U.S. District Court Judge Matthew Kacsmaryk, a Trump appointee based in Amarillo, ruled that doctors may discriminate based on sexual orientation or gender identity. The Bostock ruling that prohibits employment discrimination does not extend to a doctor’s care.
The judge wrote that Congress could have included sexual orientation and gender identity in Title IX but didn’t.
In Neece vs. Bacerra, Dr. Susan Neese refused to prescribe hormone therapy to a transgender patient. The judge notes that the Affordable Care Act prevents discrimination based on sex. He ruled that the plaintiffs weren’t discriminating since they are refusing hormone treatments to all patients, regardless of sex.
Both Neese and co-plaintiff Dr. James Hurly claim to have treated a number of transgender patients.
An odd story included in the opinion as a reason to deny care to transgender patients is one about a trans woman he treated who developed prostate cancer. The trans patient insisted she couldn’t have prostate cancer because she was a woman. Hurly claims to have encouraged his patient to get immediate treatment for the cancer, but now doesn’t want to treat patients based on their perceived gender.
What’s not clear is if that patient had had gender reassignment surgery, what that surgery included and what the patient understood about her transition.
Secretary of Health and Human Services Xavier Bacerra may appeal the ruling.
In the mean time, straight doctors may discriminate against their LGBTQ patients. On the other hand, LGBTQ doctors may discriminate against providing care to their straight and cisgender patients.
— David Taffet
