September 23, 2019; ACLU Northern California

The ACLU reports that the California Court of Appeal has unanimously ruled that transgender patient Evan Minton can pursue his discrimination case against Mercy San Juan Medical Center in Sacramento, which is owned by Dignity Health. The hospital had denied him a hysterectomy.

This issue with the treatment or lack thereof of trans patients now joins a host of other concerns regarding the dangers inherent in the growing domination of Catholic hospitals in some markets. This dominance, as we have written previously, can essentially serve to deny service and discriminate against the rights of women and LGBTQ populations under Catholic Ethical & Religious Directives. These contain bans of abortion, sterilization, and emergency contraception for rape victims, as well as in vitro fertilization, artificial insemination, surrogate pregnancy, and anything that remotely resembles assisted suicide.

The ACLU has long been active on this issue. When we first wrote about the problems posed by expansions of that system in 2013, they were already embedded in defense of local populations, but the problem has persisted.

In California, religious restrictions on health care continue to present a significant and growing threat. ACLU affiliates in California currently have two lawsuits against Catholic hospitals for denying health care to trans people, as well as a third challenging Catholic hospitals’ refusal to allow patients to obtain tubal ligations, known as getting one’s tubes tied, after giving birth.

Lawyers for the Catholic hospitals argue that religious freedom gives them the right to pick and choose who they treat in their hospitals—in plain violation of state nondiscrimination law. For the first time, the court specifically confirmed that Catholic hospitals are not exempt from these laws: that they, like all other businesses open to the general public, cannot turn away someone just because they are transgender.

Public awareness of the problem has grown; in May, Michael Hiltzik, a business reporter for the L.A. Times, wrote that UC San Francisco pulled out of a planned expanded affiliation with Dignity Health based on concerns about its discriminatory practices, particularly in a political environment that’s becoming more toxic.

“We’ve heard a growing chorus of concern from multiple stakeholders over the last several weeks,” Vanessa Jacoby, an associate OB-GYN professor at UCSF and a leading opponent of the proposal, “particularly in light of the passage of very severe anti-abortion legislation in many states and the stripping down of transgender anti-discrimination protections by the [Trump] administration.”

Alabama, Georgia, Mississippi, Missouri and Ohio, among other states, have enacted strict limits on abortion in recent weeks. The administration last week proposed rolling back Obama-era rules that forbid discrimination based on gender identity. The change would allow healthcare providers to refuse to provide gender reassignment surgery and might allow insurers to refuse to cover the procedure.

“What may have been theoretical in peoples’ minds has become a reality in terms of encroachments on women’s reproductive health and protections for transgender people.”

Catholic hospitals in the US account for one of six hospital beds, according to the ACLU.—Ruth McCambridge