A federal court has ruled that a Catholic hospital violated the Affordable Care Act (ACA) by denying a transgender man gender-affirming healthcare.
The ruling in the District Court of Maryland found that St. Joseph Medical Center, which merged with the University of Maryland Medical System (UMMS) in 2012 and is located in suburban Baltimore, could not legally deny a transgender individual care simply because of their gender identity. According to The Hill:
“Judge Deborah K. Chasanow ruled that UMMS and St. Joseph Medical Center had violated Section 1557 of the Affordable Care Act – which prohibits discrimination in health care on the basis of sex – in denying Hammons [the patient] a hysterectomy simply because he is transgender. . .
“‘The undisputed facts establish that the decision to cancel Mr. Hammons’ hysterectomy pursuant to a policy that prohibits gender-affirming care was discrimination on the basis of his sex,’ Chasanow wrote.
“UMMS had tried to remove itself as a defendant in Hammons’ case, arguing that only the funding recipient for the ‘specific discriminatory program’ – which in this case is St. Joseph Medical Center – is liable under Section 1557.
“Chasanow on Friday denied that claim, arguing that UMMS is ‘undoubtedly’ engaged in the business of providing health care through its network of hospitals.”
Jesse Hammons, who is trans, has been represented by the American Civil Liberties Union since the lawsuit began in 2020. ACLU senior staff attorney Joshua Block argued that the ruling was a positive step in the broader debate over whether Catholic hospitals should be allowed to merge with public institutions. Block stated:
“‘We’re thankful the court saw through a transparently discriminatory and harmful action by UMMS…The government has no business operating a religious hospital, much less do they have the right to deny transgender patients care they routinely provide to cisgender patients.'”
Hammons was scheduled for a hysterectomy in January of 2020, which is a medically-necessary procedure for some people experiencing gender dysphoria. According to NBC News, he was abruptly told that the hospital would be canceling the procedure, even though the hospital regularly performs hysterectomies.
According to the Washington Post, Gail Cunningham, a senior vice president at the hospital, “ordered the surgery canceled, telling the surgeon that Hammons’ gender dysphoria did not qualify as a sufficient medical reason to authorize the procedure.”
The new ruling is a win for nondiscrimination advocates who argue that Catholic hospitals which utilize public funding (St. Joseph’s received upwards of $40 million in state funding in 2018 according to NBC) cannot violate the ACA’s civil rights protections.
Hospital mergers between public and Catholic systems are commonplace in today’s medical landscape, which has led some policymakers to propose limits on the capacity of these mergers to change the services which physicians are allowed to provide. The Hammons v. UMMS ruling is an important development surrounding these mergers because the court’s opinion finds that a Catholic hospital which receives substantial amounts of taxpayer funding should be regulated in the same manner as public hospitals.
The district court’s ruling in Hammons v. UMMS can ensure that transgender people are not denied critical care. It is unfortunate that a Catholic hospital was not able to recognize the dignity of a patient due to their gender identity. Catholic healthcare services ought to distinguish themselves by providing high-quality, inclusive care to all patients.
—Andru Zodrow (he/him), New Ways Ministry, January 16, 2023