Transgender man will be allowed to sue Catholic hospital over hysterectomy

A Sacramento-area woman who identifies as a transgender man will be allowed to sue a Catholic hospital for cancelling and rescheduling a procedure to remove her uterus, following a ruling from the 1st District Court of Appeal that overturned a lower court ruling on Wednesday.

Sacramento, Calif., (CNA) - A Sacramento-area woman who identifies as a transgender man will be allowed to sue a Catholic hospital for cancelling and rescheduling a procedure to remove her uterus, following a ruling from the 1st District Court of Appeal that overturned a lower court ruling on Wednesday.

Evan Minton, who identifies as a male, says in the lawsuit that Dignity Health, a Catholic health system that operates Mercy San Juan Medical Center outside Sacramento, in 2017 cancelled a planned hysterectomy when she mentioned to a nurse that she identifies as trangendered.

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.

Minton sued, arguing that the hospital's actions violated California's Unruh Civil Rights Act, which says businesses must offer full and equal access to state residents, the Bee reports.

Dignity Health provided a response to the Sacramento Bee.

"Catholic hospitals do not perform sterilizing procedures such as hysterectomies for any patient regardless of their gender identity, unless there is a serious threat to the life or health of the patient," the Dignity statement said.

"Courts have repeatedly recognized the right of faith-based hospitals not to provide services based on their religious principles....In this case, Mr. Minton was able to quickly receive the sought-after procedure at another nearby Dignity Health hospital that is not Catholic-affiliated."

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.

Court records show that Minton underwent hormone replacement therapy in 2012 and a mastectomy in 2014, and planned to undergo the hysterectomy before having a penis surgically created.

Another Catholic health system in California, St. Joseph Health, is facing a similar lawsuit filed in March from another woman who identifies as a transgender man after one of its locations, St. Joseph Hospital in Eureka, refused to perform a hysterectomy.

After the surgery at St. Joseph was denied, Knight underwent a hysterectomy at a hospital unaffiliated with the St. Joseph Health of Northern California system, 30 minutes away.

Like Dignity Health, St. Joseph Health said in a statement that hysterectomies are only performed at their facilities when they have been deemed "medically necessary," and not for purposes of sterilization.

The teaching of the Catholic Church recognizes a hysterectomy as licit when there is a grave and present danger to the life or health of the mother, and when the intention of the procedure is not to prevent the possibility of conception. The hysterectomy must be chosen for therapeutic reasons, so that it aims to curtail a serious present danger such as hemorrhage which cannot be stopped by other means; hysterectomy is illicit if it is intended to prevent an eventual pregnancy which can pose some risk for the mother. 
A 2016 letter to the Centers for Medicare & Medicaid Services signed by the general counsel for the United States Conference of Catholic Bishops, together with other groups, affirmed that the denial of surgery to someone seeking to change their gender would not be discriminatory, noting that in such cases there would be nothing medically wrong with otherwise healthy organs to be removed.

"It is not 'discrimination' when a hospital provides care it considers appropriate, declines to perform procedures destructive to patients' welfare and well-being, or declines to take actions that undermine the health, safety, and privacy of other patients," the letter said. 
"A hospital does not engage in 'discrimination' when, for example, it performs a mastectomy or hysterectomy on a woman with breast or uterine cancer, respectively, but declines to perform such a procedure on a woman with perfectly healthy breasts or uterus who is seeking to have the appearance of a man."

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