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Appeals court rules that transgender man denied hysterectomy can sue hospital for discrimination

September 26, 2019
Area(s) of Interest: LGBT Health Advocacy 


The First District Court of Appeal in San Francisco has ruled in the case of Minton v. Dignity Health that Evan Minton—a transgender man—can sue Dignity Health for discrimination after he was denied a hysterectomy at one of Dignity’s Catholic hospitals. The appeals court overturned a lower court ruling that had dismissed the case.

Mr. Minton filed a lawsuit against Dignity Health alleging that its actions violated California’s Unruh Civil Rights Act, which prohibits discrimination on the basis of sex – which includes a person’s gender, gender identity, and gender expression – in all business establishments and guarantees Californians full and equal “accommodations, advantages, facilities, privileges, or services” in business establishments the State. 

Dignity Health filed a motion to dismiss the case, arguing that sterilization procedures are not provided at its Catholic hospitals in accordance with the Catholic Church’s Ethical and Religious Directives for Catholic Health Care Services (ERDs) and that its alleged conduct is protected by its constitutional amendments under the First Amendment. The trial court granted Dignity Health’s motion and dismissed the complaint. 

The Court of Appeal, agreeing with an amicus brief filed by the California Medical Association (CMA), reversed the trial court's decision to dismiss Mr. Minton's case and found that the fact that Mr. Minton was able to have the surgery at an alternate hospital did not extinguish his claim for discrimination under the Unruh Act.

The court held that while Dignity Health may assert its reliance on the ERDs as a defense to Mr. Minton’s discrimination claim, the matter of whether Dignity’s actions was motivated by the ERDs and not by Mr. Minton’s medical condition or gender identity is not suitable for the case to be dismissed as a matter of law. In addition, the court found that Mr. Minton was subject to discrimination when Dignity Health refused to allow the scheduled procedure and restated the California Supreme Court’s decision that “any burden the Unruh Act 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, and there are no less restrictive means available for the state to achieve that goal.”

CMA filed a brief with the Court of Appeal, arguing that  the mere fact that Mr. Minton was able to obtain the hysterectomy at another facility does not absolve Dignity of its obligations to provide full and equal access to services under the Unruh Act. CMA's brief further argued that Dignity Health’s adherence to the Catholic Church’s ERDs not only discriminates against transgender patients, but also adversely impacts patient access to care, interferes with physician clinical decision making and medical staff governance, and threatens California’s longstanding policies prohibiting the lay practice of medicine. 

For more details, see CMA’s brief

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