A federal lawsuit filed on July 16, 2020 in the United States District Court for the District on Maryland by a transgender man (Jesse Hammons) alleges, “As part of Mr. Hammons’s medically necessary treatment relating to his diagnosis of gender dysphoria, Mr. Hammons’s surgeon scheduled a hysterectomy to be performed at University of Maryland St. Joseph Medical Center on January 6, 2020. But approximately 7–10 days before Mr. Hammons’s scheduled operation, Defendants canceled the surgery based on a discriminatory and unconstitutional application of Catholic religious doctrine,” allegedly because Jesse Hammons could not receive his medical treatment at the University of Maryland St. Joseph Medical Center because “Mr. Hammons’s treatment would violate Catholic religious doctrine, as announced in the Catholic Directives. The Catholic Directives state that Catholic hospitals may not perform procedures that induce sterility unless “their direct effect is the cure or alleviation of a present and serious pathology and a simpler treatment is not available.””
Transgender men are men who were assigned “female” at birth, but have a male gender identity. Transgender women are women who were assigned “male” at birth, but have a female gender identity. Being transgender is not a mental disorder, but transgender people may require treatment for “gender dysphoria,” the diagnostic term for the clinically significant emotional distress experienced as a result of the incongruence of one’s gender with their assigned sex and the physiological developments associated with that sex. Gender dysphoria is a serious medical condition codified in the Diagnostic and Statistical Manual of Mental Disorders (“DSM-V”) and International Classification of Diseases (“ICD-10”). The criteria for diagnosing gender dysphoria are set forth in the DSM-V (302.85).
The World Professional Association for Transgender Health (“WPATH”) publishes widely accepted standards of care for treating gender dysphoria. Medically necessary treatment for gender dysphoria may require medical steps to affirm one’s gender identity and transition from living as one gender to another. This treatment, often referred to as transition-related care, may include hormone therapy, surgeries (sometimes called “sex reassignment surgery” or “gender affirming surgery”), and other medical services that align an individual’s body with their gender identity. The plaintiff alleges that transgender men often require a hysterectomy as a gender-affirming surgical treatment for gender dysphoria and that “treatments for gender dysphoria, including surgical procedures such as hysterectomy, are effective, safe, and medically necessary.”
The Catholic Directives state that “[d]irect sterilization of either men or women, whether permanent or temporary, is not permitted,” with a lone exception: “Procedures that induce sterility are permitted when their direct effect is the cure or alleviation of a present and serious pathology and a simpler treatment is not available.”
The plaintiff alleges that the “University of Maryland St. Joseph Medical Center routinely performs hysterectomies when they are medically necessary to treat a diagnosed condition other than gender dysphoria. When they canceled Mr. Hammons’s medically necessary surgery, Defendants thus treated Mr. Hammons—as a man who is transgender—differently from non-transgender patients who require medically necessary hysterectomies for other medical conditions.”
The plaintiff alleges that the University of Maryland St. Joseph Medical Center, as “[a]n instrumentality of the state may not operate a Catholic hospital or deny medical care to transgender patients based on Catholic religious beliefs. By invoking Catholic religious doctrine as a basis for canceling Mr. Hammons’s medically necessary surgery, Defendants violated the Establishment Clause of the First Amendment. And by subjecting Mr. Hammons to different and unequal treatment, Defendants also violated the Equal Protection Clause of the Fourteenth Amendment and Section 1557 of the Affordable Care Act.”
The plaintiff alleges that he was not able to have his hysterectomy performed until June 24, 2020 and that as a result of the rescheduling, he had to spend more money on an additional round of pre-operative tests; he had to spend another six months experiencing gender dysphoria without the therapeutic benefits of the surgery; and he had to spend another six months carrying the stress and anxiety of having to mentally prepare himself for the surgery all over again.
Source Jesse Hammons v. University of Maryland Medical System et al., No. 1:20-cv-02088-ELH.
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