The American Civil Liberties Union will square off once again against Mercy San Juan Medical Center in a San Francisco courtroom on Tuesday, asking that an appeals court overturn a lower-court ruling allowing the Carmichael-based hospital to deny hysterectomies to transgender patients.

“It is illegal for hospitals that are open to the general public in California to turn away patients simply because they are transgender,” said Elizabeth Gill, a senior staff attorney with the ACLU Foundation of Northern California. “Everyone should be able to get the care they need, even if their local hospital has a religious affiliation.”

Dignity Health, which operates Mercy San Juan, said in a statement provided to The Bee on Monday the medical center offers care to all members of the community without discrimination.

“We do not provide elective sterilizations at Dignity Health’s Catholic facilities in accordance with the Ethical and Religious Directives for Catholic Health Care Services (ERDs) and their medical staff bylaws,” the Dignity statement said. “We understand how important this type of surgery is for transgender individuals and are pleased that Mr. Minton was able to quickly receive the sought-after procedure at one of Dignity Health’s non-Catholic community hospitals.”

The patient in this case, Evan Minton, had been diagnosed with gender dysphoria, a serious medical condition that results from a feeling of incongruence between one’s gender identity and one’s sex assigned at birth, according to a court filing dated April 19, 2017. Minton was assigned the sex of female, the lawsuit stated, but identified as a male as he developed.

His physicians recommended a series of treatments to help him transition and affirm his gender identity, records showed, and Minton underwent hormone replacement therapy in 2012 and a mastectomy in 2014. He planned to undergo the hysterectomy before undergoing the surgical creation of a penis.

Minton’s surgeon, Dr. Lindsey Dawson, scheduled the procedure on a day when she planned another hysterectomy at Mercy San Juan, court records stated, but two days before the surgery, Minton mentioned to a pre-operation nurse that he is transgender. In an interview with The Bee in April 2017, Dawson said Dignity Health officials helped her get emergency privileges at Methodist so she could perform the procedure there.

Elizabeth Gill, senior staff attorney for the ACLU Northern California, told The Bee on Monday this procedure was not any more elective for Minton than it is for cisgender women who get hysterectomies at Mercy San Juan for conditions that are not life-threatening.

In the lawsuit, Gill noted there are widely accepted standards of care for treating gender dysphoria published by the World Professional Association for Transgender Health, saying the standards are recognized by leading medical organizations, the U.S.Department of Health and Human Services, and federal courts.

Although Gill argued Mercy San Juan’s actions violated California’s Unruh Civil Rights Act, which says businesses must offer full and equal access to state residents, a San Francisco Superior Court judge dismissed the lawsuit, agreeing the hospital followed the direction of California Supreme Court justices in rescheduling the procedure within 72 hours at a different facility. The superior court found this action fell in line with the high court’s decision in North Coast Women’s Care Medical Group Inc. v. San Diego County Superior Court.

Gill said the ACLU is appealing the decision because the lower court acknowledged that Mercy is discriminating against Minton because of his transgender status and Catholic hospitals should not be able to turn away patients based on religious doctrine rather than patient need.

The appeal goes before justices in the 1st District Court of Appeal in San Francisco on Tuesday. The Catholic Health Association and Catholic Medical Association have weighed in on behalf of Dignity while the California Medical Association and the National Center for Lesbian Rights and 12 other groups have filed briefs in support of Minton and the ACLU.


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