This case challenged a hospital system’s decision to deny a male transgender patient a hysterectomy as a gender-affirming surgical treatment for gender dysphoria. The plaintiff, represented by the ACLU, filed this action on April 19, 2017, in the Superior Court of California for the County of San Francisco, alleging that Dignity Health, a Catholic hospital, violated the Unruh Civil Rights Act by denying him full and equal access to health care treatment. The plaintiff sought declaratory relief, damages in the amount of $4,000, injunctive relief, and attorneys fees.

The defendant moved to dismiss the complaint on the ground that the plaintiff failed to allege a violation of the Unruh Civil Rights Act. While the hospital system denied care where the plaintiff was originally scheduled for care, it did allow him to receive a hysterectomy at another of its hospitals. Further, the defendant asserted that the plaintiff’s claim was barred by the hospital’s constitutional rights of free exercise of religion and freedom of expression. As a Catholic hospital, they contended that they were required to follow the directives of the US Conference of Catholic Bishops, which prohibit direct sterilization and require that bodily and functional integrity be protected and preserved.

The defendant’s motion was sustained with leave to amend by Judge Harold Kahn. The plaintiff filed an amended complaint to clarify that while he had been permitted to receive treatment at an alternative hospital three days after his original procedure had been scheduled, the defendant only allowed this after outreach to local media and other advocacy from the plaintiff’s legal team. The defendant moved to dismiss the amended complaint on the same grounds it originally stated. Judge Harold Kahn sustained the defendant’s motion, this time without leave to amend, and entered a judgment of dismissal on January 3, 2018. 2018 WL 10158560.

The plaintiff appealed. Judge Stuart Pollak issued an opinion for the Court of Appeal, First District on September 17, 2019. The court reversed the lower court’s decision and held that he could pursue a claim for discrimination based on the hospital’s cancellation of his surgery. 2019 WL 4440132. The court reasoned that it was improper to dismiss the case on demurrer because the plaintiff had shown that the hospital was applying its directives in a discriminatory manner, since they were denying a procedure for the treatment of gender dysphoria, a condition that affects only transgender people. While the defendant mitigated its potential damages by arranging for the procedure to be done at another hospital, the plaintiff was still denied full and equal access to treatment when his procedure was originally canceled. The Court of Appeal remanded the case to the trial court and ordered that the plaintiff should recover his costs on appeal.

The defendant petitioned for review by the Supreme Court of California but was denied on December 18, 2019. On March 13, 2020, Dignity Health filed a petition for writ of certiorari with the United States Supreme Court based on the free exercise claim it made in state court. The trial court extended all case deadlines pending resolution of that petition.

On November 1, 2021, the United States Supreme Court declined to grant certiorari for the case, at which point the parties resumed litigation in the trial court. They engaged in contentious discovery, including an argument over whether discovery would include all hospitals in the network. On May 16, 2022, Judge Pro Tem David McDonald ordered that discovery would continue with regard to the hospital where the plaintiff was denied care, and would be deferred for additional hospitals.

On June 10, 2022, the plaintiff filed for voluntary dismissal, and 17 days later Dignity Health disbursed $4,200.60 in costs. This case is now closed.