April 4, 2019 at 10:15 am PST | by Amanda Goad
LGBTQ patients need access to all care everywhere

Amanda Goad is the Audrey Irmas director of the LGBTQ, Gender & Reproductive Justice Project at the ACLU of Southern California.

Oliver Knight was in a hospital gown with an IV in his arm when his doctor suddenly informed him that the hospital had canceled his surgery.

Having surgery is an incredibly stressful experience. Preparing ourselves emotionally and physically takes its toll, so it’s a big deal for a patient if your scheduled surgery doesn’t proceed as planned. But Oliver had to cope with the additional trauma of being denied medical care for the sole reason that he is transgender. This hospital actively discriminates against people like him by denying gender-affirming surgery such as the hysterectomy that Oliver had planned to undergo.

What happened to Oliver clearly violated his rights and our California values. To challenge this discrimination, the ACLU Foundation of Northern California, the ACLU Foundation of Southern California and the law firm Rukin Hyland & Riggin LLP recently filed a lawsuit against St. Joseph Health Northern California, the hospital in Eureka, California that denied Oliver’s treatment.

But Oliver is not alone. All over California and other parts of the country, patients at Catholic hospitals are being denied critical gender-affirming and reproductive care. And the problem is growing, because Catholic health care systems are the fastest growing in the nation—currently one in six patients nationally is treated in a Catholic hospital.

The Catholic chain Dignity Health is the largest in California, with 31 hospitals across the state. In addition to Oliver’s case, the ACLU, with the law firm Covington & Burling LLP, is pursuing a similar lawsuit on behalf of Evan Minton, another transgender man whose scheduled hysterectomy was cancelled when officials at a Dignity Health hospital near Sacramento realized he was transgender.

Catholic hospitals follow policies set by the United States Conference of Catholic Bishops, which has been clear that it does not recognize transgender people or the need for gender-affirming care. Indeed, the Conference of Catholic Bishops has stated that gender-affirming surgeries “are not properly viewed as health care because they do not cure or prevent disease or illness. Rather, they reject a person’s nature at birth as male or female.” Even worse, it has further proclaimed: “[c]laiming that this is a civil-rights matter and encouraging surgical intervention is in reality to collaborate with and promote a mental disorder.”

Catholic hospitals generally allow hysterectomies and other sterilizing surgeries to treat an underlying health condition. But because the Catholic bishops do not recognize gender dysphoria as a legitimate medical condition, they consider gender-affirming surgeries impermissible and “intrinsically evil” as a result of their impact on fertility. Thus, hospitals like the one Oliver dealt with turn away transgender patients who need surgery while routinely providing the same care to cisgender patients.

Transgender patients needing gender-affirming care are not the only members of the LGBTQ community who are negatively affected by the religious restrictions on health care imposed in Catholic hospitals. Catholic health care also prohibits in vitro fertilization and other assisted reproductive technologies (ART)—the Catholic directives state that ““[r]eproductive technologies that substitute for the marriage act are not consistent with human dignity.” As LGBTQ families often use assisted reproductive technologies to conceive, this has a disproportionate impact on our community.

Finally, due to their strict ban on abortion and broad definition of what an abortion is, Catholic hospitals don’t apply the prevailing standard of care for ectopic pregnancies and miscarriage management. These practices can–and have—resulted in infertility, infection, and even death.

Despite these frightening realities, most patients—like Oliver Knight—have no idea when they walk into a Catholic hospital that they may be denied care and discriminated against.

All Care Everywhere is a campaign launched by the ACLU Foundations of California and the National Health Law Program, rooted in our belief that everyone should get the care they need, regardless of who they are or where they live. Catholic hospitals serve the general public and are a major, and increasing, part of the health care landscape. Everyone is entitled to their religious beliefs, but this does not give them the right to harm other people.

All Care Everywhere is bringing attention to this problem and sharing stories with the California Department of Public Health and the California Attorney General’s office to hold Catholic hospitals accountable. If you have experienced care denial or discrimination from a Catholic hospital, or know someone who has, share that experience with the team at All Care Everywhere (allcareeverywhere.com).

We are also spreading the word about how Catholic hospitals make patient care decisions, so that people with options can choose other health care providers. But unfortunately, for many Californians, the only hospitals near them or covered by their insurance are run by Catholic health systems, which listen to bishops instead of patients and their doctors. So we need to take action.

Join us in putting an end to Catholic hospitals’ discrimination against trans people and others seeking reproductive care. With enough of our voices, we can no longer be ignored or denied. Together, we can make California a place where all of us can get all the care we need, everywhere.

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