A Hospital Refused to Provide Medically Necessary Surgery Because I Am Transgender
I was denied healthcare because I am transgender. The justification, according to the hospital, was that religious doctrine permits them to refuse transgender patients, just because of who we are.
The Trump administration agrees: Over the past few years, the government has tried to greenlight sex discrimination under the guise of religious liberty. They’re doing this through a series of policy changes targeting our access to healthcare, workplaces, schools, and other spaces that we belong in, like everybody else. It seems like the administration and discriminatory healthcare providers wish that trans people didn’t even exist, but we do, and we have medical needs just like all other people.
My story is unfortunately one of many cases of sex-based discrimination that the administration is trying to allow against LGBTQ people.
In August 2016, I was in the process of undergoing gender-affirming care through a series of medical treatments. I made an appointment to undergo a treatment at Mercy San Juan Medical Center, a hospital in the Dignity Health chain, near Sacramento, California, where I live.
Trans people exist. And we have medical needs just like all other people.
Two days before my appointment date, a nurse called me to go over the details, and I mentioned that I was transgender. The very next day — a day before my procedure was supposed to take place — the hospital called my doctor to inform her that the appointment had been canceled because the procedure was related to my gender transition. When I heard the news, I was so devastated that I collapsed on the floor. Once I was able to pick myself up, I remember just stumbling around the house, blinded by my tears.
I was fortunate to be able to undergo the procedure at a different hospital. But the experience left scars. I had no idea prior to this that my local, community hospital was a Catholic hospital, or that they would argue that religious doctrine permits them to prevent doctors from providing patients with the care they need just because those patients are transgender. It should never be okay to deny transgender people — or anyone else — the care we need just because of who we are.
Dignity Health is the fifth largest health system in the U.S., with billions of dollars in revenue. But according to the Trump administration, I’m a threat to Dignity Health. My life — and the lives of every other transgender American — doesn’t seem to matter to this administration.
In California, however, the law prohibits businesses open to the general public — including hospitals — from discriminating on the basis of gender identity. In 2017, the ACLU and the law firm Covington & Burling LLP . Just last fall, a court agreed that I suffered discrimination when the hospital cancelled my surgery. The court also said that Dignity Health does not have a right to violate California’s nondiscrimination law.
While my case has moved through the courts, the Trump administration weighed in. Less than a year after I filed my case, the Department of Health and Human Services issued the Refusal of Care Rule to support religious people and entities in limiting the care they provide to patients. HHS is supposed to protect patients and expand access to healthcare — not allow providers to use religion as a license to discriminate. In justifying their Refusal of Care Rule, the Trump administration cited three court cases that they said showed why this discriminatory rule was necessary. Mine was one of them.
HHS is supposed to protect patients and expand access to healthcare — not allow providers to use religion as a license to discriminate.
My name is now in the Federal Register. The fact that the Trump administration singled me out truly knocked me down for almost a year. When I try to explain this to people, some folks think I should see this as a badge of honor; that I must be doing something right if the administration is coming after me personally. But it doesn’t feel that way to me. It’s emotionally draining, it’s overwhelming and it’s a huge burden I have to carry. The truth of the matter is that I’m still trying to process it.
The impact of the Refusal of Care Rule will reach far beyond trans people. It will profoundly impact access to reproductive health care, particularly for the millions of patients — who are disproportionately Black and Latinx — seeking options counseling and a referral for abortion in the Title X program. It’s also part of the administration’s larger goal of erasing trans people and greenlighting religious-based discrimination.
Today, I’m speaking truth to power in Congress and defending my right and my community’s right to access healthcare. Despite the repeated efforts of the Trump administration, trans people will not be erased.
