling misinformation spreading around the web inciting community members to rush to particular religious facilities and mosques and churches on the hint or the rumor of some kind of violent activity taking place,” Minns told Australian Broadcasting Corp.

“It's very difficult to maintain community cohesion when outright lies are spread within the community inciting the worst fears of particularly young people,” Minns added.

The teen suspect was in hospital on Tuesday under police guard. He has yet to be charged.

Webb said he had been known to police, but was not on a terror watch list. He had been convicted in January for a range of offenses including possession of a switchblade knife, being armed with a weapon with an intention to commit an indictable offense, stalking, intimidation and damaging property, ABC reported.

A Sydney court released him on a good behavior bond, ABC reported.

The boy used a switchblade, which is an illegal weapon in Australia, in Monday’s attack, ABC reported.

Juvenile offenders cannot be publicly identified in New South Wales.

The church in a message on social media said the bishop and priest were in stable condition and asked for people’s prayers. The church said in a statement on Tuesday the 53-year-old Iraq-born bishop’s condition was “improving.”

Emmanuel has a strong social media following and is outspoken on a range of issues. He proselytizes to both Jews and Muslims and is critical of liberal Christian denominations. He also speaks out on global political issues and laments the plight of Palestinians in Gaza.

The bishop, described in local media as a sometimes divisive figure on issues such as COVID-19 restrictions, was in the national news last year over comments about gender.

McGuirk reported from Melbourne, Australia.

Father Daniel Kochou, right, gestures as he speaks with people, across the road from the Christ the Good Shepherd church in suburban Wakely in western Sydney, Australia, Tuesday, April 16, 2024. Australian police say a knife attack in Sydney that wounded a bishop and a priest during a church service as horrified worshippers watched online and in person, and sparked a riot was an act of terrorism. (AP Photo/Mark Baker)

People stand outside a house across the road from the Christ the Good Shepherd church in suburban Wakely in western Sydney, Australia, Tuesday, April 16, 2024. Australian police say a knife attack in Sydney that wounded a bishop and a priest during a church service as horrified worshippers watched online and in person, and sparked a riot was an act of terrorism.(AP Photo/Mark Baker)

A police forensic officer works at a crime scene at the Christ the Good Shepherd church in suburban Wakely in western Sydney, Australia, Tuesday, April 16, 2024. Australian police say a knife attack in Sydney that wounded a bishop and a priest during a church service as horrified worshippers watched online and in person, and sparked a riot was an act of terrorism. (AP Photo/Mark Baker)

A man places flowers outside the Christ the Good Shepherd church in suburban Wakely in western Sydney, Australia, Tuesday, April 16, 2024. Australian police say a knife attack in Sydney that wounded a bishop and a priest during a church service as horrified worshippers watched online and in person, and sparked a riot was an act of terrorism. (AP Photo/Mark Baker)

A police forensic officer works near cars outside the Christ the Good Shepherd Church in suburban Wakely in western Sydney, Australia, Tuesday, April 16, 2024. Australian police say a knife attack in Sydney that wounded a bishop and a priest during a church service as horrified worshippers watched online and in person, and sparked a riot was an act of terrorism. (AP Photo/Mark Baker)

A car with its windscreen smashed, is parked outside the Christ the Good Shepherd Church in suburban Wakely in western Sydney, Australia, Tuesday, April 16, 2024. Australian police say a knife attack in Sydney that wounded a bishop and a priest during a church service as horrified worshippers watched online and in person, and sparked a riot was an act of terrorism. (AP Photo/Mark Baker)

Police forensic officers inspect a car outside the Christ the Good Shepherd Church in suburban Wakely in western Sydney, Australia, Tuesday, April 16, 2024. Australian police say a knife attack in Sydney that wounded a bishop and a priest during a church service as horrified worshippers watched online and in person, and sparked a riot was an act of terrorism. (AP Photo/Mark Baker)

