On Monday, the U.S. Supreme Court declined to hear a case, Dignity Health, Inc. v. Minton, concerning Mercy San Juan Medical Center, a Catholic hospital in the Sacramento, California area, which refused to let a gender-affirming procedure for a patient living with gender dysphoria be performed in its facility, as reported by Reuters. The justices declined to hear the appeal without comment. This means that the ruling from the lower court stands.

Perhaps unsurprisingly, Clarence Thomas, Samuel Alito, and Neil Gorsuch—all conservative judges—said they would have heard the case. 

The American Civil Liberties Union (ACLU) and Covington & Burling LLP represent Evan Minton in this case. In a brief filed by the ACLU, the organization argues that Minton alleges he was “intentionally discriminated against” because of his gender identity. “He alleges that he was denied the same procedure that Dignity Health permits many other non-transgender patients to undergo, at the same facility, in a host of other, comparable circumstances,” the brief states.

And from the hospital’s perspective? The hospital argues it does not discriminate against trans patients, while Minton, who is a trans man seeking a hysterectomy as part of his treatment plan, argues otherwise based on state law. Minton says the hospital did originally schedule his surgery back in 2016, but canceled it after Minton shared with a nurse (two days before his surgery was scheduled) that he’s transgender. According to Minton’s legal filing, the hospital does perform hysterectomies—just for other reasons.

The hospital says it refuses to perform certain procedures it feels are contrary to Catholic ideology (like abortion, for example). But if the hospital is willing to schedule hysterectomies for one medically necessary reason—let’s say fibroids—and won’t for another medically necessary reason—gender-affirmation is life-saving care, remember—that’s a problem. 

Minton’s physician was ultimately able to still perform the surgery but at a different facility (a Methodist hospital in the same network). As The Washington Post notes, the surgery happened after the initial refusal got media attention. Minton also had his physician on his side, which is something not all marginalized folks can count on. 

At first, Minton sued the hospital in state court, where a trial judge ruled in favor of the hospital. According to the Associated Press, the court sided with the hospital in that the delay for the surgery (which was three days) was not a refusal of “full and equal” health care access. In 2019, however, an appeals court rejected the hospital’s argument about its core religious beliefs, essentially agreeing that providing gender-affirming care for a trans patient is not stomping on their constitutional right to freedom of religion and free speech.

So, in the short term, the Supreme Court refusing to hear the challenge is ultimately a win for Minton (and trans folks in general) and a loss for the hospital. 

“Since Dignity Health turned me away for being transgender,” Minton shared in a response to the Supreme Court’s decision per an ACLU press release. “I’ve had multiple medical emergencies and I can’t stand to go to my neighboring Dignity Hospital because of the discrimination I was put through,” Minton says. In order to avoid going to the hospital, he at one point called his physician and had them guide him through a procedure he chose to perform on himself. He went on to say he applauds all trans folks and that this should “not be our private pain and shame.”

“We deserve health care, we deserve restroom access, we deserve to play on sports teams, we deserve better,” Minton added. “With my community by my side, I look forward to carrying on in this fight for justice.”

You can check out a 2019 interview with Minton below, where he shares more about his experience and the importance of this surgery for him.

YouTube Video