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Press ReleaseDec 2024
LGBTQ Rights
President Biden Must Veto Defense Bill Attacking Military Families with Transgender YouthPresident Biden Must Veto Defense Bill Attacking Military Families with Transgender Youth
WASHINGTON — The U.S. Senate today passed a version of the National Defense Authorization Act that would ban coverage for gender-affirming care for transgender youth whose parents are active-duty military personnel. The American Civil Liberties Union is opposing final passage of the defense bill over the inclusion of this health care ban and calling on President Joe Biden to veto the bill. Section 708 of the NDAA would prohibit insurance coverage for “medical interventions for the treatment of gender dysphoria” such as hormone therapy and puberty-suppressant medications, which Speaker Mike Johnson says would “permanently ban transgender medical treatment for minors.” The same treatments would be covered by TRICARE for any medical purpose other than treating gender dysphoria, the clinical diagnosis for the psychological distress experienced by transgender people related to their gender identity. “By passing this bill, the House and Senate are forcing thousands of active-duty service members to choose between their careers in the military and the future of their transgender children,” said Mike Zamore, national director of policy & government affairs at the ACLU. “This unconscionable and unjustifiable attack on those families stands in direct contrast to President Joe Biden’s legacy of defending the civil rights of transgender Americans — including when few in his own party showed the courage to do so. President Biden should cement his legacy by vetoing this bill and sending it back to Congress to pass without Speaker Johnson’s last minute health care ban for servicemembers’ kids.” If signed by President Biden, this health care ban would be the first new anti-LGBTQ provision enacted by Congress and signed into law by the president since the enactment of the military’s since-repealed “Don’t Ask, Don’t Tell” policy for LGBTQ servicemembers and the since-repealed federal law barring recognition of same-sex marriages known as the Defense of Marriage Act. It is unknown how many transgender youth are currently enrolled in TRICARE or how many of those enrolled are currently receiving coverage for gender-affirming care. In one 2022 analysis, 2,500 minor patients sought care for gender dysphoria through TRICARE Prime insurance at military or civilian treatment facilities in 2017, and 900 received puberty suppressants or gender-affirming hormones. Earlier this month, the Supreme Court heard oral arguments in a landmark case brought by the ACLU, the ACLU of Tennessee, Lambda Legal, and Akin Gump on behalf of three families and a medical provider challenging a Tennessee ban on gender-affirming hormonal therapies for transgender youth on the grounds the ban violates the Equal Protection Clause of the U.S. Constitution. -
Press ReleaseDec 2024
LGBTQ Rights
Montana Court Blocks State From Refusing to Correct Sex Markers on Transgender People's Birth Certificates and Driver's LicensesMontana Court Blocks State From Refusing to Correct Sex Markers on Transgender People's Birth Certificates and Driver's Licenses
HELENA, Mont. – A Montana court has granted a preliminary injunction preventing the state of Montana from enforcing policies that bar transgender people from obtaining accurate sex designations on their birth certificates and driver’s licenses. After a prior restriction on amendments of birth certificates was struck down by the courts, in early 2024 the state of Montana enacted a new rule that categorically bars transgender Montanans from correcting the sex designation on their birth certificates. Around the same time, the Montana Department of Justice adopted a policy similarly restricting amendment of driver’s licenses. The plaintiffs challenged these policies in state district court, arguing that they violate various constitutional provisions, including the right to equal protection of the law. In a recent Montana Supreme Court decision, two justices concluded that discrimination on the basis of transgender status – as the state is engaging in here – is a form of sex discrimination that violates the Montana Constitution’s equal protection clause. The plaintiffs, two transgender women, are represented by the American Civil Liberties Union, the ACLU of Montana, and Nixon Peabody LLP. Plaintiff Jessica Kalarchik, a veteran who served in the United States Army for 31 years, said: “After finally being able to live my life openly as the woman I know myself to be, I am frustrated that my birth state, Montana, wants me to carry around a birth certificate that incorrectly lists my sex as male. I live my life openly as a woman, I am treated as a woman in my daily life, and there is no reason I should be forced to carry a birth certificate that incorrectly identifies me as male. Fortunately, the court agrees that this ridiculous policy should not be in effect.” “Once again the State of Montana chose to adopt a draconian policy that is clearly intended to marginalize transgender Montanans, only for that discriminatory action to be blocked by the courts,” said Akilah Deernose, executive director for the ACLU of Montana. “Here in Montana we treasure our right to privacy and to live our lives free from governmental intrusion. The State of Montana clearly has not learned any lessons from the past few years, where courts have repeatedly struck down unconstitutional laws targeting transgender Montanans.” “Forcing anyone to carry documents that contradict their identity unjustly violates their rights to privacy, equal treatment, and not being compelled to convey a government message about their sex that they disagree with,” said Malita Picasso, staff attorney for the ACLU’s LGBTQ & HIV Project. “Such a policy marks transgender people for further mistreatment and discrimination, essentially requiring them to carry papers that out them as transgender any time they need to provide identity documents. Fortunately, the court has refused to allow the state of Montana to subvert the freedom of transgender Montanans to control their own identity as this case goes forward.” In granting the plaintiffs’ motion for a preliminary injunction, the court held, “[i]f the challenged state actions discriminate against transgender individuals on the basis of their transgender status, they also necessarily discriminate the basis of sex.” The state has the option of appealing the district court’s ruling to the Montana Supreme Court, but the underlying case will proceed in district court. A trial has not yet been scheduled. -
FloridaDec 2024
LGBTQ Rights
Keohane v. DixonKeohane v. Dixon
On September 30, 2024, the Florida Department of Corrections rescinded its policy regarding treatment of gender dysphoria, which allowed for hormone therapy when deemed medically necessary, as well as access to clothing and grooming standards that accord with one’s gender identity. Under this new policy, grooming and clothing accommodations have been stripped away, and hormone therapy is not permitted unless an exception is deemed constitutionally required. The ACLU brought a class action challenging the policy. -
IdahoDec 2024
LGBTQ Rights
Robinson v. LabradorRobinson v. Labrador
Two incarcerated transgender women have sued the state of Idaho alleging that HB 688, a 2024 law barring state funding for gender-affirming medical care for transgender people, denies them access to the health care their doctors have prescribed for them and is a violation of their Eighth Amendment right to be free from cruel and unusual punishment. They represent a class of all incarcerated folks within the state of Idaho who face the loss of hormone therapy due to HB 668.