Let’s Make Catholic Hospitals the Leaders in the Journey of Transgender Resurrections
Paxton Enstad, center, with parents, Mark and Cheryl
A Catholic healthcare system has settled a lawsuit claiming it had discriminated against the transgender child of an employee. But the real story found in this incident is about the opportunity Catholic healthcare systems have to make moments of resurrection happen.
PeaceHealth, a Catholic healthcare system in Washington State, settled with Paxton Enstad and his family who had filed a discrimination suit against the system in October 2017. CrossCut reported:
“After his doctor suggested it would be the best way to treat his gender dysphoria, Paxton had chest reconstruction surgery the following year, in 2016.
“At the time, his mother, Cheryl, was a medical social worker at PeaceHealth St. Joseph Medical Center in Bellingham. But PeaceHealth refused to cover the surgery. After taking out a second mortgage and using money from his college fund, the family paid approximately $11,000 out of pocket for his operation. . .
“Now, PeaceHealth, a nonprofit, Catholic health-care organization based in Vancouver, Washington, with 10 medical centers and approximately 16,000 employees, has changed its employee policy on transgender care after settling its lawsuit with the family, who was represented by the American Civil Liberties Union of Washington.”
The settlement amount was undisclosed. PeaceHealth claimed it had already begun covering transgender-related surgeries in January 2017, but that policy only applied to individuals above the age of 18. The system’s insurance provider, Aetna, continues to deny medically necessary surgeries to transgender minors, which Enstad was at the time of his surgery.
Enstad said he and his family were “pleased they took a step, especially being a Catholic hospital,” but hoped the system “eventually removes the age-related limitation coverage” and that more employers would act similarly. According to Lisa Nowlin of the ACLU, the state affiliate has another case pending in which a transgender patient is suing another Catholic healthcare system, Providence Health and Services, for abruptly canceling his chest reconstruction surgery. The outcome of PeaceHealth’s settlement and that case could be quite determinative in Washington State, where a majority of healthcare systems are Catholic. Disputes over transgender healthcare involving Catholic providers have increased nationwide in recent years.
Beyond the legal and policy ramifications, Paxton Enstad’s story personalizes the true costs when Catholic healthcare systems deny care to transgender patients and the positive health outcomes when these systems choose to be affirming. Enstad’s parents described how their son sunk into a deep depression when he began puberty. His mother said that they knew they were “losing our kid” who was “not functioning” and “so depressed.”
But, she said, chest reconstruction “made all the difference” and immediately after surgery, Enstad’s parents knew their child had come back to life. Hilary Howes, a transgender Catholic woman, has spoken movingly of this transitioning experience:
“My path followed Christ, who as we would say, suffered, died and was buried. As a transgender person I suffered alienation, died of shame, and was buried in guilt. Through transition I rose again in accordance with God’s will for me and am now living my transfigured life.”
Shouldn’t healthcare be focused on bringing people to life and wholeness, especially healthcare from a Catholic perspective? With demand for transgender health services growing, Catholic providers should take the path of affirmation that leads to resurrection. 2019 should be the year that these providers put aside fighting and settling lawsuits, and willingly seek to make Catholic providers not just reluctant participants in LGBT care, but medical leaders in these resurrection journeys.
—Robert Shine, New Ways Ministry, January 9, 2019
Catholic Hospitals and Transgender Resurrections
This story raises three questions.
Medical Ethics
At what age is it appropriate to offer and perform top surgery for children with gender dysphoria? Is it the same age for male transition and female transition? Have any recognized professional associations provided any guidelines on these procedures?
I’m sure there are some professional associations who have spoken to those guidelines. It may be helpful if a search were conducted and presented as a blog.
Insurance Carriers
If the procedures are recommended by appropriate medical consultation and are considered ethical, is it permissible for insurance providers to deny coverage?
Catholic Hospitals
PeaceHealth is an entirely different situation than the Providence case. PeaceHealth did not deny the proposed care their insurance carrier did. PeaceHealth settled out of court. The two parties settled on a specific out come without going to trial. For that reason, it provides no guidance for the Providence case. The case was closed without a determination of the merits of the case.
Providence, on the other hand, cancelled a procedure that had already been scheduled. Among other issues, that brings into play first amendment rights. The right of the patient for freedom from religion and the right of the hospital to freedom of religion. Which denial causes the most harm? A settlement would probably be a best outcome for this case as well.
Unfortunately, settlements do little to make Catholic Hospitals the Leaders in the Journey of Transgender Resurrections. That would require discernment and policy change on the part of Catholic hospitals.
I’m not sure it is reasonable to set a specific age given this young person’s story and the transformation that took place after the chest reconstruction.
Interesting points raised about the hospital not denying surgery but the insurance company.