A police forensic officer inspects a car at the Christ the Good Shepherd Church in suburban Wakely in western Sydney, Australia, Tuesday, April 16, 2024. Australian police say a knife attack in Sydney that wounded a bishop and a priest during a church service as horrified worshippers watched online and in person, and sparked a riot was an act of terrorism. (AP Photo/Mark Baker)

Police patrol outside the Christ the Good Shepherd church in suburban Wakely in western Sydney, Australia, Tuesday, April 16, 2024. Australian police say a knife attack in Sydney that wounded a bishop and a priest during a church service as horrified worshippers watched online and in person, and sparked a riot was an act of terrorism.(AP Photo/Mark Baker)

A damaged car sits parked outside the Christ the Good Shepherd church in suburban Wakely in western Sydney, Australia, Tuesday, April 16, 2024. Australian police say a knife attack in Sydney that wounded a bishop and a priest during a church service as horrified worshippers watched online and in person, and sparked a riot was an act of terrorism. (AP Photo/Mark Baker)

A man speaks to police outside the Christ the Good Shepherd church in suburban Wakely in western Sydney, Australia, Tuesday, April 16, 2024. Australian police say a knife attack in Sydney that wounded a bishop and a priest during a church service as horrified worshippers watched online and in person, and sparked a riot was an act of terrorism.(AP Photo/Mark Baker)

Police forensic officers work at a crime scene at the Christ the Good Shepherd church in suburban Wakely in western Sydney, Australia, Tuesday, April 16, 2024. Australian police say a knife attack in Sydney that wounded a bishop and a priest during a church service as horrified worshippers watched online and in person, and sparked a riot was an act of terrorism. (AP Photo/Mark Baker)

A police forensic officer works at a crime scene at the Christ the Good Shepherd Church in suburban Wakely in western Sydney, Australia, Tuesday, April 16, 2024. Australian police say a knife attack in Sydney that wounded a bishop and a priest during a church service as horrified worshippers watched online and in person, and sparked a riot was an act of terrorism. (AP Photo/Mark Baker)

Flores sit on a fence outside the Christ the Good Shepherd church in suburban Wakely in western Sydney, Australia, Tuesday, April 16, 2024. A man has been arrested after reportedly stabbing a Christian bishop and multiple churchgoers during a televised service in Sydney Monday, April 15, 2024, police said. There were no reports of life-threatening injuries. (AP Photo/Mark Baker)

A police forensic officer works at a crime scene at the Christ the Good Shepherd Church in suburban Wakely in western Sydney, Australia, Tuesday, April 16, 2024. Australian police say a knife attack in Sydney that wounded a bishop and a priest during a church service as horrified worshippers watched online and in person, and sparked a riot was an act of terrorism. (AP Photo/Mark Baker)

New South Wales Commissioner Karen Webb, center, addresses a press conference in Sydney, Tuesday, April 16, 2024, with Police Deputy Commissioner Peter Thurtell, left, and New South Wales Ambulance Commissioner Dr Dominic Morgan, right, following a knife attack that wounded a bishop during a church service on Monday. Webb said the suspect's comments pointed to a religious motive for the attack and is being treated as an act of terrorism. (Bianca De Marchi/AAP Image via AP)

A police forensic officer works at a crime scene at the Christ the Good Shepherd Church in suburban Wakely in western Sydney, Australia, Tuesday, April 16, 2024. Australian police say a knife attack in Sydney that wounded a bishop and a priest during a church service as horrified worshippers watched online and in person, and sparked a riot was an act of terrorism. (AP Photo/Mark Baker)

CHARLESTON, W.Va. (AP) — West Virginia and North Carolina's refusal to cover certain health care for transgender people with government-sponsored insurance is discriminatory, a federal appeals court ruled Monday in a case likely headed to the U.S. Supreme Court.

The Richmond-based 4th U.S. Circuit Court of Appeals ruled 8-6 in the case involving coverage of gender-affirming care by North Carolina’s state employee health plan and the coverage of gender-affirming surgery by West Virginia Medicaid.

