Business Law

Minton v. Dignity Health (Sept. 17, 2019, No. A153662) __ Cal.App.5th __ [2019 WL 4440132]

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Unruh Act forbids religious hospital from denying treatment based on gender identity without providing treatment at comparable facility.

Evan Minton sued Dignity Health, alleging it violated the Unruh Civil Right Act (Civ. Code, § 51) by refusing to permit his doctor to perform a hysterectomy on him because of his sexual identity.  Minton is a transgender man whose physician scheduled a hysterectomy surgery at a Catholic Dignity hospital as treatment for gender dysphoria. The day before the scheduled surgery, the hospital’s president cancelled the surgery after learning the circumstances. After Minton and his representatives exerted pressure through the media and political connections, the procedure took place three days later at a non-Catholic Dignity hospital. Minton claimed that Dignity violated its duty to provide “full and equal” access to medical treatment by canceling his initial surgery.  (Civ. Code, § 51, subd. (b).) The trial court sustained Dignity’s demurrer, ruling that it satisfied its statutory obligation by completing the procedure at another location three days after it was initially scheduled.

The Court of Appeal reversed. First, the court rejected Dignity’s claim that it had denied service based on the sterilization prohibition in the “neutral” “Ethical and Religious Directives for Catholic Health Care Services” issued by the United States Conference of Catholic Bishops. The court held that issue could not be resolved on demurrer to a complaint that alleged a discriminatory motive for denying services. The court observed that “[d]enying a procedure as treatment for a condition that affects only transgender persons [while allowing the same service for other ailments] supports an inference that Dignity Health discriminated against Minton based on his gender identity.” Second, the court rejected Dignity’s claim that it provided Minton with “full and equal” access to medical treatment by allowing the procedure to take place three days later at another location. The court explained that, while the later procedure may have mitigated Minton’s damages, Dignity would remain liable for any unlawful cancelation of his initial surgery.  “ ‘Full and equal’ access requires avoiding discrimination, not merely remedying it after it occurred.” Finally, the court rejected Dignity’s free exercise defense. The court held that Minton’s claim does not compel Dignity to violate its religious principles if it can provide all persons with full and equal access to medical care at comparable facilities not subject to religious restrictions. And relying on North Coast Women’s Care Medical Group, Inc. v. Superior Court (2008) 44 Cal.4th 1145, the court held that any burden on religion imposed by the Unruh Act in this circumstance did not violate the First Amendment. 

The bulletin describing the Court of Appeal’s decision was originally prepared for the California Society for Healthcare Attorneys (CSHA) by H. Thomas Watson and Peder K. Batalden, Horvitz & Levy LLP, and is republished with permission. For more information regarding this bulletin, please contact H. Thomas Watson, Horvitz & Levy LLP, at 818-995-0800 or

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