Expansion of Catholic Hospitals Does Not Bode Well for Trans Patients

In many parts of the United States, Catholic hospitals are increasingly becoming one of the sole options for healthcare due to mergers and expansions.  This new trend can be harmful for transgender patients, among others.

The New York Times reported on several cases of patients denied care at Catholic hospitals, many of whom did not know that the services they required were banned by the hospital until quite late in the process. In some cases, the hospitals were not clearly identified as being Catholic, and in most cases, there was no easy way to identify which services they would not provide.

For example, Evan Minton, a transgender man, was denied a prescribed hysterectomy at Mercy San Juan Medical Center in Sacramento, California. Minton had a scheduled appointment with Dr. Lindsey Dawson, yet two days before the procedure, he mentioned his pronouns during a phone call with a nurse. He recounted his experience:

“She seemed really welcoming and understanding and I had a good feeling when I got off the phone.”

The next day, Dr. Dawson got a call from the hospital saying it considered the hysterectomy to be sterilization and had canceled the surgery.

The doctor was furious, saying “No one would ever, ever do a hysterectomy exclusively for sterilization. I have never even had a hysterectomy questioned. It wasn’t until he brought up his pronouns that they even paid any attention.”

Minton’s case was taken up by the American Civil Liberties Union, which sued Dignity Health for withholding medical care on the basis of his gender identity. {Editor’s note:  For more details about Minton’s case, click here.) The case was dismissed on the grounds that Minton would be able to schedule his hysterectomy at another hospital. Beyond the stress and effort of needing to find another facility at the last moment, this may not even be an option for every patient. The Times reported that a 2016 report from MergerWatch found the following numbers:

“…In 10 states, 30 percent or more of the acute-care hospital beds were under Catholic ownership, or in a hospital affiliated with a Catholic health care system. In a growing number of rural areas, a Catholic hospital is the sole provider of acute care.”

In addition, the Catholic identity of many hospitals is not always readily apparent. Dignity Health, the network of hospitals which denied Evan Minton his treatment, was called Catholic Healthcare West until 2012. They’re not the only hospital to change their name to a more secular sounding title, part of a growing trend of hospitals downplaying their visible Catholic identity while enforcing the healthcare rules from the U.S. Conference of Catholic Bishops.

The bishops’ directives are known as E.R.D.s, or the Ethical and Religious Directives for Catholic Health Care Services, and are not equally enforced around the country. Barbra Mann Wall, nursing professor and author of a history of Catholic Hospitals, told the Times: “The religion component is getting more important, but less transparent.”

According to Father Charles Bouchard, O.P., senior director of theology and ethics at the Catholic Health Association, the changes in presentation in many Catholic hospitals are intended to make all patients feel welcome, and not an attempt at deception. Bouchard also spoke to the Times on the subject of providing healthcare to transgender patients:

“Catholic hospitals are committed to receiving transgender patients hospitably and providing the same quality care for them as we do for anybody else. We’re struggling to make a very old principle relevant to an era when we know a lot more…We talk about it a lot. We just don’t have the solution ethically. It’s always open to debate.”

If Catholic hospitals do intend to make all patients feel welcome, they will need to acknowledge and resolve their current shortcomings as it relates to the healthcare of transgender patients.

One of the closing lines in the introduction to the USCCB’s healthcare directives says that “the dialogue between medical science and Christian faith has for its primary purpose the common good of all human persons.” If Catholic hospitals intend to be consistent with that messaging, it is necessary to be both transparent about their services and to adopt policies to open up a full range of medical coverage to all patients, regardless of sexual history or gender identity.

For other Bondings 2.0 coverage of transgender discrimination in Catholic Hospitals, read the 2017 stories of Pax Enstad and Jionni Conforti, as well as a discussion of the Affordable Care Act.

–Catherine Buck, New Ways Ministry, September 9, 2018

Related article:

FiveThirtyEight.com: “How Catholic Bishops Are Shaping Health Care In Rural America“