No Supreme Court hearing for Catholic hospital sued for declining transgender surgery

Patient in hospital Credit Chaikom Shutterstock CNA Chaikom/Shutterstock.

The Supreme Court has declined to intervene in a lawsuit against a Catholic hospital that declined to perform a hysterectomy on a woman who identifies as a transgender man on the grounds that doing so would violate Catholic ethics and the U.S. bishops’ directives.

“In keeping with our Catholic faith, at our Catholic-sponsored care sites we do not offer certain services including sterilizing procedures such as hysterectomies to any patient regardless of gender identity, unless the patient has a life-threatening condition,” the Dignity Health hospital network said Nov. 1. “Courts have long recognized the right of faith-based providers to offer services that are consistent with their religious beliefs. Although the Supreme Court will not consider this important issue at this time, we plan to continue to pursue the case at the lower-court level.”

Justices Clarence Thomas, Samuel Alito, and Neil Gorsuch wanted the court to hear the case, which comes amid debate over religious freedom, the ability of U.S. Catholic institutions to follow Catholic ethics, and political and legal claims related to LGBT causes.

The lawsuit was filed by the American Civil Liberties Union on behalf of Evan Minton, a Sacramento-area woman who identifies as a transgender man. Minton’s suit claimed a Catholic hospital in the Dignity Health network violated state law when it cancelled her hysterectomy procedure to remove her uterus and rescheduled it within three days at a non-Catholic institution.

In a Nov. 1 statement, Minton said that the hospital’s actions have had major effects on her life.

“Since Dignity Health turned me away for being transgender, I’ve had multiple medical emergencies and I can’t stand to go to my neighboring Dignity Hospital because of the discrimination I was put through. In one instance, I called my doctor and had them talk me through a procedure I performed on myself to avoid having to go into one of their hospitals,” she said.

“I hope Dignity Health will finally take responsibility for what they did to me and what they continue to do,” said Minton.

The operation was scheduled for Aug. 30, 2016 at Dignity Health’s Mercy San Juan Medical Center in Carmichael, Calif., in the Sacramento metro area.

Minton claims the procedure was cancelled once the hospital learned that Minton was transgender, and asked to be referred to as “he”. Court records show that Minton underwent hormone replacement therapy in 2012 and a mastectomy in 2014, and planned to undergo the hysterectomy before having physical structures that resemble male genitalia surgically created.

Dignity Health arranged for Minton to have the procedure done at a different hospital within 72 hours of the cancellation, the Sacramento Bee reports. The surgeon, Dr. Lindsey Dawson, told the Bee that Dignity Health officials assisted her in getting emergency privileges at Methodist, a non-Catholic affiliated hospital, so she could perform the hysterectomy there.

The ACLU alleges in the suit that the hospital's actions amount to “sex discrimination in violation of California's Unruh Civil Rights Act” which prohibits businesses from discriminating against patrons on the basis of one's gender. The group is seeking a court order that would force the hospital to perform elective hysterectomies in the future.

Elizabeth Gill, senior staff attorney with the ACLU LGBTQ & HIV Project, commented on Supreme Court’s decision not to hear the case.

“It’s wrong that anyone would be turned away from health care because of who they are, and when a health care provider denies care to a population they claim to serve, that’s hypocrisy,” she said. “Our work does not stop with this case. Trans people belong everywhere and we will continue to fight alongside the trans community for health care access.”

For its part, Mercy San Juan Medical Center said in its court filing that the case “poses a profound threat to faith-based health care institutions' ability to advance their healing ministries consistent with the teachings of their faith.”

A San Francisco Superior Court judge initially dismissed Minton’s lawsuit, on the grounds that the hospital followed court precedent in rescheduling the patient quickly at a different hospital. However, an appeals court reversed this decision in September 2019, saying that the hospital still initially failed to provide services and arguably provided legal grounds for the discrimination complaint.

The appellate judge, Justice Stuart R. Pollock, said that any burden that the state law places on the exercise of religion is “justified by California's compelling interest in ensuring full and equal access to medical treatment for all its residents.”

In response to the Supreme Court decision, Dignity Health stressed its services for everyone.

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“While we may not be able to provide every needed service at every hospital—no hospital can—Dignity Health does provide a range of services that LGBTQ people value and rely on,” the hospital system said. “For example, at many of our hospitals and clinics, we offer primary care and transgender health care services for transgender patients.”

Twenty-four of Dignity Health’s 39 hospitals are Catholic. However, Dignity Health’s website has an LGBT section that notes its secular hospital, Saint Francis Memorial Hospital in San Francisco, has a Gender Institute which provides “state-of-the-art gender-affirming services.” Three Dignity Health hospitals have won recognition by the LGBT group the Human Rights Commission.

Dignity Health is based in San Francisco. It is the largest hospital provider in California and the fifth-largest health system in the U.S. It traces its roots to the Sisters of Mercy hospital founded in San Francisco in the 1850s. A 1986 merger of the hospitals of two Sisters of Mercy congregations resulted in the creation of Catholic Healthcare West, which was renamed Dignity Health in 2012. Twenty-four of its 39 hospitals are Catholic.

The ACLU has long been a critic of Catholic ethics in Catholic hospitals, depicting these policies as a denial of care or discriminatory. It characterized Monday’s refusal of a Supreme Court hearing as a ruling that stopped “further attempts to authorize discrimination against trans people under the guise of religious liberty.”

On the ACLU’s web page for the Minon case, the legal group noted that one in six hospital beds across the U.S. is in an institution that follows the Catholic ethics of the U.S. bishops.

In March 2021 the ACLU renamed its LGBTQ & HIV Project in honor of donors Jon L. Stryker and Slobodan Randjelovic, his same-sex spouse, who gave $15 million in a single gift to the legal group. Stryker is a billionaire heir to the Stryker medical technology company. He is also the founder of Arcus Foundation, which funds both efforts to limit religious freedom and Christian groups, including Catholic dissenters, that want to change their churches’ teachings on marriage, sexual morality, and gender.

In a similar case, the ACLU is suing University of Maryland St. Joseph Medical Center, a Catholic-founded hospital now in the University of Maryland Medical System, for declining to perform a hysterectomy on a self-identified transgender man. That case cited a 2020 Supreme Court decision that holds employment discrimination on the basis of gender identity to be a violation of U.S. civil rights law.

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