“The coverage exclusions facially discriminate on the basis of sex and gender identity, and are not substantially related to an important government interest,” Judge Roger Gregory, first appointed by former President Bill Clinton and re-appointed by former President George W. Bush, wrote in the majority opinion.

The ruling follows a decision earlier this month by 4th Circuit judges that West Virginia's transgender sports ban violates the rights of a teen athlete under Title IX, the federal civil rights law that prohibits sex-based discrimination in schools.

Like with the transgender sports law ruling, West Virginia Attorney General Patrick Morrisey said his office planned to appeal Monday's health care case decision.

“Decisions like this one, from a court dominated by Obama- and Biden-appointees, cannot stand: we’ll take this up to the Supreme Court and win,” Morrisey said in a statement.

After the ruling, West Virginia plaintiff Shauntae Anderson, a Black transgender woman and West Virginia Medicaid participant, called her state's refusal to cover her care “deeply dehumanizing.”

“I am so relieved that this court ruling puts us one step closer to the day when Medicaid can no longer deny transgender West Virginians access to the essential healthcare that our doctors say is necessary for us,” Anderson said in a statement.

A spokesperson for North Carolina State Treasurer Dale Folwell, whose department oversees the state's health plan, said the agency was still reviewing the decision Monday but would have a response later.

During oral arguments in September, at least two judges said it’s likely the case will eventually reach the U.S. Supreme Court. Both states appealed separate lower court rulings that found the denial of gender-affirming care to be discriminatory and unconstitutional. Two panels of three Fourth Circuit judges heard arguments in both cases last year before deciding to intertwine the two cases and see them presented before the full court.

In June 2022, a North Carolina trial court demanded the state plan pay for “medically necessary services,” including hormone therapy and some surgeries, for transgender employees and their children. The judge had ruled in favor of the employees and their dependents, who said in a 2019 lawsuit that they were denied coverage for gender-affirming care under the plan.

The North Carolina state insurance plan provides medical coverage for more than 750,000 teachers, state employees, retirees, lawmakers and their dependents. While it provides counseling for gender dysphoria and other diagnosed mental health conditions, it does not cover treatment “in connection with sex changes or modifications and related care.”

In August 2022, a federal judge ruled West Virginia’s Medicaid program must provide coverage for gender-affirming care for transgender residents.

An original lawsuit filed in 2020 also named state employee health plans. A settlement with The Health Plan of West Virginia Inc. in 2022 led to the removal of the exclusion on gender-affirming care in that company’s Public Employees Insurance Agency plans.

During September’s oral arguments, attorneys for the state of North Carolina said the state-sponsored plan is not required to cover gender-affirming hormone therapy or surgery because being transgender is not an illness. They claimed only a subset of transgender people suffer from gender dysphoria, a diagnosis of distress over gender identity that does not match a person’s assigned sex.

Before offering pharmaceutical or surgical intervention, medical guidelines call for thorough psychological assessments to confirm gender dysphoria before starting any treatment.

West Virginia attorneys said the U.S. Centers for Medicare & Medicaid Services has declined to issue a national coverage decision on gender-affirming surgery.

State lawyers said West Virginia's policy is not a case of discrimination, either, but of a state trying to best utilize limited resources. West Virginia has a $128 million deficit in Medicaid for the next year, projected to expand to $256 million in 2025.

Unlike North Carolina, the state has covered hormone therapy and other pharmaceutical treatments for transgender people since 2017.

FILE - Connor Thonen-Fleck addresses reporters while his parents stand by his side, March 11, 2019, in Durham, N.C. West Virginia and North Carolina's refusal to cover certain health care for transgender people with government-sponsored insurance is discriminatory, a federal appeals court ruled Monday, April 29, 2024 in a case likely headed to the U.S. Supreme Court. (AP Photo/ Jonathan Drew, FIle)