The University of Maryland St Joseph Medical Center violated federal law when it refused to provide gender-affirming surgical care to a transgender man (ie, a natal woman), a federal court found earlier this month.

In 2020, Jesse Hammons, a transgender man diagnosed with gender dysphoria, was scheduled for a hysterectomy. But when the surgeon discovered that Hammond intended to transition, he refused to continue. He was following a hospital policy that prohibited medical personnel from providing gender-affirming surgery.

The legal responsibility in this case is a bit murky. St Joseph Medical Center is currently part of the University of Maryland Medical System (UMMS). But until 2012, it was a Catholic hospital and continues to operate “in a manner consistent with Catholic values and principles.”

The Ethical and Religious Directives for Catholic Health Services state that medical procedures that induce sterility “are permitted when their direct effect is the cure or alleviation of a present and serious pathology”. This essentially rules out hysterectomies and other gender-affirming surgeries.

“Gender transitioning should never be performed, encouraged, or positively affirmed as a good in Catholic health care,” reads a guidance document issued by the group. It adds that government mandates “do not alter the immorality of gender transitioning interventions” and Catholic hospitals should seek religious exemptions.

The court 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. “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,” District Court Judge Deborah Chasanow wrote.

“All I wanted was for UMMS to treat my health care like anyone else’s, and I’m glad the court recognized how unfair it was to turn me away,” Hammons said. “I’m hopeful UMMS can change this harmful policy and help more transgender people access the care they need.” 

Bioethics writer Wesley J. Smith commented wryly in the National Review: “I am sure there will be an appeal. But the immediate moral of the story for Catholic hospitals is not to become publicly owned. Otherwise, your Catholic-doctrine legal goose could well be cooked.”